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Ideastream Public Media investigates how racism contributes to poor health outcomes in the Cleveland area and uncovers what local institutions are doing to tear down the structural barriers to good health.

Trauma from racism — past and present — can affect your health

As a civil rights leader, Reverend Otis Moss Jr. has experienced racism in his life: assassinations and lynchings — “the personification of evil and injustice,” he said.

“I saw Dr. Martin Luther King Jr. in a casket,” said Moss. “Personally, at 11 years old, I also saw my cousin who was lynched because they could not find the person they wanted to lynch.”

Only recently have researchers begun to understand the connection between experiences like Moss' and poor health outcomes among Black Americans, said Monica Williams, a clinical psychologist from the University of Ottawa who is an expert on racial trauma.

“There's been research that's happened over the last 20 to 25 years now, showing that racism is connected to just about every major mental illness and many, physical health conditions,” she said. “So, the more racism you experience, the worse your mental health, the worse your physical health and for many reasons.”

Racial trauma refers to the severe mental and emotional response caused by encounters with racial bias and ethnic discrimination, hate crimes and the ongoing harmful emotional effects that build up over time, according to Mental Health America, a nonprofit dedicated to addressing the needs of those living with mental illness. The U.S. Department of Veteran's Affairs recognizes the effects of racial trauma on health as does the National Alliance on Mental Illness.

Recent studies have shown that there are two ways that racism can affect a person's health.

The first is historical. As a society, we haven't dealt with the generational trauma of slavery, said Angela Neal-Barnett, psychological sciences professor at Kent State University.

"We haven't addressed the trauma from 400 years” ago, she said.

That unresolved trauma can be passed down generation after generation if it's not addressed, she said.

The second is by experiencing racism personally or by consuming media that depict other people like yourself suffering at its hand.

“Experiences with racism, microaggressions and daily insults translate into higher stress steroids and higher cortisol circulating in our bloodstreams, which negatively impacts our whole bodies," said Dr. Charles Modlin, a urologist and the medical director of inclusion, diversity and equity at MetroHealth. "That results in a physical manifestation of disease, higher rates of obesity, diabetes, high blood pressure."

Exposure to discrimination either directly or indirectly can trigger racial trauma. Even vicarious exposure — when an individual is not personally the target but can see themselves in that position — can traumatize.

Media depictions of racism may also trigger feelings of racial trauma, Neal-Barnett said.

“The reason that we (African Americans) can't watch it is because it could be our brother, our husbands, our uncles. It could be us,” said Neal-Barnett.

Even today while sitting in the chapel of University Hospitals' Otis Moss, Jr. Health Center — a health center in Cleveland's Fairfax neighborhood that is named after him — Moss said that seeing the murder of George Floyd and its aftermath was like reliving the past.

Throughout history, African Americans have fought to be seen as human beings with every right as others in our country, Neal-Barnett said. “And in that fight, in that struggle comes stress and trauma," she said.

In some cases, these prolonged incidents of racism and discrimination can lead to symptoms like those who battle post-traumatic stress disorder or PTSD, Williams said.

“It's like the more racism you endure in your life, the more traumatized you get, the more problems you have sleeping, the more problems you have trusting others, the more anxiety you have, the more fear you have,” Williams said.

Williams, who is working on a teaching manual that addresses working with racial trauma patients, stresses a need for more people of color to work in the clinical professions, as well as more money for research.

As we all try to understand and address the impact of racial trauma, Moss said he will also rely on his faith and the hope of a better day.