The Stress of Stigma
A number of studies, including the seminal work of Gernomius [19] and Williams [20], have suggested that the stress of coping with racism and marginalization may be in part responsible for the persistent racial and ethnic disparities in health outcomes. A related body of work by Marmot, Wilkinson and others has linked relative social standing to health through biological and behavioral pathways arising from stress [21]. In several focus groups participants argued about whether racism and discrimination are, indeed, sources of stress. Nevertheless, many noted that their stress was amplified by an overarching feeling of being devalued. In every group, people recounted humiliating encounters with the police, schools, health care providers, and social service agencies. And many identified a broader sense of inequity as a source of debilitating stress. One young man explained how the neighborhood conditions send a message about his place and value in society.