Structural racism a 'critical public health threat,' increases psychosis risk
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Structural racism in the United States has had a significant effect on psychosis risk at the individual and neighborhood levels, according to results of a review paper published in American Journal of Psychiatry.
“Black and Latinx individuals suffer disproportionately from psychosis risk factors at the neighborhood and individual level, in large part as a result of structural racism,” Deidre M. Anglin, PhD, of the department of psychology City College of New York, said during a press briefing at the American Psychiatric Association’s annual meeting. “Of 85,000 papers published in JAMA and New England Journal of Medicine in the past 30 years, only 15 included the word racism anywhere in the text.”
Anglin and colleagues assessed possible risk factors for and effects of structural racism in the U.S. in three areas, which were neighborhood disparities; trauma/stress experienced on individual and collective levels; and pregnancy-related complications.
They found inequitable access to health care, healthy foods, education and employment opportunities and safe housing perpetuated disparities in U.S. neighborhoods for Black and Latino individuals. Research suggested that these disadvantages were linked to cumulative stress and increased risk for psychosis.
Anglin and colleagues also found that trauma history was common among individuals with schizophrenia, with more than 85% having reported one or more adverse childhood experience. Further, studies suggested a link between multiple experiences of trauma and increased risk for psychosis. Black or Latino individuals who experienced psychosis had significantly higher rates of trauma and adversity compared with white individuals. They also found an association between several obstetric complications and increased risk for psychotic disorders, including infections, maternal stress and increased maternal inflammation. Black women in the U.S. were at significantly increased risk for many obstetric complications compared with white women.
“The contribution of structural racism to psychosis risk is a neglected issue in the U.S.,” Anglin said. “Our research indicates that we need to treat structural racism as what it is: a critical public health threat. There are so many pathways through which it works to make people more likely to have a higher risk for psychosis.”