This paper provides a review and critique of empirical research on perceived discrimination and health. The patterns of racial disparities in health suggest that there are multiple ways by which racism can affect health. Perceived discrimination is one such pathway and the paper reviews the published research on discrimination and health that appeared in PubMed between 2005 and 2007. This recent research continues to document an inverse association between discrimination and health. This pattern is now evident in a wider range of contexts and for a broader array of outcomes. Advancing our understanding of the relationship between perceived discrimination and health will require more attention to situating discrimination within the context of other health-relevant aspects of racism, measuring it comprehensively and accurately, assessing its stressful dimensions, and identifying the mechanisms that link discrimination to health. KeywordsRacism; Discrimination; Stress; Health disparities; Race; Ethnicity This paper will provide an overview of the current evidence for and needed research on the role of perceived discrimination in health. It seeks to situate the research on personal experiences of discrimination within the larger literature on racism and health. It begins by describing some salient patterns in the large and persistent racial/ethnic variations in health that have provided an impetus to better understand the role of racism in health. It centrally focuses on recent research on perceived discrimination and health. It critiques the existing literature with an eye toward highlighting the needed improvements in the conceptualization and measurement of perceived discrimination that would advance our understanding of the potential role of race-related stressors in health. Disparities and the added burden of raceRacial disparities in health in the U.S. are large and pervasive. For most of the 15 leading causes of death including heart disease, cancer, stroke, diabetes, kidney disease, hypertension, liver cirrhosis and homicide, African Americans (or blacks) have higher death rates than whites (Kung et al. 2008). These elevated death rates exist across the life-course with AfricanCorrespondence to: David R. Williams, dwilliam@hsph.harvard.edu. NIH Public AccessAuthor Manuscript J Behav Med. Author manuscript; available in PMC 2010 February 14. NIH-PA Author ManuscriptNIH-PA Author Manuscript NIH-PA Author ManuscriptAmericans and American Indians having higher age-specific mortality rates than whites from birth through the retirement years (Williams 2005). Other data indicate that almost 100,000 black persons die prematurely each year who would not die if there were no racial disparities in health (Levine et al. 2001). Another noteworthy characteristic of racial disparities is their persistence over time. Despite gains in life expectancy for both blacks and whites, the 7 year racial gap in life expectancy in 1960 was still 5.1 years in 2005 (National Center for Health Statistics (2007). Similarly, altho...

Various authors have noted that interethnic group and intraethnic group racism are significant stressors for many African Americans. As such, intergroup and intragroup racism may play a role in the high rates of morbidity and mortality in this population. Yet, although scientific examinations of the effects of stress have proliferated, few researchers have explored the psychological, social, and physiological effects of perceived racism among African Americans. The purpose of this article was to outline a biopsychosocial model for perceived racism as a guide for future research. The first section of this article provides a brief overview of how racism has been conceptualized in the scientific literature. The second section reviews research exploring the existence of intergroup and intragroup racism. A contextual model for systematic studies of the biopsychosocial effects of perceived racism is then presented, along with recommendations for future research.

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