If researchers produced a study finding that poor and minority people tend to be more likely to have health problems and die at a younger age, it probably wouldn’t be published in a leading medical journal or covered with articles in national newspapers. It would rightly be seen as a restatement of the well-known, sad reality that for a variety of reasons poor and minority people tend to have worse diet and exercise and are more likely to use drugs and alcohol, contributing to worse health and earlier death.
But if researchers relabel the problems poor and minority people experience as “cumulative lifespan stress” and suggest those problems are the result of “systemic and explicit discrimination,” those same banal observations can earn a spot in one of the American Medical Association’s top journals and be covered in The Washington Post under the headline: “New evidence shows how discrimination shortens lives in Black communities.”
To be clear, the study published in JAMA Network Open does not demonstrate in any way that discrimination shortens lives in black communities. All it does is show that five measures, which they combine and call “cumulative lifespan stress,” are correlated with indicators of inflammation and are also correlated with dying younger. They also observe that black subjects scored higher on the index they called “stress,” had higher measures of inflammation, and also tended to die at an earlier age. The study’s research design does not allow them to identify whether the five measures they combine and label as “stress” caused inflammation or earlier death, nor can their study exclude whether other factors that they did not examine could have caused both the measures of inflammation and dying at a younger age.
Let’s consider the five measures the researchers use as an index for the physiological stress over one’s life to see how weak the study’s research design is. To capture this cumulative lifespan stress, researchers surveyed study participants to collect information on “(1) childhood maltreatment[…], (2) adult lifetime trauma exposure[…], (3) researcher-verified stressful life events[…], (4) discrimination[…], and (5) indices of socioeconomic status.”
The researchers combine these five measures into a single indicator that they call “cumulative lifespan stress,” but it is far from clear that these five measures actually capture physiological stress. In fact, many of these five measures include information on health problems or factors that could contribute to health problems. For example, the survey used to capture “adult lifetime trauma exposure” includes measures of whether subjects had “experienced a life threatening illness,” “experienced a miscarriage,” and was involved in an accident or otherwise received a serious injury. The measure of “stressful life events” includes information on serious illness or injury and whether a close relative had died.
These health challenges may be stressful, but it would be highly misleading to conclude that the stress associated with serious illnesses caused people to die at a younger age as opposed to the illnesses themselves. The researchers never control for the actual illnesses that subjects have when examining the correlation between their “cumulative lifespan stress” measure and the probability of early death. A subject could have chronic diabetes, uncontrolled blood pressure, or cancer and the researchers would conclude that they died of stress rather than these various diseases.
It is also important to note that only one of the five measures that they claim capture stress includes indicators of discrimination. And that measure asks whether subjects believe they had been treated “unfairly” in employment, housing, or other matters for a variety of reasons, only one of which is race. To conclude that this information, which is part of one of five measures that collectively are associated with early death, means that “discrimination shortens lives” would be completely irresponsible.
The reason this shoddy research receives such favorable treatment by a leading medical journal and alarmist coverage from national newspapers is that people wish to advance a political argument blaming racism for higher rates of health problems and early death in the black community. But nothing in this research demonstrates societal discrimination is to blame. By failing to control for the health challenges associated with diet, exercise, and alcohol and drug use, and by falsely relabeling reports of serious illness or risks of getting serious illnesses as “cumulative lifespan stress,” the study is attributing to racism what could easily be explained by medical comorbidities, individual choices, and community dysfunction.
If you are wondering who is paying for this shoddy research, the answer is you are.
Taxpayers funded this research through grants awarded by the National Institute on Aging, the National Science Foundation, and the National Institute on Alcohol Abuse and Alcoholism. The last source of funding is particularly ironic since the study did not examine the obvious possibility that alcohol abuse could be part of the explanation for the results they observe. It’s bad that the American people must be falsely blamed for causing their black neighbors to die because of stressful discrimination, but even worse that they have to pay for such chicanery. Perhaps paying to be falsely blamed is also dangerously stressful.
