health. Laboratory studies reveal that exposure to discrimination leads to cardiovascular and psychological reactivity (Anderson, 1989; Armstead et al., 1989; Dion, 1975; Pak et al., 1991). Two studies of Hispanic females note that self-reported experiences of discrimination are positively related to psychological distress (Amaro et al., 1987; Salgado de Snyder, 1987). Epidemiologic studies indicate that, at least under some conditions, racial discrimination is positively related to blood pressure among Blacks (Krieger, 1990; Krieger and Sidney, 1996). Similarly, two studies using national probability samples found that self-reports of discrimination are adversely related to both physical and psychological distress (Williams and Chung, in press; Jackson et al., in press). One recent study of a major metropolitan area found that discrimination made more of an incremental contribution to racial disparities in health than SES and, in combination with SES, completely explained racial differences in physical health (Williams et al., 1997).

Widespread negative societal stereotypes can adversely affect the health status of minority group members in that the stigma of inferiority can, for some, create certain expectations, anxieties, and reactions that affect motivation, performance, and psychological well-being. Research across a broad range of societies reveals that groups that are socially unequal have lower scores on standardized tests (Fischer et al., 1996). U.S.-based studies reveal that the performance of Black students on an exam is adversely affected when the stereotype of Black intellectual inferiority is made salient (Steele, 1992). This phenomenon is so robust that the performance of females is adversely affected when told in advance that they perform more poorly than men, and White men’s performance is negatively affected when they are contrasted with Asians (Fischer et al., 1996). Health researchers have also documented that among Blacks, there is a correlative relationship between mental and physical health problems and the endorsement of the dominant society’s negative stereotypes of Blacks. Taylor found that Blacks who believe that Blacks are inferior have higher levels of psychological distress and alcohol use (Taylor and Jackson, 1990; Taylor et al., 1991). Analyses of data from the National Study of Black Americans revealed that Blacks who endorse negative stereotypes of Blacks as accurate were more likely to report poorer physical and mental health than those who rejected those stereotypes (Williams and Chung, in press).

Research is needed to identify the mechanisms and processes that link location in social structure to health outcomes. Healthy People: The Surgeon General’s Report on Health Promotion and Disease Prevention (U.S.