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Although there is growing support for the importance of a relationship between experiences with race-based discrimination and various physical health outcomes in African Americans, full understanding of the phenomenon is still a long way off. Indeed, in the next couple of decades, work from other fields, such as the genetic bases of mental and physical health morbidities, promises to complicate attempts to fully capture the complex causal pathways that link the effects of discrimination in the social environment to health at an individual level. But the emerging methodological tools and the increasingly interdisciplinary nature of health-related research offer the promise of articulating how social unfairness works to harm individual health. The work that we have reviewed here merely highlights new directions in the research in this area.

If these methodologies succeed in reliably identifying insidious neighborhood effects on health or specific areas of the brain that are damaged by discrimination, psychologists will face new challenges. What are our social responsibilities to change or alter the conditions that harm health? How do we develop interventions to alter neighborhood structure? If the effects of discrimination are such that early experiences with being treated badly or unfairly alter brain function toward greater sensitivity, quicker reactivity, and greater vulnerability to the impact of later experiences, would we then assign less blame or responsibility to either the behavior of individuals who experience discrimination or the behavior of perpetrators of discrimination on individuals who themselves have had early exposures to discrimination? What will be our societal response if science establishes that discrimination is a brain assault with tangible harmful effects on both quality of life and physical health?

A number of important areas could be more fully explored to help us gain insights into the pathways that may account for the relationship of experiences of race-based discrimination to negative health status in African Americans. Because of page constraints in this review, we could not fully address all of the areas, and for some areas that we discussed above, there was a need for brevity. However, we have presented a number of concepts, many of which are still only possibilities that remain in need of further study to explain upstream/downstream health effects in African Americans.

Psychology is unique as a discipline in being located with one foot solidly in the science of upstream effects and the other in the direct examination of downstream effects. That places us in an enviable position to study the effects of racial discrimination and negative health outcomes in African Americans in a comprehensive manner. In doing so, we honor our long tradition of efforts to use the scientific method to pursue social justice and fairness (Deutsch 1975Lewin 1997). Much of America’s ability to dialogue dispassionately about race had its birth in the early research done by social psychologists on racial attitudes and symbolic racism (Bobo 1983Bobo & Fox 2003; Sears 1998; Sears & Henry 20032005). This work has also informed the justice system. With these emerging methods, approaches, and collaborative relationships, psychology as a discipline has even greater opportunities to shape our understanding of the ways in which race, racism, and race-based discrimination affect the health of African Americans.


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