Journal of Behavioral Medicine

, Volume 41, Issue 2, pp 208–220 | Cite as

Psychological pathways from racial discrimination to cortisol in African American males and females

  • Daniel B. LeeEmail author
  • Melissa K. Peckins
  • Justin E. Heinze
  • Alison L. Miller
  • Shervin Assari
  • Marc A. Zimmerman


The association between racial discrimination (discrimination) and stress-related alterations in the neuroendocrine response—namely, cortisol secretion—is well documented in African Americans (AAs). Dysregulation in production of cortisol has been implicated as a contributor to racial health disparities. Guided by Clark et al. (Am Psychol 54(10):805–816, 1999. doi: 10.1037/0003-066X.54.10.805) biopsychosocial model of racism and health, the present study examined the psychological pathways that link discrimination to total cortisol concentrations in AA males and females. In a sample of 312 AA emerging adults (45.5% males; ages 21–23), symptoms of anxiety, but not depression, mediated the relation between discrimination and total concentrations of cortisol. In addition, the results did not reveal sex differences in the direct and indirect pathways. These findings advance our understanding of racial health disparities by suggesting that the psychological consequences of discrimination can uniquely promote physiologic dysregulation in AAs.


Discrimination Cortisol Stress Health disparities Gender 



This research was supported by a Grant from the Eunice Kennedy Shriver National Institute of Child Health and Development (NICHD) (5T32HD079350-02) for the Daniel B. Lee. Melissa K. Peckins was supported by a Grant from the NICHD (2T32 HD007109-36).

Compliance with ethical standards

Conflict of interest

Daniel B. Lee, Melissa K. Peckins, Justin E. Heinze, Alison L. Miller, Shervin Assari, and Marc A. Zimmerman declare that they have no conflict of interest.

Human and animal rights and Informed consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.


