What Explains Why White People Have Worse Mental Health?

Novel research offers some insight into an old paradox.

In 1989, the feminist scholar Peggy McIntosh wrote an essay titled “White Privilege: Unpacking the Invisible Knapsack.” McIntosh, who is white, described white people as carrying an “invisible package of unearned assets” that they can “count on cashing in each day.”

No matter what your station in life, your white skin color alone ensures that you have access to this “invisible weightless knapsack of special provisions, maps, passports, codebooks, visas, clothes, tools and blank checks.”

McIntosh went on to list some of these privileges, including items such as saying that if she goes to a music shop she can find music produced by people of her own race and and that she can find a publisher for material on white privilege.

The essay wasn’t very empirically sound the year it was written — was it really all that difficult to find music from non-white artists in the year 1989? — but the basic framework that she laid out became hegemonic among cultural progressives in the decades since it was written. (The fact that teaching people about white privilege may actually just make them less sympathetic to poor whites without helping anyone else doesn’t seem to be much of a deterrence.)

Although it’s hard to deny that having white skin color can sometimes be an advantage in some cases, the doctrine of white privilege tells us that it’s always an advantage in all cases. It’s impossible for any white person to not have white privilege, and it’s impossible for being white to actually be a disadvantage.

Of course, discussions about racial privilege are not normally about the benefits purely of having one skin color or another. If they were, we might acknowledge that, for instance, not having white skin is actually an enormous privilege when it comes to something like avoiding death from melanoma.

Instead, our conversations about race and privilege are typically about other things we’re using race as a proxy for, like culture or social class. We often assume that our culture generally makes you better off if you’re white. But what if that’s not always true?

For years we’ve known that there’s one huge area of life where white people are, on average, worse off than most of the rest of the population. While whites generally face fewer risks to their physical health and occupy a better socioeconomic status — they often have higher income than non-whites and have much less exposure to things like homicide — their mental health tends to be significantly worse when you compare like to like (that is, people in similar social circumstances even if their skin color is different).

The white suicide rate is several times higher than the Asian, black, or Latino suicide rate (if you adjust for age, the Native American suicide rate usually exceeds the white one by a bit). An interesting Brookings Institute study from a few years ago found that poor African Americans tend to be much more optimistic than poor whites are.

People who study these topics have deemed this gap the “black-white mental health paradox.” As one paper put it, “despite higher stress exposure, greater material hardship, and worse physical health, black Americans tend to experience similar or relatively lower rates of psychiatric disorders than whites.”

A recent study published in the Journal of Health and Social Research offers us some new explanations for why so many white people are at a disadvantage when it comes to mental health. The researchers looked at a large sample of African American and white Americans between the ages of 22 and 69 from Nashville, Tennessee and the surrounding area.

They looked at the mental health of these individuals along two different measures: Diagnostic and Statistical Manual of Mental Disorders-IV (DSM-IV) mental disorders and depressive symptoms. These are common measurements of mental health in the field.

They then sought to see if different coping mechanisms were associated with better mental health outcomes.

What they found is that black Americans reported higher levels of self-esteem, higher levels of religious attendance, family social support, and higher “sense of divine control” — for which they borrow the following definition from fellow researchers: the “individual perception that ‘God controls the good and bad outcomes in their lives…and that their fate evolves according to God’s will or plan for them.’”

Using causal mediation techniques, they find that self-esteem has “the largest effect in explaining black-white differences in depressive symptoms, whereas divine control has the largest effect in explaining differences in disorder.”

This study offers some insight into the question of why the group we’re often told is the most privileged in society suffers from some of the worst mental health outcomes. It’s possible that it’s not always so beneficial to be white. The paper above demonstrates that the distribution of things like self-esteem and religiosity among white Americans may be making it more difficult for them to cope with the stresses of life. Telling these people over and over that they have it so great and that they should shut up at best or repent at worst can be both counterproductive or cruel in light of these findings and the larger data we have on white mental health.

It also offers an opportunity for us to highlight the positive benefits of things like religious practice and positive self-image. It appears that some minority cultures have benefited from retaining a relatively high degree of religiosity while also inculcating self-esteem.

Far from being mere victims clinging to life rafts amongst a sea of white supremacy, many Americans from minority ethnic backgrounds have developed cultures of resilience. This resilience helps protect them against mental health problems; there’s no reason why everyone, regardless of skin color, can’t learn from that example. It is one area of American life where many minorities are better off than many white people, and where the former can play a role in helping the latter by highlighting positive culture and social practices that inculcate self-esteem and religiosity.

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