Google searches could unveil patterns in Black mortality rates across the US, according to a new University of Maryland study. Researchers found that those areas with greater levels of racism, as indexed by the proportion of Google searches containing the "n-word," had higher mortality rates among Blacks. The study, led by David H. Chae, assistant professor of epidemiology in the University of Maryland School of Public Health, is the first to examine an Internet query-based measure of racism in relation to mortality risk, and is published in the journal PLOS ONE.
"Racial disparities in health and disease represent a significant public health concern. Research suggests that racism is a major culprit that contributes to the gap in mortality between Blacks and Whites," said Chae. "Our study points to the utility of an Internet-search based measure to monitor racism at the area-level and assess its impact on mortality."
Most research examining the link between racism and health has relied on people self-reporting whether they had been the victims of racial discrimination. These measures, however, may not fully capture the extent of racism in a geographic area given that racist acts are often not committed overtly. "Contemporary forms of racism are more subtle, and people may not recognize that the social insults they experience are driven by discrimination or prejudice," Chae explained. "Discrimination is more insidious today. Racism in major societal domains, such as in housing, employment, and criminal justice contexts continues despite the existence of protective legislation."
Given the challenges in measuring racism through surveys, the researchers used a proxy measure previously developed by Seth I. Stephens-Davidowitz, co-author on the study, that was based on the volume of searches for the "n-word" ending in -er or -ers, not including those ending in -a or -as as such searches were shown to be used in different contexts. "Such Internet query-based measures may be less susceptible to self-censorship of socially unacceptable attitudes. They may also reflect those instances of racism that are covert or hidden," Chae explained. This measure does not necessitate that all searches containing the "n-word" are motivated by racism, or that all people holding racist attitudes conduct such searches. It only assumes that areas with a greater concentration of these searches have higher levels of racism overall. The researchers wanted to examine whether this measure would predict differences in Black mortality rates across the country.
They examined Black mortality rates in 196 media markets, which were compiled by the National Center for Health Statistics. Each one standard deviation increase in the level of area racism was related to an 8.2% greater all-cause Black mortality rate, which would be equivalent to over 30,000 deaths annually in the country. When they took into account additional demographic and socioeconomic characteristics of these areas, such as the number of Blacks, and levels of education and poverty, there remained a significant effect of area racism.
Because some geographic areas may be more prone to mortality regardless of race, the researchers also adjusted for the White mortality rate in their analyses. "By doing this, we are showing that it is not only associated with the Black mortality rate, but also the excess Black mortality rate relative to Whites," Chae explained. The researchers also found significant associations between the Google measure of area racism and Black mortality from three of the four leading causes of death in this population-heart disease, cancer, and stroke.
"Racism is a social toxin that increases susceptibility to disease and generates racial disparities in health," said Chae. Racism has been shown to increase the risk of disease and poor health outcomes through several channels. For example, institutional forms of racism lead to systemic disadvantage, and segregate Blacks into health-damaging environments. As a source of stress, racism also has direct effects on mental and physical well-being.
Chae acknowledges the need to examine data collected over longer periods of time and at smaller geographic units. He also notes that because the timeframe of the Google and mortality data overlap, conclusions about the direction of the associations they found and making inferences about causality are limited. Despite these caveats, Chae said that their findings offer avenues for future research on the health implications of racism that takes advantage of newer technologies, including social media-based measures. "These findings add to mounting evidence that population-level racial disparities in health are driven by racism," said Chae. "Racism represents a serious social and moral dilemma. The persistence of racial disparities in disease and mortality reflects the fact that issues of racism remain unresolved."
“Association Between an Internet-Based Measure of Area Racism and Black Mortality” was authored by David H. Chae, Sacoby M. Wilson, and Robert S. Gold (University of Maryland, College Park); Sean Clouston (Stony Brook University); Mark L. Hatzenbuehler and Bruce G. Link (Columbia University); Michael R. Kramer and Hannah L.F. Cooper (Emory University); and Seth I. Stephens-Davidowitz (Harvard University), and published in PLOS ONE. It is available at: http://dx.plos.org/10.1371/journal.pone.0122963.