Originally posted on Johns Hopkins University Press Blog:
Guest post by Maxwell J. Mehlman
In a November article for the New England Journal of Medicine, Harvard law professors Michelle Mello and Glenn Cohen argue that in upholding the Affordable Care Act’s individual insurance mandate as a tax the Supreme Court “has highlighted an opportunity for passing creative new public health laws.” As a bioethicist who writes extensively on the question of coercive public health this troubled me on several fronts. In this case, Mello and Cohen give an example of the laws that they have in mind: higher taxes on people whose body-mass index falls outside of the normal range, who do not produce an annual health improvement plan with their physician, who do not purchase gym memberships, who are diabetic but fail to control their glycated hemoglobin levels, and who do not declare that they were tobacco-free during the past year.
Some of these suggestions seem ineffectual. It’s hard to imagine what the public health benefit would be from rewarding people for making a health-improvement plan without having to follow it or for joining a gym without having to use it. As for swearing off the use of the “pernicious weed,” aside from being unenforceable, it is too reminiscent of the loyalty oaths of the McCarthy era to be taken seriously.
Increased levels of depression as a result of discrimination could contribute to low birth weight babies.
Given the well-documented relationship between low birth weight and the increased risk of health problems throughout one’s lifespan, it is vital to reduce any potential contributors to low birth weight. A new study by Valerie Earnshaw and her colleagues from Yale University sheds light on one possible causal factor. Their findings, published online in Springer’s journal, theAnnals of Behavioral Medicine, suggest that chronic, everyday instances of discrimination against pregnant, urban women of color may play a significant role in contributing to low birth weight babies.
Twice as many black women give birth to low birth weight babies than white or Latina women in the U.S. Reasons for this disparity are, as yet, unclear. But initial evidence suggests a link may exist between discrimination experienced while pregnant and the incidence of low birth weight. In addition, experiences of discrimination have also been linked to depression, which causes physiological changes that can have a negative effect on a pregnancy…
Levels of everyday discrimination reported were generally low. However, the impact of discrimination was the same in all the participants regardless of age, ethnicity or type of discrimination reported. Women reporting greater levels of discrimination were more prone to depressive symptoms, and ultimately went on to have babies with lower birth weights than those reporting lower levels of discrimination. This has implications for healthcare providers who work with pregnant teens and young women during the pre-natal period, while they have the opportunity to try and reduce the potential impacts discrimination on the pregnancy.
The authors conclude that “Given the associations between birth weight and health across the life span, it is critical to reduce discrimination directed at urban youth of color so that all children are able to begin life with greater promise for health. In doing so, we have the possibility to eliminate disparities not only in birth weight, but in health outcomes across the lifespan.”
- Study finds racism may harm pregnant women of color and cause low birth weight in newborns (thegrio.com)
- The effects of discrimination could last a lifetime (eurekalert.org)
- The effects of discrimination could last a lifetime (whitenewsnow.com)
- Increased risk of prematurity and low birth weight in babies born after 3 or more abortions (eurekalert.org)
- Health News: Maternity leave delay as dangerous to unborn baby as smoking (dailyrecord.co.uk)
Excerpt from the 12 January 2012 Science Daily news item
Racial discrimination may be harmful to your health, according to new research from Rice University sociologists Jenifer Bratter and Bridget Gorman.
n the study, “Is Discrimination an Equal Opportunity Risk? Racial Experiences, Socio-economic Status and Health Status Among Black and White Adults,” the authors examined data containing measures of social class, race and perceived discriminatory behavior and found that approximately 18 percent of blacks and 4 percent of whites reported higher levels of emotional upset and/or physical symptoms due to race-based treatment.
“Discriminatory behavior very well may be a ‘missing link’ in the analysis of racial and ethnic health disparities,” Bratter said. “It’s important to acknowledge and study its impact on long-term health…
A greater number of blacks report poor health due to discrimination, and the study did find that black-white disparities in health are shaped in part by the differential exposure of blacks to the harmful effects of discrimination. However, Bratter and Gorman also show that while perceiving discrimination exacerbates some of the economic-based health risks more typically experienced by black adults, patterns differ for white adults. Regardless of social-class position, white adults who perceive unfair treatment relative to other racial groups in either workplace or health care settings report poorer health.
“A relatively small proportion of white adults report unfair treatment that is race-based, but those who do say their health status is harmed more than blacks who report the same experiences,” Gorman said.
- Study Reveals Discrimination May Harm Your Health (medicalnewstoday.com)
- Study finds racial and ethnic disparities in US cancer screening rates Screening rates lower among Asian and Hispanic Americans (CDC.gov)
Screening rates for all three cancers were significantly lower among Asians (64.1 percent for breast cancer, 75.4 percent for cervical cancer, and 46.9 percent for colorectal cancer) compared to other groups, the study found. Hispanics were less likely to be screened for cervical and colorectal cancer (78.7 percent and 46.5 percent, respectively) when compared to non-Hispanics (83.8 percent and 59.9 percent, respectively).
- Discrimination may harm your health, according to new Rice study (esciencenews.com)
- Discrimination may harm your health, according to new Rice study (eurekalert.org)
- Discrimination may harm your health (sciencedaily.com)
- Could Discrimination Help Trigger Illness in Blacks? (nlm.nih.gov)
University Park, Pa. — Just as the constant pressure soldiers face on the battlefield can follow them home in the form of debilitating stress, African-Americans who face chronic exposure to racial discrimination may have an increased likelihood of suffering a race-based battle fatigue, according to Penn State researchers.
African-Americans who reported in a survey that they experienced more instances of racial discrimination had significantly higher odds of suffering generalized anxiety disorder (GAD) some time during their lives, according to Jose Soto, assistant professor, psychology.
Generalized anxiety disorder has both psychological and physical symptoms that are so severe that they can significantly affect everyday tasks and job performance. People with the disorder may have chronic worrying, intrusive thoughts and difficulty concentrating. Physically, the disorder may manifest such symptoms as tension headaches, extreme fatigue and ulcers. Some of these symptoms are associated with “racial battle fatigue,” a term coined by William A. Smith, associate professor, University of Utah….
Discrimination experienced by U.S. teens from Latin American and Asian backgrounds can affect their grades and health, and is associated with depression, distress and reduced self-esteem, a new study has found….
Discrimination can be especially hard on teens, the study authors noted.
“These are the years when social identity is arguably more salient among teenagers who are struggling with defining who they are. Adding on a ‘layer’ of discrimination is not an easy thing for them to deal with,” one of the study authors, Andrew J. Fuligni, a professor of psychiatry at UCLA’s Semel Institute for Neuroscience and Human Behavior, said in a university news release.
“Discrimination significantly predicted lower [grade-point averages], higher levels of depression, higher levels of distress, lower self-esteem and more physical complaints,” Fuligni added. “So the bottom line? Discrimination is harmful.”
The study was released online in advance of publication in an upcoming print issue of the Journal of Research on Adolescence. If you do not have a subscription to this journal, check with your local public or academic library to see if there is a way you can access it for free or a lower cost.
**Teen Mental Health (MedlinePlus) has great informational links for teens and parents
Remember your local public library!
**Your local public library not only has books, but information about local agencies which can assist you in many areas, including parenting, mental health, and dealing with discrimination. Ask for a reference librarian! She or he will give your professional confidential assistance in locating information online and in print.