The seemingly ‘protective’ effect of internalised racism on overall health among 780 Black/African Americans: the serial mediation of stigma consciousness and locus of control

Abstract

Objective Internalised racism (IR) is associated with better and worse health outcomes among racial/ethnic minorities. However, the underlying mechanisms associating IR with either positive or negative health outcomes are not well understood. Design & main outcomes measures: To address this gap, this study investigated two pathways that associate increased IR with better self-reported overall health (OH; i.e. dental, mental, physical and vision health) among 780 Black/African American adults (mean age 37.68 years, 57.6% female): (1) via stigma consciousness and (2) via stigma consciousness and locus of control beliefs. Results Consistent with predictions, stigma consciousness mediated the indirect effect of IR on OH, such that higher IR was associated with lower stigma consciousness, which was associated with better self-reported OH. Confirming predictions, this indirect effect was also carried through locus of control beliefs, such that higher IR was associated with lower stigma consciousness; lower stigma consciousness was also associated with internal locus of control beliefs, which were associated with better self-reported OH. Conclusions Although seemingly protective, this adaptive, strategic and short-term response to race-based threat in which group stereotypes are internalised can lead to negative health outcomes over time. These findings have implications for understanding IR and associated health disparities.