Research on the link between racial discrimination and poor health outcomes is not new. However, until now, there has been little exploration around that link — the why, how, who and when.
Researchers in Virginia Commonwealth University’s Department of Psychology in the College of Humanities and Sciences explored the “why” in a recent study published in the Journal of Behavioral Medicine in December. They surveyed 130 black Americans and found evidence that a just world belief — the belief that we live in a world in which people get what they deserve and deserve what they get — has a negative impact on the health of black Americans.
We talked to VCU researcher Nao Hagiwara, Ph.D., assistant professor in the Department of Psychology, about the findings and its implications for the health care of black Americans.
What led you to explore the just world belief as an influencer in the relationship between racial discrimination and health consequences?
Prior research often failed to address why some black Americans experience better health than others, even when they reported the same levels of perceived discrimination. I wanted to address this question.
There are a number of previous studies that have shown that people from socially disadvantaged groups — racial and ethnic minorities, and women — and who strongly endorse the just world belief are more likely to experience negative effects than their counterparts who weakly endorse this belief. This includes psychological reactions, like lower self-esteem as well as physiological reactions, like increased stress when they face discrimination at least temporarily. I thought there must also be long-term health consequences.
How did you determine who did and did not hold a just world belief within the research sample?
We used a well-validated, widely used scale, called “Belief in Just World Scale.” It asks individuals to report, on a five-point scale, how much they agree or disagree with eight statements that are designed to tap into just world beliefs. Examples include ‘‘I feel that the world treats people fairly’’ and ‘‘I feel that people get what they deserve.”
How was that linked to health outcomes?
Endorsement of the just world belief was not directly associated with physical or mental health self-reported by the survey group. However, it moderated the effects of perceived discrimination on the number of chronic illnesses and systolic blood pressure. Specifically, black Americans who strongly believed that the world is a just place and report experiencing high levels of discrimination were more likely than other blacks to suffer from a greater number of chronic illnesses. Likewise, among blacks who strongly endorsed the just world belief, higher levels of perceived discrimination was associated with higher blood pressure. In contrast, among blacks who weakly endorsed the just world belief, perceived discrimination and systolic blood pressure were unrelated.
Does the scale of a just world belief match the extent of health problems?
We are not arguing that black Americans who don’t hold a just world belief would be healthy even when facing racial discrimination. There are multiple pathways for racial discrimination to affect health. For example, it often forces black Americans to live in harsh environments that have high violence, more pollution and less access to fresh vegetables and fruits. Racial discrimination also can impact how physicians interact with and treat their black patients. Whether black Americans strongly versus weakly endorse the just world belief is one piece of this complicated puzzle.
What are the avenues for educating people on this association, and is it a process of unlearning long-held beliefs?
Prior research has shown that black Americans who strongly endorse the just world belief are likely to be threatened by the experience of discrimination for at least two reasons. First, they believe they are responsible for the experience of unfair treatment. Second, it challenges their core belief that people are treated fairly in the world.
In order to address the first reason, interventions may focus on modifying a person’s cognitive framing from ‘‘I am responsible for the negative events that happen to me’’ to ‘‘Some of the negative events are due to racism, and I am not responsible for those events.’’
In order to address the second issue, interventions may also focus on educating blacks who strongly endorse the just world belief by cultivating the belief that unfair and unjust things can happen to undeserving people. However, this messaging has to be delivered carefully so that it does not blatantly challenge someone’s core value, which could have a backfire effect.
Are the “side effects” of having a just world belief specific to black Americans or does it carry over to other groups that are discriminated against?
The short-term negative psychological and physiological consequences of holding a just world belief have been examined in multiple socially disadvantaged groups. So, I would predict that we would find similar patterns of results in other socially disadvantaged groups, such as other racial/ethnic minorities or individuals with mental health, criminal history or disabilities. The generalizability of the current findings is an empirical question and would be a great next study.