It’s amazing how many people become uncomfortable as soon as the word racism comes up.

As writer Nadra Kareem Nittle concisely sums it up, “Say the word ‘racism’ and many people might imagine someone in a white hood. However, discrimination is much more complex and comes in different types. In reality, ordinary people perpetuate racism daily.”

When thinking about racism, remember it includes:

Individual or internalized racism — It is when one holds negative ideas about his/her own culture, even if unknowingly.

Interpersonal racism — It is the holding of negative attitudes toward a different race or culture.

Institutional racism — Benefits are structured to the advantage of powerful groups at the expense of other groups. Jim Crow laws and redlining practices are two examples of institutional racism.

Structural racism — Examples of structural racism include power inequalities, unequal access to opportunities and differing policy outcomes by race. Because these effects are reinforced across multiple institutions, the root causes of structural racism are difficult to isolate. Structural racism is cumulative, pervasive and durable.

Some racism is so subtle that neither victim nor perpetrator may entirely understand what is going on. There is a term which describes this particular form of racism: racial microaggression.

What does this have to do with health? It all begins with an understanding of the link between stress and inflammation.

The immune system is an intricate network consisting of processes, systems, cells, tissues and organs that work together to defend the body against attacks by “foreign” invaders.

When stress becomes ongoing and uncontrollable it then becomes dangerous to our health and well-being.

Our ongoing survival depends on our ability to respond to any kind of infection, stress and/or injury. Any of these threats trigger an immune system response to fight off these “invaders” and repair damaged tissues. A “deployment” of specific group of genes in the immune system is key to this defense process. Inflammation is a sign that those genes are working to counter the threat or repair the damage.

Inflammation serves to protect an organism from a health threat. First, let me say that stress has both its benefits and its downfalls. The physical stress on our muscles or the cardiovascular system from exercise to maintain fitness, or the level of mental needed to take an exam in school, or the stress of paying attention while driving during bad weather. But if someone feels under threat for long periods of time, their health may suffer significantly with chronic inflammation.

A team of USC and UCLA scientists has found that racist experiences increase inflammation in African-American individuals, raising their risk of chronic illness, according to the study published in the Psychoneuroendocrinology Journal. The study confirms what many of us had pretty much concluded that was a connection between discrimination and health outcomes, we just never knew how it affected health.

Turns out that racial discrimination appears to trigger an inflammatory response among African Americans at the cellular level. The basis for this concept was already established in earlier research that found this process took place in the inflammatory responses for people in socially marginalized those experiencing chronic loneliness, poverty, PTSD and other types of adverse life situations.

All of this leads us back to the concept of racial microaggression. It is the culminative, institutionalized, ever-present, everyday insults, indignities and demeaning messages sent to Black people by well-intentioned white people who are unaware (maybe) of the hidden messages being sent by them.

The crazy thing is that a Black person is in somewhat of a Catch-22 when it comes to racial microaggression.

If you confront the perpetrator, they will outright deny any racist meaning behind their words or actions. After all, they are (presumably) not even aware of what they did! So, the Black person is forced to either create a confrontation, or just move on.

Either way, the damage is done.

Once the full-blown stress response is activated, there is little you can do to override it because the hormones being secreted, such as cortisol and adrenalin, trigger a chain of unstoppable events inside of cells. The effect of the inflammatory response by the immune system to the stressor is underway: heart disease; high blood pressure; diabetes; depression; cancer; and so on, and so on. Ironically, all things that impact the health of Blacks disproportionately; or is it irony?

Of course, any, or all, of these conditions are absolutely possible without being a victim of racial microaggression. You can be sure that, racism or not, inflammation is in play with any of these diseases. The research from the USC and UCLA scientists shows that racism may account for as much as 50% of the heightened inflammation among African Americans.

It’s kinda like the old adage, “when white folks get a cold, Black folks get pneumonia”!

With all the talk about addressing disparities, health inequities and social determinants of health, it’s time to acknowledge the science and the research that makes it clear that it racial microaggression is real, and it is deadly, particularly to Blacks.

It’s important to keep shining a light on the harm these behaviors inflict, no matter how Black people decide to handle a given encounter.

Glenn Ellis is a Research Bioethics Fellow at Harvard Medical School and an active media contributor on health equity and medical ethics. For more good health information visit: www.glennellis.com.

Glenn Ellis is a Research Bioethics Fellow at Harvard Medical School and an active media contributor on health equity and medical ethics. For more good health information visit: www.glennellis.com.

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