How race-related stress impacts older African Americans

There are currently more than 4 million African Americans over the age of 65, with a projected growth of about 12 million by 2060. Like the general population of older adults, African American older adults are living longer. Unlike their White counterparts, however, African American older adults experience significant health disparities, including lower life expectancies and an increased risk of chronic health conditions such as hypertension, diabetes, dementia, stroke, and cancer.

In recent years there has been a surge of interest in the impact of racial discrimination on the quality of life of African Americans, sparked in part by #BlackLivesMatter. Research indicates that African Americans—young and old—experience subtle and overt forms of racial discrimination. African American older adults, however, have also experienced cumulative race- related stressors that negatively impact their physical and mental health.

Despite the vulnerability of African American older adults to the cumulative effect of race-related stressors, the dialogue has yet to focus on the physical and mental health impact of these stressors. Therefore, service providers in the aging and health-care fields need greater awareness, education, and training to competently address race-related stress in African American older adults.

Race-related stress occurs when an individual experiences or witnesses racist incidents that evoke social and historical experiences of racism. For African American older adults, these encounters are accumulated over the lifespan, stored in memory, and relived with each new racist and discriminatory experience.

Age also impacts an individual’s mental and physical response to racism. For African American older adults, exposure to cumulative experiences of racism has resulted in limited access to resources such as education, employment, health care, housing, and political participation, contributing to health disparities and increased rates of mental health disorders such as depression, anxiety, and dementia.

Limited access to community resources (e.g., grocery stores, pharmacies, culturally competent health and aging service providers, transportation, housing, etc.) significantly contributes to the experience of race-related stress and creates barriers to achieving healthy and productive aging.

• Understand the impact of racism. For African Americans, the effects of racism are felt daily. Racism also intersects with other forms of discrimination, including ageism, classism, sexism, ableism, and heterosexism. Therefore, aim to understand the lens through which individuals view their experiences.
• Listen with empathy. Recognize and acknowledge past and present experiences. Provide support for the thoughts, feelings, and experiences shared.
• Create safe spaces. Provide opportunities for dialogue around race, culture, gender, sexuality, and socioeconomic issues.
• Support, strengthen, and enhance resilience. Resilience refers to the ability to successfully adapt and overcome negative life events such as stress and trauma. African American older adults have their roots firmly planted in hope and determination. Support spirituality, family ties, and strong positive racial group identity.
• Celebrate culture. Organize and encourage activities that celebrate African American life, history, culture, customs, and norms.
• Be mindful of triggers. Pay attention to the impact of stressful events and incidents continuously showcased in the media (e.g., television, radio, or newspaper). When possible, limit exposure.
• Be aware. Consider your own cultural background and its influence on your values, beliefs, assumptions, and biases. Seek out training opportunities on culturally competent geriatric care, with special attention to race- related stress.
• Refer to mental health services and support. Most African American older adults have developed effective coping skills (e.g., spirituality, kinship networks) to manage experiences of racism. However, when needed, culturally competent mental and behavioral health services should be made available.
• Advocate. Support and promote local and national efforts to increase access to community and national resources for African Americans across the lifespan.