African Americans' Lives Today: Reflections from an RWJF Investigator

Jun 11, 2013, 4:12 PM, Posted by Ari Kramer

Recently, the Robert Wood Johnson Foundation, Harvard School of Public Health and National Public Radio conducted a national survey which provides a snapshot of African-Americans’ views on a range of issues in their personal lives and communities, including and beyond health and health care. A majority of respondents reported being overall satisfied with their lives and communities. At the same time, many reported concerns about their economic stability and resources to pay for a major illness, and experiences of discrimination.

To get some historical perspective and insights into how the findings relate to existing research, we spoke with James S. Jackson, Ph.D., professor at the University of Michigan School of Public Health, and director of its Institute for Social Research. For more than 40 years, Jackson has been studying the racial and ethnic influences on American personal, social and community life, and growing heterogeneity of the nation’s Black population. Also a RWJF Investigator in Health Policy Research, he is currently directing extensive surveys on the social and political behavior and mental and physical health of the African American and Black Caribbean populations.

As a long-time researcher on America’s Black population, what is your first reaction to these poll findings?

Many of the issues that came through in this study are very familiar to us. The reporting of a lack of resources, difficulties accessing health care, issues of diabetes and stroke, substantial reports of experiences of racism, these findings are pretty much consistent with how we understand these issues within the population. And when asked to assess their lives, this population overall tends to report being fairly satisfied.  That is something we've been reporting for the last 30 years—it’s actually a common finding in research on the Black population.

Based on studies you have conducted, what do you think is behind some of these numbers?

In many ways, the findings are in line with what we often hear in our research around disparities, in health and other areas, when we pose questions about satisfaction. Within the answers, there is an attitude of, “Compared to what? What other choices are there?” People have to bring their expectations in line with what their life experiences are.

A second thing I’d point out is that [depending on] African Americans’ age in this population, with the introduction of Social Security and so on, for many of them it may be the first time that they really have stable incomes in their lives.  We've shown in a lot of research that when this occurs, there's a tendency for satisfaction actually to rise among this particular group, because their fortunes in life are actually better at that point than they were before. 

What are some key trends you’ve seen in your research that are supported by this poll?

The real key issue here is the growing divide between the haves and the have-nots.  And the fact that large numbers of African Americans are indicating job insecurities and feeling that they may lose their jobs… this really connects to the challenge for a large proportion of the African Americans in the United States, even those solidly within the middle class, to be able actually grow wealth. Even as incomes have risen, and circumstances have improved, it is a stubborn problem in this country. Today, there are many more Blacks who are actually well off, and when we talk about being middle-class today, they truly are. But large numbers of Blacks, particularly African Americans, still are not in those circumstances. And the differences among these groups are growing rapidly.

Are there any important trends you’ve been capturing that didn't come through?

First, I would really again point to the growing disparities in terms of wealth and income among what we call the Black population.  And a second trend would be the growing influx of Black immigrants to the United States, primarily from Africa and the Caribbean, which is creating changes in that population. I think it is going to be really important going forward that we disaggregate the ethnic from the racial designation of what it means to be Black in America.  There is also the growth of the Spanish black population. So to talk about the Black population as simply the historical African American population is going to become less and less true.

Substantial numbers reported specific experiences of racial discrimination. Has research shown a relationship between discrimination and health?

The day-to-day, mundane experiences people have that are clearly based upon race, as well as kind of larger instances of maltreatment that people have—like discrimination in housing—these are very stressful. For those African Americans who are better off, actually the experiences are even worse. And the relationship between chronic stress and lots of different health challenges are well documented in the literature, whether that is Type 2 diabetes, hypertension or other kinds of heart disease. 

What this also ties to is… one of the interesting conundrums in our research. For almost every single physical health disorder, African Americans suffer disproportionately in comparison to non-Hispanic whites.  But if one examines the research on mental health and mental disorders, African Americans actually enjoy lower prevalence rates. As African Americans traverse the life course, there are many who actually learn to deal with their major stresses in ways like overeating, smoking, drinking, that are actually harmful to their health. We argue that these behaviors are not just life choices; they actually are functional in relieving the kinds of stressors that Black people face in everyday life in this society.  And this has this kind of perverse outcome of contributing to the negative differences in physical health, while at the same time tending to be protective of mental health, particularly serious mental disorders.

From your perspective as a researcher, for there to be meaningful change where the greatest health disparities, what has to happen?

First, you have to get the analysis right, and get some fundamental notion about what actually produces the disparities we see. Then, at the same time as we pursue policies to address some of the fundamental challenges, we also need [strategies] that can help people cope with these difficulties, and try to change the trajectories of their lives. For instance, are there ways we can intervene in inner-city schools to keep people in school so they graduate?  Are there ways we can do a better job of reducing dropout rates among African American college students, so more of those students can graduate?  Are there ways we could work with local municipalities to improve the nature of the local environments where people live? I really think we also have to take kind of an approach of one community at a time, one individual at a time.