Understanding how discrimination can affect health

Health Serv Res. 2019 Dec;54 Suppl 2(Suppl 2):1374-1388. doi: 10.1111/1475-6773.13222. Epub 2019 Oct 29.


Background: To provide an overview of the empirical research linking self-reports of racial discrimination to health status and health service utilization.

Methods: A review of literature reviews and meta-analyses published from January 2013 to 2019 was conducted using PubMed, PsycINFO, Sociological Abstracts, and Web of Science. Articles were considered for inclusion using the Preferred Reporting Items for Systematic Review and Meta-Analyses (PRISMA) framework.

Results: Twenty-nine studies met the criteria for review. Both domestic and international studies find that experiences of discrimination reported by adults are adversely related to mental health and indicators of physical health, including preclinical indicators of disease, health behaviors, utilization of care, and adherence to medical regimens. Emerging evidence also suggests that discrimination can affect the health of children and adolescents and that at least some of its adverse effects may be ameliorated by the presence of psychosocial resources.

Conclusions: Increasing evidence indicates that racial discrimination is an emerging risk factor for disease and a contributor to racial disparities in health. Attention is needed to strengthen research gaps and to advance our understanding of the optimal interventions that can reduce the negative effects of discrimination.

Keywords: discrimination; health; health disparities; mental health; racism.

Publication types

  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Health Behavior
  • Health Status
  • Healthcare Disparities*
  • Humans
  • Mental Health*
  • Patient Acceptance of Health Care*
  • Racism*