  1. Abelson, J. L., Khan, S., Liberzon, I., & Young, E. A. (2007). HPA axis activity in patients with panic disorder: Review and synthesis of four studies. Depression and Anxiety, 24, 66–76. doi: 10.1002/da.20220/full CrossRefPubMedGoogle Scholar
  2. Adam, E. K., Heissel, J. A., Zeiders, K. H., Richeson, J. A., Ross, E. C., Ehrlich, K. B., et al. (2015). Developmental histories of perceived racial discrimination and diurnal cortisol profiles in adulthood: A 20-year prospective study. Psychoneuroendocrinology, 62, 279–291. doi: 10.1016/j.psyneuen.2015.08.018 CrossRefPubMedPubMedCentralGoogle Scholar
  3. Aiyer, S. M., Heinze, J. E., Miller, A. L., Stoddard, S. A., & Zimmerman, M. A. (2014). Exposure to violence predicting cortisol response during adolescence and early adulthood: Understanding moderating factors. Journal of Youth and Adolescence, 43, 1066–1079. doi: 10.1007/s10964-014-0097-8 CrossRefPubMedPubMedCentralGoogle Scholar
  4. Arbuckle, J. L. (1996). Full information estimation in the presence of incomplete data. In G. A. Marcoulides & R. E. Schumacker (Eds.), Advanced structural equation modeling: Issues and techniques. Mahwah, NJ: Lawrence Erlbaum Associates, Inc.Google Scholar
  5. Arnett, J. J., & Brody, G. H. (2008). A fraught passage: The identity challenges of African American emerging adults. Human Development, 51, 291–293. doi: 10.1159/000170891 CrossRefGoogle Scholar
  6. Assari, S., Smith, J. R., Caldwell, C. H., & Zimmerman, M. A. (2015). Gender differences in longitudinal links between neighborhood fear, parental support, and depression among African American emerging adults. Societies, 5, 151–170. doi: 10.3390/soc5010151 CrossRefGoogle Scholar
  7. Berger, M., & Sarnyai, Z. (2015). “More than skin deep”: Stress neurobiology and mental health consequences of racial discrimination. Stress, 18, 1–10. doi: 10.3109/10253890.2014.989204 CrossRefPubMedGoogle Scholar
  8. Bernard, D. L., Lige, Q. M., Willis, H. A., Sosoo, E. E., & Neblett, E. W. (2017). Impostor phenomenon and mental health: The influence of racial discrimination and gender. Journal of Counseling Psychology, 64(2), 155–166. doi: 10.1037/cou0000197 CrossRefPubMedGoogle Scholar
  9. Brooks, K. P., & Robles, T. F. (2009). Recent depressive and anxious symptoms predict cortisol responses to stress in men. Psychoneuroendocrinology, 34, 1041–1049. doi: 10.1016/j.psyneuen.2009.02.005 CrossRefPubMedGoogle Scholar
  10. Brown, T. N., Williams, D. R., Jackson, J. S., Neighbors, H. W., Torres, M., Sellers, S. L., & Brown, K. T. (2000). Being black and feeling blue: The mental health consequences of racial discrimination. Race and Society, 2(2), 117–131. doi: 10.1016/S1090-9524(00)00010-3 CrossRefGoogle Scholar
  11. Burke, H. M., Davis, M. C., Otte, C., & Mohr, D. C. (2005). Depression and cortisol responses to psychological stress: A meta-analysis. Psychoneuroendocrinology, 30, 846–856. doi: 10.1016/j.psyneuen.2005.02.010 CrossRefPubMedGoogle Scholar
  12. Bylsma, L. M., Morris, B. H., & Rottenberg, J. (2008). A meta-analysis of emotional reactivity in major depressive disorder. Clinical Psychology Review, 28, 676–691. doi: 10.1016/j.cpr.2007.10.001 CrossRefPubMedGoogle Scholar
  13. Chae, D. H., Epel, E. S., Nuru-Jeter, A. M., Lincoln, K. D., Taylor, R. J., Lin, J., et al. (2016). Discrimination, mental health, and leukocyte telomere length among african american men. Psychoneuroendocrinology, 63, 10–16. doi: 10.1016/j.psyneuen.2015.09.001 CrossRefPubMedGoogle Scholar
  14. Chrousos, G. P. (2009). Stress and disorders of the stress system. Nature Reviews Endocrinology, 5, 374–381. doi: 10.1038/nrendo.2009.106 CrossRefPubMedGoogle Scholar
  15. Clark, R., Anderson, N. B., Clark, V. R., & Williams, D. R. (1999). Racism as a stressor for African Americans: A biopsychosocial model. American Psychologist, 54, 805–816. doi: 10.1037/0003-066X.54.10.805 CrossRefPubMedGoogle Scholar
  16. Cohen, S., Schwartz, J. E., Epel, E., Kirschbaum, C., Sidney, S., & Seeman, T. (2006). Socioeconomic status, race, and diurnal cortisol decline in the Coronary Artery Risk Development in Young Adults (CARDIA) Study. Psychosomatic Medicine, 68, 41–50. doi: 10.1097/01.psy.0000195967.51768.ea CrossRefPubMedGoogle Scholar
  17. Dearing, E., & Hamilton, L. C. (2006). V. Contemporary advances and classic advice for analyzing mediating and moderating variables. Monographs of the Society for Research in Child Development, 71, 88–104. doi: 10.1111/j.1540-5834.2006.00406.x Google Scholar
