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Chapter 14: Race and Mental Health

Chapter 14: Race and Mental Health

pp. 281-303

Authors

David R. Williams, Director and René Dubos University Professor, Emeritus, Institute for Health, Health Care Policy, and Aging Research, Rutgers University, Manuela Costa, Healthcare and Project Management, InFlexxon, Boston, MA, Jacinta P. Leavell, Associate Professor and Chair, Dental Public Health, Meharry Medical College
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Summary

Williams and colleagues provide an overview of the mental health status for each minority population, evaluating the available scientific evidence of racial variations in mental health. Due to different research methodologies and varying criteria for the identification of both mental disorder and minority status, it is difficult to make many generalizations about mental health differences. The intersection of race, socioeconomic status, and gender within and between populations contributes to difficulties in assessing group differences. Consequently, despite decades of research, we lack a clear picture of the mental health status of the major minority populations. Research must overcome problems with inadequate coverage of the population and find ways to capture the considerable heterogeneity of minority groups. A second group of problems concerns limitations on the measurement of mental health status. Finally, culture affects the manifestation of mental health problems because cultures vary in their emphasis on particular emotions and standards for acceptable expression and emotion. That is, culture affects the interpretation of symptoms of disorder. Research must identify the ways in which social, economic, political, and cultural factors impact on the health status of minority groups. Racism and migration experiences are also critical to mental health, and need further investigation. What is this multifaceted phenomenon called race and how can it lead to variations in mental health?

Introduction

In the United States, federal statistical agencies are required to report statistics for five racial groups (white, black, Asian, Native Hawaiian or other Pacific Islander, and American Indian or Alaskan Native) and one ethnic category (Hispanic) (Office of Management and Budget [OMB], 1997). These categories are socially constructed and with almost 70 percent of Hispanics preferring to have Hispanic included as a racial category (Tucker et al., 1996), this chapter treats all the categories as “races,” and examines the extent to which these categories predict variations in mental health status. Racial groups are more alike than different in terms of genetic characteristics, with humans being identical for about 75 percent of known genetic factors, and with 95 percent of human genetic variation existing within racial groups (Lewontin, 1972; Lewontin, Rose, & Kamin, 1984). Since the first US Census in 1790, no two censuses have used identical racial categories (Nobles, 2000), with historical events and political factors playing an important role in determining which racial categories are officially recognized at a given time (Williams, 1997a).

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