Do Racist Attidues Harm The Community Health Including Both the Victims and Perpetrators?- Multilevel Survival Analysis

Many studies have focused on whether racism harms the health of targeted individuals. However less is known about whether and how racial prejudice harms the health of all community members including those who harbor such prejudice across time. The aim of this study is to examine racism as a risk factor harmful for the health of communities within which it occurs. We used data from the 1985-2002 General Social Survey (GSS), a representative sample of the U.S. non-institutionalized population that included questions about racist attitudes towards blacks. We prospectively linked the GSS data to mortality data through 2008 via the National Death Index (NDI) and assessed the effect of racial prejudice on all-cause mortality of individuals above age 18 nested within 384 U.S. Primary Sampling Units using multilevel models and age-period-cohort models. The study reveals that both black and white individuals living in communities with higher levels of racial prejudice had increased mortality rates compared to residents living in communities with less racial prejudice. This association was robust to controls for other individual- and community-level socio-economic characteristics.