Lived experience and trust · Other Considerations

Anti-Black racism remains a daily lived experience for African Americans across all classes, regions, and contexts. This is not history. It is current.

Forms

Police violence — Black Americans are killed by police at rates approximately 2.5 times white rates. Cases that have shaped contemporary consciousness include Trayvon Martin, Mike Brown, Eric Garner, Tamir Rice, Sandra Bland, Philando Castile (Falcon Heights, Minnesota), Daunte Wright (Brooklyn Center, Minnesota), George Floyd (Minneapolis), Breonna Taylor.

Mass incarceration — Black Americans are about 13 percent of the population and about 38 percent of the prison population.

Wealth gap — median Black household wealth is approximately one-eighth of median white household wealth.

Housing discrimination — redlining (historical), continued steering, predatory lending, gentrification.

Healthcare disparities — Black maternal mortality about three times the white rate; lower life expectancy; under-treatment for pain; mistrust grounded in Tuskegee, Henrietta Lacks, and ongoing experiences.

Educational disparities — under-resourced schools, harsher discipline, racialized tracking.

Employment discrimination — résumé-name studies; “Black tax” (extra effort required); double consciousness at work.

Microaggressions — daily slights, comments, assumptions.

Trauma and mental health

Racial trauma is real, accumulating, and intergenerational. Historical trauma — slavery, Jim Crow, lynching, the Tulsa Race Massacre (1921), countless others. Ongoing trauma — police killings, discrimination, anti-Black hate crimes. Vicarious trauma — through media exposure to anti-Black violence.

Cultural attitudes toward mental health: significant stigma, particularly in older generations — “Black people don’t go to therapy,” “give it to God,” “we got family.” Religious framing of mental health — depression as spiritual struggle, anxiety as faithlessness. Distrust of the healthcare system, grounded in real history. Concern about being labeled in ways that affect family, work, custody. Growing acceptance in younger generations — increasing therapy use, Black mental health advocacy, organizations like the Loveland Foundation and the Boris Lawrence Henson Foundation (Taraji P. Henson).

Race is relevant to mental health. Experiences of racism are real. Black or culturally competent providers — Therapy for Black Girls, Therapy for Black Men, the Association of Black Psychologists — matter when people want them. Church community, family, music, and ancestral practices are cultural strengths, not a substitute for care.

Follow law. Still see a family. Do not out anyone.

The Michigan Department of Health and Human Services African American Culture guide: there is a high incidence of diabetes, hypertension, heart disease, and obesity among African Americans. African Americans account for one-third of all patients receiving dialysis in the United States, three times the rate of whites.

Conditions

Black Americans have higher prevalence and worse outcomes in many conditions. Hypertension — affects about 55 percent of Black adults; earlier onset. Diabetes — about 13 percent prevalence; higher than the white rate. Heart disease and stroke — higher mortality. Kidney disease — three times the dialysis rate. Maternal mortality — about three times the white rate; Black women die in childbirth at devastatingly high rates regardless of income or education. Sickle cell disease — primarily affects the Black population; chronic and serious. HIV/AIDS — disproportionate impact. Cancer — higher mortality for prostate, breast, colorectal cancers. Mental health — under-diagnosed, under-treated. Infant mortality — Black infant mortality is about 2.3 times the white rate.

The trust gap

Mistrust of the healthcare system is real and well documented — rooted in historical abuses (Tuskegee Syphilis Study 1932–1972; Henrietta Lacks 1951; J. Marion Sims’s surgical experiments on enslaved women) and continued differential treatment. Black pain is famously under-treated. Believe reported pain. Listen to symptoms. Build trust over time. Family and faith leaders may be in the room if this family wants them. Referrals to Black or culturally competent providers when people want them. Faith-based and community resources when this family names them.

A rate is not the person. A physician, a nurse, and a patient in the same clinic can all be this page.

Black LGBTQ Americans navigate multiple, sometimes intersecting marginalizations: anti-Black racism, including within white-dominant LGBTQ spaces; homophobia and transphobia, including within some Black communities and some Black churches (though this is rapidly evolving); higher rates of HIV, violence (especially against Black trans women), and economic precarity.

Culture and gathering

Vibrant cultural production — ballroom culture (the Houses, voguing, Paris Is Burning, Pose); Black LGBTQ writers (James Baldwin, Audre Lorde, Essex Hemphill, Roxane Gay); artists and performers. Black Pride events exist in D.C., Atlanta, Philadelphia, Chicago, and other cities.

Use the name and pronouns. Outing someone to family or church is not culture. The people-page rule is the workplace rule.