  18. Derogatis, L. R., & Spencer, P. M. (1982). Administration and procedures: BSI manual I. Baltimore: Clinical Psychometric Research.Google Scholar
  19. DeSantis, A. S., Adam, E. K., Doane, L. D., Mineka, S., Zinbarg, R. E., & Craske, M. G. (2007). Racial/ethnic differences in cortisol diurnal rhythms in a community sample of adolescents. Journal of Adolescent Health, 41, 3–13. doi: 10.1016/j.jadohealth.2007.03.006 CrossRefPubMedGoogle Scholar
  20. Dickerson, S. S., & Kemeny, M. E. (2004). Acute stressors and cortisol responses: A theoretical integration and synthesis of laboratory research. Psychological Bulletin, 130(3), 355–391. doi: 10.1037/0033-2909.130.3.355 CrossRefPubMedGoogle Scholar
  21. English, D., Lambert, S. F., & Ialongo, N. S. (2014). Longitudinal associations between experienced racial discrimination and depressive symptoms in African American adolescents. Developmental Psychology, 50, 1190–1196. doi: 10.1037/a0034703 CrossRefPubMedGoogle Scholar
  22. Fekedulegn, D. B., Andrew, M. E., Burchfiel, C. M., Violanti, J. M., Hartley, T. A., Charles, L. E., & Miller, D. B. (2007). Area under the curve and other summary indicators of repeated waking cortisol measurements. Psychosomatic Medicine, 69(7), 651–659. doi: 10.1097/PSY.0b013e31814c405c CrossRefPubMedGoogle Scholar
  23. Fuller-Rowell, T. E., Evans, G. W., & Ong, A. D. (2012). Poverty and health the mediating role of perceived discrimination. Psychological Science, 23, 734–739. doi: 10.1177/0956797612439720 CrossRefPubMedGoogle Scholar
  24. Geronimus, A. T., Hicken, M., Keene, D., & Bound, J. (2006). “Weathering” and age patterns of allostatic load scores among blacks and whites in the United States. American Journal of Public Health, 96, 826–833. doi: 10.2105/AJPH.2004.060749 CrossRefPubMedPubMedCentralGoogle Scholar
  25. Graber, J. A., & Sontag, L. M. (2009). Internalizing problems during adolescence. In R. M. Lerner & L. Steinberg (Eds.), Handbook of adolescent psychology: Individual bases of adolescent development (3rd ed., Vol. 1). New Jersey: Wiley.Google Scholar
  26. Hankin, B. L., & Abramson, L. Y. (2001). Development of gender differences in depression: An elaborated cognitive vulnerability–transactional stress theory. Psychological Bulletin, 127(6), 773–796. doi: 10.1037/0033-2909.127.6.773 CrossRefPubMedGoogle Scholar
  27. Harrell, S. P. (1997). The racism and life experience scales (RaLES): Self-administration version. Unpublished manuscript.Google Scholar
  28. Hoggard, L. S., Hill, L. K., Gray, D. L., & Sellers, R. M. (2015). Capturing the cardiac effects of racial discrimination: Do the effects “keep going”? International Journal of Psychophysiology, 97, 163–170. doi: 10.1016/j.ijpsycho.2015.04.015 CrossRefPubMedPubMedCentralGoogle Scholar
  29. Hope, E. C., Hoggard, L. S., & Thomas, A. (2015). Emerging into adulthood in the face of racial discrimination: Physiological, psychological, and sociopolitical consequences for African American Youth. Translational Issues in Psychological Science, 1, 342–351. doi: 10.1037/tps0000041 CrossRefGoogle Scholar
  30. Hudson, D. L., Neighbors, H. W., Geronimus, A. T., & Jackson, J. S. (2016). Racial discrimination, John Henryism, and depression among African Americans. Journal of Black psychology, 42, 221–243. doi: 10.1177/0095798414567757 CrossRefPubMedPubMedCentralGoogle Scholar
  31. Hurd, N. M., Varner, F. A., Caldwell, C. H., & Zimmerman, M. A. (2014). Does perceived racial discrimination predict changes in psychological distress and substance use over time? An examination among Black emerging adults. Developmental Psychology, 50, 1910–1918. doi: 10.1037/a0036438 CrossRefPubMedPubMedCentralGoogle Scholar
  32. Jackson, J. S., Knight, K. M., & Rafferty, J. A. (2010). Race and unhealthy behaviors: Chronic stress, the HPA axis, and physical and mental health disparities over the life course. American Journal of Public Health, 100, 933–939. doi: 10.2105/AJPH.2008.143446 CrossRefPubMedPubMedCentralGoogle Scholar
  33. Jones, S. C., Lee, D. B., Gaskin, A. L., & Neblett, E. W., Jr. (2014). Emotional response profiles to racial discrimination: Does racial identity predict affective patterns? Journal of Black Psychology, 40, 334–358. doi: 10.1177/0095798413488628 CrossRefGoogle Scholar
