Racism and Older Black Americans' Health: a Systematic Review

We reviewed research that examines racism as an independent variable and one or more health outcomes as dependent variables in Black American adults aged 50 years and older in the USA. Of the 43 studies we reviewed, most measured perceived interpersonal racism, perceived institutional racism, or residential segregation. The only two measures of structural racism were birth and residence in a Jim Crow state. Fourteen studies found associations between racism and mental health outcomes, five with cardiovascular outcomes, seven with cognition, two with physical function, two with telomere length, and five with general health/other health outcomes. Ten studies found no significant associations in older Black adults. All but six of the studies were cross-sectional. Research to understand the extent of structural and multilevel racism as a social determinant of health and the impact on older adults specifically is needed. Improved measurement tools could help address this gap in science.

Automated summary

This review examines the impact of racism as an independent variable on various health outcomes in Black American adults aged 50 and older in the USA. Most studies focused on perceived interpersonal racism, perceived institutional racism, or residential segregation. The results show associations between racism and mental health, cardiovascular health, cognition, physical function, telomere length, and general health/other outcomes. However, some studies found no significant associations. It is necessary to conduct further research to understand the extent of structural and multilevel racism as a social determinant of health in older adults and improve measurement tools in this field.