Racial Disparities in Physical and Mental Health: The Consequences of White Supremacist Organizing, Public Confederate Monuments, and Exposure to Lethal Police Encounters

Abstract

Health disparities have existed in the United States between black and white Americans since indicators of morbidity and mortality were first formally recorded. This three-paper dissertation uses elements of the stress process, life course, and cumulative inequality theories to examine racial disparities population, mental, and cardiovascular health. Paper One uses county-level longitudinal data from ten southern states to assess the influence of the civil rights era Ku Klux Klan mobilization on nonwhite and white infant mortality rates between 1960 and 2000. Findings from fixed effects models show that Klan activity was associated with significantly higher nonwhite infant mortality rates over a decade after the Klan’s decline. The presence of Klan chapters in adjacent counties was associated with increases in white and nonwhite infant mortality from 1960 to 1970. Paper Two merges data from the 2015 Behavioral Risk Factor Surveillance System (BRFSS) with a census of Confederate monuments collected by the Southern Poverty Law Center to examine the relationship between Confederate monuments and the mental health of black and white residents. Findings show that black Americans on average report better mental health than white Americans. However, the mental health advantage in heavy drinking experienced by black Americans over white Americans is eliminated in states with greater numbers of Confederate monuments. Paper Three uses data from a crowdsourced collection of deadly police encounters—the Mapping Police Violence database—and from the 2017 BRFSS to examine the association between exposure to police officers’ use of lethal force against unarmed black Americans and the cardiovascular health of black and white Americans. Results from generalized multilevel models show that police killings of unarmed black Americans were associated with significant increases in the likelihood of hypertension and stroke among exposed black Americans but not among white Americans. The three extensions of white supremacy examined in these papers factor strongly into racial disparities in health.