As ethnic minority psychology students, we have noticed significant connections between race-related generational trauma and increased stress and anxiety due to health fears, especially within the past year. During the COVID-19 pandemic, we observed increased rates of social isolation, fear, anxiety, and depression in individuals, especially those who are older adults and are at higher risk of significant negative health consequences if they contract it, due to having pre-existing health conditions. According to Zelner et al. (2021), the COVID-19 virus disproportionately affected ethnic minorities, including Black Americans. They also stated that Black older adults are among the highest mortality rates from COVID-19 in relation to the majority of the global population. Not only are Black older adults experiencing the highest rates of infection, but it seems that there has been a great deal of vaccination refusal, which may be due to fear and mistrust of the medical health system. Although racial disparities displayed within the current health system are longstanding (e.g., Egede, 2006), it seems that they have become highlighted due to the pandemic. The disparity within the mental health care system seems to have been facilitated not just by lack of accessibility and information but by blatant discrimination towards Black older adults.
Furthermore, during the pandemic, a great deal of social injustice and racial violence provoked by police brutality has been publicized. This high degree of racial unrest may have affected older Black Americans differently compared to younger Black adults. Race related stress can build up when an individual witnesses a racial incident that reminds them of historical experiences of racism (Himmelstein et al., 2015). The past experience can be relived with each new racist encounter witnessed or learned compounded levels of stress and anxiety within the older Black community, which when experienced chronically can impact physical and mental health (Himmelstein et al., 2015). Experienced racism is related to significantly poorer mental health outcomes. As for the intersection with gender, Coley et al. (2017) found that, within Black Americans, women had a stronger association between quality of life and perceived discrimination in regards to mental health than men. This specific gender differentiation suggests the need for attention to different types of diversity and cultural identities when understanding how environmental situations may impact a patient’s well-being.
The pandemic and racial injustice occurring within the past year has magnified the already pressing need to address the disparities in adequate care that have been put in place by racism and racial stress when working with Black older adults. As psychologists-in-training, we should engage in community outreach and provide psychoeducation about the compounded stress of Black older adults due to their intersecting identities (being Black and an older adult) for inclusion in terms of mental health awareness and needed intervention. When clinically working with Black older adults, we should seek consultation and/ or supervision from individuals who have worked with these clients and who can provide mentorship about how to address specific diversity considerations. Providing community resources such as a link to Black Mental Wellness, a website that offers ways to cope with COVID-19 related stress as well as racial stress, would be helpful to this population. As students and future psychologists, we can, in practice and research, work with Black older adults to develop and promote more culturally sensitive assessments and treatments to enhance the wellbeing of these vulnerable and underserved older adults.
References
Coley, S. L., Mendes de Leon, C. F., Ward, E. C., Barnes, L. L., Skarupski, K. A., & Jacobs, E. A. (2017). Perceived discrimination and health-related quality-of-life: gender differences among older African Americans. Quality of Life Research: An International Journal of Quality-of-Life Aspects of Treatment, Care and Rehabilitation, 26(12), 3449–3458. https://doi.org/10.1007/s11136-017-1663-9
Egede, L. E. (2006). Race, ethnicity, culture, and disparities in health care. Journal of General Internal Medicine, 21(6), 667–669. https://doi.org/10.1111/j.1525-1497.2006.0512.x
Himmelstein, M. S., Young, D.M., Sanchez, D. T., & Jackson, J. S. (2015). Vigilance in the discrimination-stress model for Black Americans. Psychology & Health, 30(3), 253-267
Zelner, J., Trangucci, R., Naraharisetti, R., Cao, A., Malosh, R., Broen, K., Masters, N., & Delamater, P. (2021). Racial disparities in coronavirus disease 2019 (COVID-19) mortality are driven by unequal infection risks. Clinical Infectious Diseases, 72(5), e88-e95.
References
Coley, S. L., Mendes de Leon, C. F., Ward, E. C., Barnes, L. L., Skarupski, K. A., & Jacobs, E. A. (2017). Perceived discrimination and health-related quality-of-life: gender differences among older African Americans. Quality of Life Research: An International Journal of Quality-of-Life Aspects of Treatment, Care and Rehabilitation, 26(12), 3449–3458. https://doi.org/10.1007/s11136-017-1663-9
Egede, L. E. (2006). Race, ethnicity, culture, and disparities in health care. Journal of General Internal Medicine, 21(6), 667–669. https://doi.org/10.1111/j.1525-1497.2006.0512.x
Himmelstein, M. S., Young, D.M., Sanchez, D. T., & Jackson, J. S. (2015). Vigilance in the discrimination-stress model for Black Americans. Psychology & Health, 30(3), 253-267
Zelner, J., Trangucci, R., Naraharisetti, R., Cao, A., Malosh, R., Broen, K., Masters, N., & Delamater, P. (2021). Racial disparities in coronavirus disease 2019 (COVID-19) mortality are driven by unequal infection risks. Clinical Infectious Diseases, 72(5), e88-e95.