Against a backdrop of the vote to leave the European Union, hostility towards migrants, and the growth in right-wing nationalist movements, racial discrimination is sadly on the rise in the UK. There is evidence that experiencing racial discrimination can negatively impact health. However, the majority of studies to date have been carried out in the US. The makeup of ethnic minority groups in the UK differs to that in the US, with those of South Asian backgrounds forming the largest minority group. Therefore, it is important to understand the extent to which racial discrimination impacts health in the UK-context.

People who reported racial discrimination were more likely to rate their health as poor and to suffer from a limiting longstanding illness at follow-up

Our study looked at over 4800 people who took part in the UK Household Longitudinal Study over a period of two years. One in five participants from an ethnic minority group reported racial discrimination (which included feeling unsafe, avoiding certain places, being insulted and being physically attacked). We found that these individuals were more likely to develop poorer mental and physical health after these experiences. Specifically, we found that perceived racial discrimination was associated with increased psychological distress and poorer mental functioning two-years later. Moreover, people who reported racial discrimination were more likely to rate their health as poor and to suffer from a limiting longstanding illness at follow-up, regardless of their health at the time of the discriminatory experience.

The study builds upon previous research which has mostly measured racial discrimination and health at the same time, meaning that establishing the direction of the relationship is difficult. Here we show that the experience of racial discrimination precedes the development of poorer health. One previous study linked racial discrimination with a deterioration in mental health in a UK sample. Our findings build upon this evidence and show that the negative effects of racial discrimination extend to physical health also.

Our findings suggest racial discrimination is a chronic stressor, that might bring about changes in stress-related biology and stress-related health behaviors

But how can experiencing racial discrimination lead to serious health outcomes? At the individual level, our findings suggest racial discrimination is a chronic stressor, that might bring about changes in stress-related biology and stress-related health behaviors (e.g. excessive alcohol intake) that can lead to poor health. Feeling discriminated against might also mean that people avoid engaging with health or well-being services perceived to be discriminatory. At the broader structural level, racial discrimination might negatively impact health through inequalities in healthcare and the unfair distribution of social determinants of health such as education, employment, and housing.

The issue of racial discrimination is one that has garnered increasing attention, particularly this year in the wake of the Black Lives Matters protests. The results of our study are concerning suggesting an enduring impact of experiences of racism on mental and physical health. They highlight the need to tackle racial discrimination – not only as a human rights issue, but as an issue that may also have a lasting legacy on health. We need to educate, raise awareness, and promote activism to bring about legislative and social change required to eliminate racial discrimination both in the UK and worldwide. We also need to target the structural macro-level forces that shape the position of ethnic minorities in society. More research is needed to understand the pathways linking racial discrimination and health in order to develop interventions and policy that can be used to tackle socio-political processes that promote racial discrimination.