Objectives: A growing number of studies have documented the deleterious health consequences of the experience of racial discrimination in African Americans. The present study examined the association of racial prejudice--measured at a collective level--to black and white mortality across the United States.
Methods: Cross-sectional ecologic study, based on data from 39 states. Collective disrespect was measured by weighted responses to a question on a national survey, which asked: "On the average blacks have worse jobs, income, and housing than white people. Do you think the differences are: (A) Mainly due to discrimination? (yes/no); (b) Because most blacks have less in-born ability to learn? (yes/no); (c) Because most blacks don't have the chance for education that it takes to rise out of poverty? (yes/no); and (d) Because most blacks just don't have the motivation or will power to pull themselves up out of poverty? (yes/no)." For each state, we calculated the percentage of respondents who answered in the affirmative to the above statements. Age-standardized total and cause-specific mortality rates in 1990 were obtained for each state.
Results: Both measures of collective disrespect were strongly correlated with black mortality (r = 0.53 to 0.56), as well as with white mortality (r = 0.48 to 0.54). A 1 percent increase in the prevalence of those who believed that blacks lacked innate ability was associated with an increase in age-adjusted black mortality rate of 359.8 per 100,000 (95% confidence interval: 187.5 to 532.1 deaths per 100,000).
Conclusions: These data suggest that racism, measured as an ecologic characteristic, is associated with higher mortality in both blacks and whites.