  34. Kaholokula, J. K. A., Grandinetti, A., Keller, S., Nacapoy, A. H., & Mau, M. K. (2012). Association between perceived racism and physiological stress indices in Native Hawaiians. Journal of Behavioral Medicine, 35, 27–37. doi: 10.1007/s10865-011-9330-z CrossRefPubMedGoogle Scholar
  35. Kirschbaum, C., & Hellhammer, D. H. (1989). Salivary cortisol in psychobiological research: An overview. Neuropsychobiology, 22(3), 150–169. doi: 10.1159/000118611 CrossRefPubMedGoogle Scholar
  36. Klimes-Dougan, B., Hastings, P. D., Granger, D. A., Usher, B. A., & Zahn-Waxler, C. (2001). Adrenocortical activity in at-risk and normally developing adolescents: Individual differences in salivary cortisol basal levels, diurnal variation, and responses to social challenges. Development and Psychopathology, 13(3), 695–719. Retrieved from Scholar
  37. Lee, D. B., & Neblett, E. W. (2017). Religious development in African American adolescents: Growth patterns that offer protection. Child Development. doi: 10.1111/cdev.12896 Google Scholar
  38. Lee, D. B., Neblett, E. W., Jr., & Jackson, V. (2014). The role of optimism and religious involvement in the association between race-related stress and anxiety symptomatology. Journal of Black Psychology, 41, 221–246. doi: 10.1177/0095798414522297 CrossRefGoogle Scholar
  39. Lewis, T. T., Cogburn, C. D., & Williams, D. R. (2015). Self-reported experiences of discrimination and health: Scientific advances, ongoing controversies, and emerging issues. Annual Review of Clinical Psychology, 11, 407–440. doi: 10.1146/annurev-clinpsy-032814-112728 CrossRefPubMedPubMedCentralGoogle Scholar
  40. Loesch, D. Z., Hopper, J. L., Rogucka, E., & Huggins, R. M. (1995). Timing and genetic rapport between growth in skeletal maturity and height around puberty: similarities and differences between girls and boys. American Journal of Human Genetics56(3), 753. Retrieved from
  41. McEwen, B. S. (1998). Stress, adaptation, and disease: Allostasis and allostatic load. Annals of the New York Academy of Sciences, 840, 33–44. doi: 10.1111/j.1749-6632.1998.tb09546.x CrossRefPubMedGoogle Scholar
  42. McLaughlin, K. A., Hatzenbuehler, M. L., & Keyes, K. M. (2010). Responses to discrimination and psychiatric disorders among Black, Hispanic, female, and lesbian, gay, and bisexual individuals. American Journal of Public Health, 100, 1477–1484. doi: 10.2105/AJPH.2009.181586 CrossRefPubMedPubMedCentralGoogle Scholar
  43. Muthén, L. K. & Muthén, B. O. (1998–2012). Mplus user’s guide (7th ed.). Los Angeles, CA: Muthén & Muthén.Google Scholar
  44. Neblett, E. W., & Carter, S. E. (2012). The protective role of racial identity and africentric worldview in the association between racial discrimination and blood pressure. Psychosomatic Medicine, 74, 509–516. doi: 10.1097/PSY.0b013e3182583a50 CrossRefPubMedGoogle Scholar
  45. Pager, D., & Shepherd, H. (2008). The sociology of discrimination: Racial discrimination in employment, housing, credit, and consumer markets. Annual Review of Sociology, 34, 181–209. doi: 10.1146/annurev.soc.33.040406.131740 CrossRefPubMedPubMedCentralGoogle Scholar
  46. Pieterse, A. L., Todd, N. R., Neville, H. A., & Carter, R. T. (2012). Perceived racism and mental health among Black American adults: A meta-analytic review. Journal of Counseling Psychology, 59, 1–9. doi: 10.1037/a0026208 CrossRefPubMedGoogle Scholar
  47. Polanco-Roman, L., Danies, A., & Anglin, D. M. (2016). Racial discrimination as race-based trauma, coping strategies, and dissociative symptoms among emerging adults. Psychological Trauma: Theory, Research, Practice, and Policy, 8, 609. doi: 10.1037/tra0000125 CrossRefGoogle Scholar
  48. Powers, S. I., Laurent, H. K., Gunlicks-Stoessel, M., Balaban, S., & Bent, E. (2016). Depression and anxiety predict sex-specific cortisol responses to interpersonal stress. Psychoneuroendocrinology, 69, 172–179. doi: 10.1016/j.psyneuen.2016.04.007 CrossRefPubMedGoogle Scholar
  49. Richman, L. S., & Jonassaint, C. (2008). The effects of race-related stress on cortisol reactivity in the laboratory: Implications of the Duke lacrosse scandal. Annals of Behavioral Medicine, 35, 105–110. doi: 10.1007/s12160-007-9013-8 CrossRefPubMedPubMedCentralGoogle Scholar
  50. Rockett, I. R., Samora, J. B., & Coben, J. H. (2006). The black–white suicide paradox: Possible effects of misclassification. Social Science and Medicine, 63, 2165–2175. doi: 10.1016/j.socscimed.2006.05.017 CrossRefPubMedGoogle Scholar
