This is the second part of a Rewire.News series on potential interventions for the health impacts of racism. Read part one here.

For more anti-racism resources, check out our guide, Racial Justice Is Reproductive Justice.

Here is what we know: Racism is bad for your health. Here is what we’re exploring: possible interventions that could help ameliorate the health impacts on people of color while the broader work to dismantle racism continues. In the first installment of this series, we explored how self-regulation, a set of teachable skills and behaviors that help us cope with stress, could be a key to reducing or eliminating the impacts of racism and discrimination. But there are other areas of research that show some potential. One such area social science researchers have explored is how racial identity, cultural connection, and conversations with kids about race might improve resiliency in the face of racism and systemic bias.

In part two, we’ll take a closer look at this research, and how a person’s relationship to their racial and ethnic community shapes their experience with discrimination. While there is still more research to do in this arena, certain behaviors and attitudes have been found to promote resilience in the face of discrimination for people of color. These findings lend themselves toward certain interventions, both on the individual and community level, that could potentially improve the health of people of color.

We should also note that any interventions regarding racial and ethnic identity are complicated by the nature of race and ethnicity itself—fluid constructs that are very much shaped by power and structure, and do not always offer individuals easy or accessible routes toward identity or connection. This can be particularly true for people with more than one racial identity or ethnicity and people who are disconnected from their communities or practices for a whole host of reasons. That said, when it comes to people who have a strong cultural connection and whose parents talk to them about race, the opportunities for intervention are clear, based on the research that is currently available.

Three Factors

Enrique Neblett, a clinical psychologist at the University of North Carolina at Chapel Hill, began his career as a counselor working with Latinx and Black youth. In a phone interview with Rewire.News, Neblett shared: “I was just really impressed with how [among the young people who] experienced racial discrimination, some kids were really impacted by it but others weren’t.” That observation, Neblett explained, led him to his research interest: “I wanted to understand why some kids were resilient and some weren’t.”

In a 2012 review of the existing literature of the factors associated with positive development of youth of color, Neblett and his colleagues Deborah Rivas-Drake and Adriana J. Umaña-Taylor identified three factors that previous researchers have found to be associated with better outcomes: racial and ethnic identity, racial socialization, and cultural orientation.

Racial and ethnic identity is defined in the paper as “youth’s attitudes and behaviors that define the significance and meaning of race and ethnicity in their lives.” One study they cite from 2003 that addresses this factor looked at self-esteem among Mexican American youth and the impact of both ethnic identity and discrimination on that self-esteem. What they expected to find was that a stronger ethnic identity would be connected to higher levels of discrimination and lower self-esteem. Instead, they found that while yes, the youth with a positive feeling about being Mexican-American did experience more discrimination, they also had stronger self-esteem than their counterparts who didn’t have such positive feelings about their ethnic identity. Another study found that for Black youth, positive connection to their racial group was associated with better academic achievement and fewer problem behaviors (such as skipping class, getting into fights, or cheating on exams).

Racial socialization is defined as “a process through which caregivers convey implicit and explicit messages about the significance and meaning of race and ethnicity, teach children about what it means to be a member of a racial and/or ethnic minority group, and help youth learn to cope with discrimination.” Neblett himself looked at this factor in a 2008 study, which he says is his most useful and exciting finding to date. That study surveyed Black adolescent youth in the Midwest, ages 11 to 17, and compared a number of measures of well-being—depressive symptoms, stress, problem behaviors—alongside experiences of discrimination and racial socialization messages. What the study found is that for the adolescents whose parents were talking to them about race, as well as integrating culturally relevant activities, their stress levels did not increase as they experienced higher levels of discrimination. “The data shows that it’s not just what parents are saying, it’s in tandem with buying books and toys that reflect the cultural background,” explained Neblett. “In addition, for the young people whose parents weren’t talking about race at all, or who were saying negative things about being Black, when they experience discrimination, their depressive symptoms were off the charts, they were getting in trouble in school, etc.”

The research review explains the impact of this socialization, arguing that it enables “youth to think more positively about themselves and equip[s] them with specific strategies and skills to successfully negotiate the challenges they encounter.” The idea here is that being educated about racial and ethnic identity helps young people feel good about themselves and gives them skills to deal with the problems they might face in the future.

The third factor shown in the research to improve outcomes, cultural orientation is explained as “youth’s orientations toward mainstream culture and their ethnic culture and has often been indexed by youth’s endorsement of particular cultural values.” Neblett investigated this question of cultural orientation in a 2012 study with colleague Sierra Carter, now a professor of psychology at Georgia State University.

They compared blood pressure and certain measures of identity and worldview in a group of 200 African American college students. Researchers asked the students to fill out a survey that evaluated their experiences with racial discrimination, their racial identity, and their relationship to an “Africentric worldview.” “In contrast to a European worldview,” the paper explains, “an optimal Africentric belief system is characterized by a nonmaterialistic, holistic, and communal orientation.” So things like being more oriented toward community and putting emphasis on things other than amassing material possessions are part of this worldview. That orientation, as well as the other elements in the study, were measured via a survey that included questions like, “If I just had more money, my life would be more satisfying; If I were better looking, my relationships with others would be more satisfying; and I feel badly when I see friends from high school who have better cars, clothes, or homes than I do.”

The study essentially compared three things: experiences of discrimination, blood pressure, and identity and worldview factors referenced above. Researchers found that among some of the participants who had experienced high levels of historic discrimination, the lowest blood pressures were among those “who felt that others viewed African Americans less favorably and who endorsed the uniqueness of the African American experience.” They also found that the individuals whose well-being was tied to more materialistic things had higher blood pressure in relationship to experiences of discrimination. “In other words, greater prior racial discrimination experiences were associated with greater [blood pressure] for individuals whose positive well-being was based on material possessions such as money, appearance, and clothing.”

