Chapter 56 - Racial/ethnic health disparities

Abstract

Large racial inequalities exist in the onset, course, and outcomes of illness in the United States and certain other race-conscious countries. Despite our extensive knowledge of the magnitude, trends, and determinants of these social inequalities in health, there is still much that we need to learn about the forces that drive them. This chapter provides an overview of current knowledge of racial/ethnic inequities in health with a focus on the United States and the potential contribution of psychosocial stressors to account for them. It describes key patterns in the distribution of disease by race/ethnicity. It also considers evidence of relationships between psychosocial stress and health. It will explore how stress is experienced in the body and how psychosocial stressors are characterized. Then, it will examine the evidence relating psychosocial stressors with health and discuss some of the biological mechanisms by which these relationships occur. It will also highlight evidence indicating that differential exposure to chronic and acute psychosocial stressors may be an important part of social experience that matters for health and can importantly contribute to health disparities. The research suggests the importance of taking a comprehensive view of stressors to capture the full effect of stress on human physiology, health, and health disparities. Finally, the chapter considers some research and clinical implications of the association between psychosocial stressors and health.