The election of an African-American president, Barack Obama, brought the racists back out from under their rocks. And sadly, the election of Donald Trump has further energized those racists -- making them bolder in both their hate-filled speech and actions. It has also expanded their hate, especially toward muslims and the LGBT community. This growth of hate in the United States is also having a negative effect on the health of many American citizens.
That's the conclusion of a new report printed in the prestigious New England Journal of Medicine. Here is part of that report:
A small but growing body of evidence suggests that election campaigns can have both positive and negative effects on health. Campaigns that give voice to the disenfranchised have been shown to have positive but short-term effects on health. Such associations have been observed among black South Africans at the time of Nelson Mandela’s 1994 election, among black Americans during Jesse Jackson’s 1988 presidential campaign, and among Hispanic and black Americans when Barack Obama was nominated for President in 2008.1 Thus, increases in psychological well-being, pride, and hope for the future are likely to be evident among Donald Trump supporters.
At the same time, events linked to the recent presidential campaign and election have given rise to fear and anxiety in many Americans. Research suggests that these events can have negative health effects on people who have been direct targets of what they perceive as hostility or discrimination and on individuals and communities who feel vulnerable because they belong to a stigmatized, marginalized, or targeted group. It is worth exploring the scientific research in this area and considering its implications for health care providers.
INCREASED RACIAL HOSTILITY
There has been an increase in racial resentment, animosity, and political polarization in the United States in recent years. The election of President Obama played a key role: research indicates that Obama’s election led to increases in the rate of belief among white Americans, especially conservatives, that racism no longer exists.2 At the same time, in the wake of his election, one third of white Americans indicated that they were “troubled” that a black man was President, the Tea Party movement emerged with antiminority rhetoric, resentment toward Democrats increased, support among whites for the Democratic party declined, and white support for addressing racial inequities decreased.2 Obama’s election also led to a marked increase in racial animosity expressed in social media: there was a proliferation of hate websites and anti-Obama Facebook pages, with the widespread use of historical racial stereotypes that are no longer seen in mainstream media.3
The presidential candidacy of Donald Trump appeared to bring further to the surface preexisting hostile attitudes toward racial and ethnic minorities, immigrants, and Muslims. In a national (nonrepresentative) survey of 2000 elementary and high school (K–12) teachers, more than half of respondents said that since the 2016 presidential campaign began, many of their students had been “emboldened” to use slurs and name calling and to say bigoted and hostile things about minorities, immigrants, and Muslims.4 Not surprisingly, 67% of these teachers reported that many U.S. students (especially immigrants, children of immigrants, and Muslims) were scared and worried and had expressed concerns or fears about what might happen to their family after the election. Even some native-born black children whose ancestors have been in the United States for centuries expressed concerns about a return to slavery or being sent back to Africa.
One of the first postelection messages on the Daily Stormer, a hate website, claimed that the election was a referendum on “multiculturalism” and encouraged verbal intimidation of foreigners, especially those wearing Islamic clothing. It declared, “We want these people to feel unwanted. We want them to feel that everything around them is against them. And we want them to be afraid.”5The Southern Poverty Law Center has documented an increase in incidents of harassment and hateful intimidation since Trump’s election.6 Disturbingly, the locations where incidents of harassment have most commonly been reported have been K–12 schools. Other research using relatively small, nonrepresentative samples has documented that incidents of racial discrimination experienced by teenagers predicted flatter diurnal cortisol slopes and lower cortisol awakening response in young adulthood,7 elevated levels of endocrine, cardiovascular, and metabolic parameters at age 20,8 as well as epigenetic patterns of aging at age 22.9
Beyond being potential personal targets of hostility, a large proportion of U.S. adults are stressed by the current political environment. A January 2017 national survey found that Democrats were more likely than Republicans (72% vs. 26%) and minorities (69% of blacks, 57% of Asians, 56% of Hispanics) more likely than non-Hispanic whites (42%) to report that the outcome of the 2016 presidential election was a significant source of stress.10 Moreover, two thirds of all adults surveyed said they were stressed about the future of the United States.
COMMUNITY-LEVEL PREJUDICE
Although their ecologic designs limit making inferences about causality, several recent studies have consistently found that living in communities with high levels of racial prejudice is associated with an elevated risk of disease and death. One study found an elevated risk of death among adults residing in communities where levels of racial prejudice were high.11 The highest mortality risk was observed among people who themselves scored low on survey measures of self-reported racial prejudice but who resided in highly prejudiced communities.
Another study conducted in 1836 U.S. counties revealed an elevated risk of death from heart disease among both black and white residents of high-prejudice counties, with a stronger effect among blacks than among whites.12 Research has also found that even an Internet-based measure of the racial prejudice in a geographic area — communities with a higher proportion of Google searches using “the N-word” — predicted elevated all-cause mortality among black adult residents.13 Similarly, research has found that lesbian, gay, and bisexual people residing in communities with high levels of antigay prejudice had a risk of death three times that of their counterparts in low-prejudice communities.14
HOSTILITY IN THE LARGER ENVIRONMENT
A limited body of research also suggests that increased exposure to racial or ethnic hostility in the media or society in general can predict adverse changes in health among members of targeted groups. In the wake of the September 11th terrorist attacks, there were well-documented increases in harassment of and discrimination against persons perceived to be Arab American. Consistent with other research, a study in the Detroit area found that experiences of discrimination and abuse after September 11 were positively associated with psychological distress and inversely related to happiness among persons from the Middle East.15 A study of birth outcomes among women of multiple racial and ethnic groups in California revealed that only among Arab American women was there a pattern of increased risk of low-birth-weight babies or preterm births in the 6 months after 9/11 as compared with the preceding 6-month period.16
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