The Health Divide: Racist language gets under the skin and erodes health
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(Photo by Jonathan Brady/PA Images via Getty Images)
Published on
April 20, 2026
The first time a white person used the N-word against me was in fourth grade, and 49 years later, I still remember it clearly.
It happened during recess in late January 1977, while some of us were trying to make a snowman on the playground. My friend Scott — who was white — got angry because I didn’t want to throw the football with him, and he told me to “stop acting like a (N-word).”
I was shocked and pushed him to the ground. We weren’t friends after that.
Scott, like most of us, had watched the miniseries “Roots,” which aired on ABC over eight consecutive nights. This series, based on Alex Haley’s 1976 novel, followed the story of an African American family from 18th-century West Africa through slavery.
I wish it were the last time someone used that word against me, but it wasn’t. I heard that word directed at my parents when we first moved into our neighborhood when I was 7. I encountered it again while spending my childhood summers with my grandparents in Mississippi, and I continued to hear it throughout my adolescence and adulthood. As a reporter tackling issues of race, I still occasionally receive emails from people using the N-word, as well as calling me names like "monkey," "ape," and other racist terms.
Recently, social media influencer Amber Rose, who identifies as biracial, said in an interview that she believes white people should be allowed to use the N-word. The model, actress, and television personality explained that when we stop caring about harmful words, we will stop hurting each other. She also noted the difference between using the word to cause harm and using it as a term of endearment in some parts of the hip hop and rap communities.
Such views miss an important point: Racism is a serious public health issue in the United States, and the use of racial slurs and hate speech raises bigger questions about racist language and its effects on the health of Black and Hispanic people.
The N-word is more than just a word. It is historically linked to enslavement, violence, dehumanization, and systemic oppression. When people outside the Black community use it casually or deliberately, it can trigger racial trauma and chronic stress, which is linked to anxiety, depression, and symptoms like post-traumatic stress disorder (PTSD). Regular encounters with racism, even in language, can increase cortisol levels, a stress hormone.
Racism affects health outcomes
The N-word has been used as a slur against Black people for over a century and continues to symbolize racism. It was so reviled by the Black community that the NAACP held a public funeral for it during its annual convention in 2007.
During this ceremony, Black leaders and Black church leaders urged the entertainment industry and the American public to stop using the N-word and other racial slurs.
Allowing white people unrestricted use of the N-word, like Amber Rose advocates, isn’t just about free speech — it’s about power, history, and consequences. From a public health perspective, it can increase psychological stress, normalize harmful biases, undermine trust in vital systems like healthcare, and worsen mental and physical health disparities.
Allowing white people to use racist language and hate speech freely can contribute to the stress experienced by Black individuals. This stress, sometimes referred to as “weathering,” can result in accelerated aging and increased susceptibility to chronic diseases. The continuous exposure to racism prevents the body and mind from finding relief, according to Arline T. Geronimus, a public health researcher and professor at the University of Michigan, who introduced this hypothesis in 1992.
Geronimus, who has spoken to health journalists taking part in the Center for Health Journalism’s fellowship programs, has long highlighted the profound effects of persistent racism and the threats people face as a result. These threats can include living in dangerous neighborhoods, facing harassment from law enforcement, struggling to gain financial stability, and enduring ongoing slurs and racism. Such experiences can trigger a person’s fight-or-flight response, which releases stress hormones that raise the heart rate and thicken the blood to protect against injury.
Over time, this constant physiological stress leads to faster aging and shorter life expectancy for those affected.
Personally, I am acutely aware of the impact that racism has had on me throughout my 56 years of life. I can vividly recall the countless times I've encountered it, and even now, thinking about those experiences often elicits a strong emotional response within me.
Focus on systems
Reporters play a crucial role in shaping how the public understands that racism is not just a social issue but also a public health issue. When framed effectively, such work can highlight harm, influence policymakers, and improve outcomes in affected communities.
Part of that work entails linking racism to measurable health outcomes such as hypertension, infant mortality, and the reluctance of individuals to seek medical care due to feeling mistreated. Reporters can also explain how the cumulative experience of racism can induce chronic stress and lead to unequal treatment.
The best way to frame these stories can be to focus on systems rather than individual racist language or behavior. Incidents of racism often attract immediate attention and should certainly be called out, but investigating deeper systemic issues — often referred to as “structural racism” — can yield compelling stories that drive societal change.
For instance, how does hospital quality differ by ZIP code? Are grocery stores and pharmacies concentrated in more affluent neighborhoods? If so, why is that the case? Investigating how implicit bias in health care settings affects pain management or diagnosis rates can reveal patterns that harm not only individuals but entire communities.
Such bias can have profound and detrimental effects on both patient safety and the overall trust in medical institutions. When such treatment becomes commonplace, it can create an environment where Black patients feel marginalized, disrespected, and unsafe.
In a 2023 survey from KFF on racism, discrimination, and health, 18% of Black adults said they had been treated unfairly or with disrespect by a health care provider in the past three years because of their race or ethnicity, and 24% said they had experienced at least one negative health care encounter in which race or ethnicity was a factor.
And while data is important, connecting that data with human stories — like my fourth grade experience — makes these narratives difficult to ignore. Community voices paint a fuller picture of the data points, and their stories can go a long way in breaking down barriers and showing what it’s like to live within flawed systems.