All Discrimination causes Trauma (experience of harm to self).
Discrimination is unjust or prejudicial treatment, an organized system that categorizes and ranks, devalues and disempowers certain groups based on perceived differences. Although many types of discrimination occur, the most common and severe are based on race, gender, ethnic background, sexual orientation.
All populations who experience discrimination have been shown to experience Health Disparity: increased incidence of disease, earlier onset, more severe course of disease, premature death. Research shows that Socio-Economic Status (SES) - income, education or wealth - is a strong predictor of health. But for groups experiencing discrimination, Health Disparities exist regardless of income. Income or wealth do not protect against discrimination on an institutional level (obtaining a mortgage, job, medical care, and more) or the personal stress of being treated differently.
The Everyday Discrimination SCALE was developed and validated by Dr. David Williams (Harvard Public Health) as a self-reported measure of the day-in/day-out exposure to unfair
treatment in all situations (school, work, shopping, travel, and more). Negative stereotypes based on race, ethnicity and sexual orientatio are deeply embedded in our culture - and
Everyday Discrimination is a COMPLEX Trauma (Chronic and Severe) - and has devastating impacts on mental and physical health.
In your day-to-day life how often do these happen to you?
• You are treated with less courtesy than other people.
• You are treated with less respect than other people.
• You receive poorer service than other people at restaurants or stores.
• People act as if they think you are not smart.
• People act as if they are afraid of you.
• People act as if they think you are dishonest.
• People act as if they’re better than you are.
• You are called names or insulted.
• You are threatened or harassed.
What do you think was the main reason for these experiences?
* David Williams, PhD MPH initially published 1997; revised in different versions since
Dreyer (2021) The Toll of Racism on African American Mothers and Their Infants. JAMA Netw Open. Predatory policing and mass incarceration continue to exert extreme psychological stress for the Black American community. Odds of preterm birth for both White and US-born Black pregnant people were approximately twice as high in high–police contact census tracts.
Cuevas (2020) Discrimination and systemic inflammation. Brain Behav Immun Discriminatory experiences may operate like other stressors in that they activate physiological responses that adversely affect the maintenance of homeostasis.
Williams (2019) Understanding how discrimination can affect health. Health Services Research - Special Issue: Experiences of Discrimination in America.
Brody (2018). Racial Discrimination, Body Mass Index, and Insulin Resistance. Health Psychol. Study of 315 Black adolescents (age 16-18) in rural Georgia. The experience of racial discrimination increased risk of obesity and insulin resistance over 8 years during adolescence and early adulthood.
Merriwether (2021) Racial and weight discrimination associations with pain intensity and pain interference. BMC Public Health. Pain is highly prevalent in adults (particularly women) with obesity and exacerbated by the experience of racial discrimination.
Moody (2019). Everyday Discrimination Prospectively Predicts Blood Pressure Across 10 Years in Racially/Ethnically Diverse Midlife Women. Ann Behav Med Exposure to everyday discrimination predicted increases in Systolic and Diastolic Blood Pressure, even after adjusting for known demographic, behavioral and medical risk factors.
Zahodne (2019) Longitudinal effects of race, ethnicity, and psychosocial disadvantage on systemic inflammation. SSM Popul Health. Racially patterned social disadvantage is prospectively associated with longitudinal inflammatory processes.
Brown (2018) Discrimination hurts. The effect of discrimination on the development of chronic pain. Soc Sci Med. Dose-Response relationship to occurrence and severity of pain (More severe discrimination = Higher Dose, increased risk of chronic pain.) Based on prevalence in this study, authors estimate 4.1 million Americans experience chronic pain related to discrimination.
Wheaton (2018) Discrimination and Depressive
Symptoms Among African American Men Across the Adult Lifecourse. J Gerontol B Psych Everyday discrimination was associated with
depressive symptoms among African American men.
Moody (2018) Everyday Discrimination and Metabolic Syndrome Incidence in a Racially/Ethnically Diverse Sample Psychosom Med. Everyday Discrimination at baseline predicted a 33% greater incidence of Metabolic Syndrome (cardiovascular disease, diabetes, obesity) 13 years later.
Kogan (2015). Racial microstressors, racial self-concept, and depressive symptoms among male African Americans during the transition to adulthood J Youth Adol Exposure to racial discrimination from ages 16 to 18 predicted depressive symptoms at age 20.
Goosby (2015) Perceived Discrimination and Markers of Cardiovascular Risk among Low-Income African American Youth. Am J Human Biol. The experience of discrimination among African American youth age 10-15 was associated with multiple markers of cardiovascular risk including elevated blood pressure and inflammatory markers. Early life course inflammation contributes to racial health inequities.
Beatty (2014). Everyday Discrimination Prospectively Predicts Inflammation Across 7-Years in Racially Diverse Midlife Women. J Soc Issues.