This study illustrates what is reinforced in the broader literature, which is that having an attitude that is grounded in your specific cultural context is associated with resilience in the face of discrimination. That echoes similar findings from Monica Tsethlikai on Native communities, referenced in the first installment of our series. Tsethlikai found that Native children who were engaged in activities based in their tribal communities had better cognitive skills, skills that are part of the skill set needed to cope with stress. “It’s a really tough place for ethnic minorities, and the more grounded they are in cultural traditions and spirituality, the better off they will be,” she explained.

Health Disparities

A bulk of the existing psychology research on racial and ethnic identity focuses on indicators of emotional well-being, not physical health. “Clinical psychologists don’t tend to study physical health,” Neblett said. But he, and others, have been exploring these linkages. “I became interested in that because wow—how do we understand these blatant physical health disparities?” Neblett is referring to the racial disparities in health outcomes, especially for African Americans, who have high rates of heart disease, asthma, maternal mortality and diabetes among a host of other problems. In addition to the blood pressure study referenced above, Neblett and his colleagues have been trying to paint a more complete picture of the impact of discrimination on well-being by including physiological measures.

Another such study from 2013, conducted with Steven O. Roberts, a psychology professor at Stanford University, measured nervous system responses among African American students, ages 18-29, while listening to (and being asked to imagine) scenarios that evoked varying levels of discrimination. For example, one scenario is described as “a police officer unjustly pulls someone aside and uses a racial slur to denigrate the individual’s race.” The study then looked at how the subjects’ nervous systems responded to survey questions about their racial identity and how African Americans are perceived. Overall, Neblett said, they found that “identity is influencing how your body is responding to racial stimuli.”

They found that participants who “felt really positively about being African American had a more kind of flight-or-fight response when [they] imagined a vignette with a white perpetrator.” The flight-or-fight response refers to activation of the sympathetic nervous system, which kicks in when we are facing a perceived threat. It’s associated with certain physiological changes, which Neblett’s study measured. Those who didn’t have the same level of positive feeling about being African American showed less or more muted responses to the same vignettes.

This study isn’t the first to look at racial identity and find what could be considered mixed results. More activation in response to stimuli among those with positive feelings about being Black actually goes against what some of the earlier findings, in particular what Neblett and his co-authors found in the review of the literature, imply about strong racial identity as a protective factor.

A more recent study Neblett conducted that has yet to be published found something along similar lines. From 2014-2017, Neblett surveyed a group of Black students, ages 18-22, at the University of North Carolina (UNC) at Chapel Hill. The students were surveyed three times over that period. For the students who said that being Black was really important to them, Neblett found that their level of vigilance went up the following year, and that increased vigilance was correlated with a more negative mood.

The big question here is why these findings differ from previous research. Neblett’s theory is that context plays a big role. Neblett said that the study was conducted during a tense time on the UNC Chapel Hill campus, when debates where raging about whether to remove a confederate statue on campus, and rumors about an potential Ku Klux Klan rally on campus. “So if being Black is a central part of my identity, and I’m in a context where all of this is going on, it’s a lot, and you might experience more distress,” explained Neblett of the results. So he is now embarking on more research, building off of this study.

He and Camara Jules P. Harrell, a professor at Howard University, were recently awarded a National Science Foundation grant to replicate the study at Howard University. “I don’t think our ultimate conclusion is that racial identity is bad for you,” explains Neblett. “There is just going to be some nuance, and it’s going to take some time to figure that out. We think it may be the context you’re in—a place like UNC or someplace where you’re not thinking about race every day.” Neblett and Harrell will be exploring the hypothesis that students at Howard, a historically Black university, might respond differently because of their environment. “Identity will be protective in a context like Howard, where you aren’t dealing with things like the KKK,” said Neblett of their hypothesis. They will also be adding in physiological measures into this next phase of the study.

Tiffany Yip, a professor of psychology at Fordham University, recently published a paper looking more deeply into the mixed findings on the question of racial and ethnic identity. She agrees that there are many factors that might explain the results, including context, as well as variations between ethnic groups and inconsistent methodologies. Both she and Neblett agree that rather than disregard the idea that a strong racial and ethnic identity could be beneficial, more research is needed to explain the nuance.

Next Steps

The question underlying all of this research is how it might actually be applied so that people of color can benefit from what we know can improve health in the face of racism. While these applications aren’t usually the domain of psychologists, unless they are specifically in applied psychology or public health, Neblett has been shifting some of his efforts in that direction. “With all the stuff that has been going on, I’ve been really hungry to figure out a way to get in the communities and figure out how the stuff we’re studying can benefit real people in real time.” To that end, he’s been working with a predominantly Black and low-income community in southeastern Raleigh, North Carolina, to help parents talk to their kids about race and racism. The youth have also asked for help responding to experiences of racism—like being stopped more by school security officers. It’s a slow process, he says, in part because he wants it to be informed by what community members actually want and need.

Neblett’s project is just one example of how these findings could be applied. Tsethlikai’s research on Native languages and games could be used to design (and fund) language programming and other cultural activities in communities and schools. And the researchers’ work on Africentric worldview could be turned into books and games for Black children and families aimed at strengthening cultural orientation.

At its most basic, these findings encourage people of color to resist assimilation, and center cultural practices and values. It is not an easy task given the context of racism and white supremacy in the United States, but the hope is that this kind of work will be propelled by scientific research that promotes its positive impact on health and well-being.