  51. Pruessner, J. C., Kirschbaum, C., Meinlschmid, G., & Hellhammer, D. H. (2003). Two formulas for computation of the area under the curve represent measures of total hormone concentration versus time-dependent change. Psychoneuroendocrinology, 28(7), 916–931. doi: 10.1016/S0306-4530(02)00108-7 CrossRefPubMedGoogle Scholar
  52. Schmeelk-Cone, K. H., Zimmerman, M. A., & Abelson, J. L. (2003). The buffering effects of active coping on the relationship between SES and cortisol among African American young adults. Behavioral Medicine, 29(2), 85–94. doi: 10.1080/08964280309596061 CrossRefPubMedGoogle Scholar
  53. Shin, L. M., & Liberzon, I. (2010). The neurocircuitry of fear, stress, and anxiety disorders. Neuropsychopharmacology, 35, 169–191. doi: 10.1038/npp.2009.83 CrossRefPubMedGoogle Scholar
  54. Soto, J. A., Dawson-Andoh, N. A., & BeLue, R. (2011). The relationship between perceived discrimination and generalized anxiety disorder among African Americans, Afro Caribbeans, and non-Hispanic Whites. Journal of Anxiety Disorders, 25, 258–265. doi: 10.1016/j.janxdis.2010.09.011 CrossRefPubMedGoogle Scholar
  55. Stewart, E. A., Baumer, E. P., Brunson, R. K., & Simons, R. L. (2009). Neighborhood racial context and perceptions of police-based racial discrimination among black youth. Criminology, 47(3), 847–887. doi: 10.1111/j.1745-9125.2009.00159.x CrossRefGoogle Scholar
  56. Susman, E. J. (2006). Psychobiology of persistent antisocial behavior: Stress, early vulnerabilities and the attenuation hypothesis. Neuroscience and Biobehavioral Reviews, 30, 376–389. doi: 10.1016/j.neubiorev.2005.08.002 CrossRefPubMedGoogle Scholar
  57. Vreeburg, S. A., Zitman, F. G., van Pelt, J., DeRijk, R. H., Verhagen, J. C., van Dyck, R., et al. (2010). Salivary cortisol levels in persons with and without different anxiety disorders. Psychosomatic Medicine, 72, 340–347. doi: 10.1097/PSY.0b013e3181d2f0c8 CrossRefPubMedGoogle Scholar
  58. Williams, M. T., Chapman, L. K., Wong, J., & Turkheimer, E. (2012). The role of ethnic identity in symptoms of anxiety and depression in African Americans. Psychiatry Research, 199, 31–36. doi: 10.1016/j.psychres.2012.03.049 CrossRefPubMedPubMedCentralGoogle Scholar
  59. Williams, D. R., & Mohammed, S. A. (2009). Discrimination and racial disparities in health: Evidence and needed research. Journal of Behavioral Medicine, 32, 20–47. doi: 10.1007/s10865-008-9185-0 CrossRefPubMedGoogle Scholar
  60. Williams, D. R., & Mohammed, S. A. (2013). Racism and health I: Pathways and scientific evidence. American Behavioral Scientist. doi: 10.1177/0002764213487340 Google Scholar
  61. Zeiders, K. H., Doane, L. D., & Roosa, M. W. (2012). Perceived discrimination and diurnal cortisol: Examining relations among Mexican American adolescents. Hormones and Behavior, 61, 541–548. doi: 10.1016/j.yhbeh.2012.01.018 CrossRefPubMedPubMedCentralGoogle Scholar
  62. Zeiders, K. H., Hoyt, L. T., & Adam, E. K. (2014). Associations between self-reported discrimination and diurnal cortisol rhythms among young adults: The moderating role of racial–ethnic minority status. Psychoneuroendocrinology, 50, 280–288. doi: 10.1016/j.psyneuen.2014.08.023 CrossRefPubMedPubMedCentralGoogle Scholar
  63. Zhao, X., Lynch, J. G., & Chen, Q. (2010). Reconsidering Baron and Kenny: Myths and truths about mediation analysis. Journal of consumer research, 37, 197–206. doi: 10.1086/651257 CrossRefGoogle Scholar
  64. Zimmerman, M. A., & Schmeelk-Cone, K. H. (2003). A longitudinal analysis of adolescent substance use and school motivation among African American youth. Journal of Research on Adolescence, 13, 185–210.CrossRefGoogle Scholar

Copyright information

© Springer Science+Business Media, LLC 2017

Authors and Affiliations

  • Daniel B. Lee
    • 1
    Email author
  • Melissa K. Peckins
    • 2
  • Justin E. Heinze
    • 3
  • Alison L. Miller
    • 1
  • Shervin Assari
    • 3
  • Marc A. Zimmerman
    • 3
  1. 1.Center for Human Growth and DevelopmentUniversity of MichiganAnn ArborUSA
  2. 2.Department of PsychologyUniversity of MichiganAnn ArborUSA
  3. 3.Department of Health Behavior and Health Education, School of Public HealthUniversity of MichiganAnn ArborUSA

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