Attributing racial disparities to factors related to individuals (individual causes) or to societal factors (structural causes) is linked to attitudes toward racial equity policies. Membership in a dominant or subordinated racial group might shape these associations. Using the case of Black and White Americans' attributions for Black-White economic inequality, we investigated the association between distinct kinds of individual (i.e., innate factors, lack of motivation) and structural (i.e., discrimination, lack of educational opportunity) attributions and attitudes toward racialized policies. We used cross-sectional samples of non-Hispanic Black and White Americans from the 2016 (N = 2361) and 2018 (N = 1875) General Social Survey to examine these associations. Results show that Black Americans were more likely to make attributions to discrimination and individual factors than White Americans. Generally, structural attributions were associated with stronger support for policies aimed at addressing racial inequality, whereas individual attributions showed opposite associations. Effects varied by the kind of attribution and policy. Race moderated the effects of attribution on attitudes toward government spending and racist expression policies, but not affirmative action. These studies contribute to understanding how group position and attributions of racial inequality relate to policy preferences, which have implications for developing initiatives to improve policy support.

Prior meta-analyses reveal small-to-large associations between internalized racism (IR) and poor mental health among diverse ethnoracial groups. However, understanding this relationship among Asian Americans is critical given their unique U.S. history and distinct manifestations of IR, including endorsement of the model minority myth and colonial mentality. The current meta-analysis synthesized cross-sectional associations between IR and mental health among Asian Americans (k = 156; N = 12,480; 39 studies, 2006-2024). Results revealed statistically significant (p < .05) small and small-to-moderate positive correlations between IR and anxiety symptoms (r = .19), depressive symptoms (r = .26), psychological distress (r = .09), suicidal ideation (r = .23), and assorted poor mental health indicators (r = .17). IR was also weakly but significantly negatively associated with life satisfaction (r = -.06). IR was not significantly (p > .05) correlated with varied positive mental health indicators (r = -.06) or somatic distress (r = .03). Using a pooled mental health outcome, moderator analyses revealed stronger associations when IR was group-directed rather than self-directed, manifested as self-hatred or cultural and ethnoracial group inferiority rather than colonial mentality, and was negative rather than positive valenced. Tests of bias suggested that higher quality studies reported stronger associations with varied positive mental health, whereas smaller studies yielded larger effects for depression. Precision-Effect Test-Precision-Effect Estimate with Standard Errors and rank-correlation tests did not suggest bias across outcomes. These findings highlight that IR undermines psychological well-being among Asian Americans and underscore the need for culturally specific research to clarify causal mechanisms and inform clinical interventions. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

Community-based participatory research (CBPR) provides a collaborative framework for addressing health inequities through equitable partnerships, community engagement, and culturally responsive methods. Although widely used in public health and community psychology, CBPR's visibility within the core publication outlets of health psychology remains unclear. This review, inspired by the 2004 Journal of Health Psychology special issue on Community Health Psychology, examines the extent to which CBPR is represented and integrated within the institutional core of health psychology journals over the past two decades. We systematically searched for CBPR-related terms in 10 health psychology journals (e.g., Applied Psychology: Health and Well-being, Journal of Health Psychology) between 2004 and 2024. From the empirical articles identified, we determined whether CBPR was mentioned, discussed, or substantively implemented. For studies using CBPR methods, we coded engagement with nine core elements (e.g., community involvement in design). Of the 14,084 articles published between 2004 and 2024, 28 empirical articles mentioned CBPR without elaboration (~0.2%), 16 discussed CBPR concepts without implementing participatory methods (~0.1%), and 30 incorporated CBPR methods (~0.2%). Among studies incorporating CBPR, engagement varied considerably: on average, studies included 2.67 CBPR elements (SD = 2.99), with scores ranging from 0 to 8; the largest subset (n = 10; 33.3%) addressed only one element. These findings indicate a marked disconnect between the field's stated commitments to equity and the visibility of participatory approaches within its primary publication infrastructure. We conclude by identifying structural and conceptual factors that may limit CBPR's integration and outlining directions for advancing participatory approaches within health psychology.

Abstract Background Sexual minority men (SMM) of color face disproportionate risk for noncommunicable diseases (eg, hypertension) and associated risk factors (eg, substance use) due to intersecting ethnoracial and heterosexist stressors. Existing research often examines experiences of ethnoracial and heterosexist discrimination separately, thereby overlooking the distinct nature of intersectional discrimination. Purpose We used 2 independent samples of SMM of color to examine (1) the impact of intersectional discrimination on noncommunicable disease outcomes and risk factors above and beyond experiences of ethnoracial and heterosexist discrimination, and (2) whether effects differ by type of intersectional discrimination (racism in LGBT communities; heterosexism in POC [people of color] communities). Methods Study 1. Participants were 414 SMM of color from a large cohort study (Mage = 26.37). Study 2. Participants were 767 gay/bisexual men of color from a web-based survey (Mage = 30.67). Regressions examined the effect of intersectional discrimination on noncommunicable disease outcomes (eg, chronic illness) and risk factors (eg, substance use), controlling for socio-demographics and ethnoracial and heterosexist discrimination. Results Intersectional discrimination (Study 1), racism in LGBT communities (Study 2), and heterosexism in POC communities (Study 2) were uniquely associated with perceived stress and alcohol use. Racism in LGBT communities and heterosexism in POC communities were uniquely associated with self-reported body mass index (Study 2). Racism in LGBT communities was associated with illicit drug use (Study 2). Few significant findings emerged for disease outcomes. Conclusions Intersectional discrimination was associated with stress and health behaviors (eg, alcohol use), highlighting pathways that may increase chronic disease risk among SMM of color.

Internalized racism, although widely studied, remains conceptually fragmented and theoretically underdeveloped. I advance the Internalized Racism Process Model (IRPM), a process framework that conceptualizes internalized racism as a recursive, motive-driven system of self-regulation through which structurally organized ethnoracial hierarchy becomes embedded in psychological functioning. The IRPM specifies how structural conditions, sociocultural socialization, and identity processes converge to organize internalized racism. The model identifies a functional–motivational architecture in which needs for self-integrity and belonging give rise to three regulatory functions—threat minimization, ideological acceptance, and identity translation—that structure diverse forms of internalized racism and their behavioral enactments. Through recursive feedback loops, these processes stabilize into enduring patterns of self-regulation. The IRPM integrates previously fragmented literatures by distinguishing forms from manifestations, linking motives to regulatory functions, and specifying cross-level dynamics between structural contexts and individual regulation. It explains variability in who internalizes (via vulnerability and resistance resources), when internalization is likely (under conditions of threat and belonging pressure), and why consequences differ (as a function of form and configuration). Finally, the model specifies how strategies that provide short-term regulatory relief can consolidate into entrenched patterns that undermine psychological functioning. Although designed to generalize across hierarchically organized systems, the IRPM centers on internalized racism among subordinated groups, where empirical foundations are most developed, while also providing a framework for examining internalized racial dominance among advantaged groups. The IRPM offers a unifying account that advances explanation, generates testable predictions, and establishes an agenda for future research on the psychological organization of inequality.

This cross-sectional study examined the relationships among healthcare provider trust, social identity concordance (i.e. race, sex/gender, sexual orientation), internalized racism, everyday discrimination, and healthcare discrimination across four healthcare settings: dental, medical, mental, and vision. The study sample included Black American adults (Mean age = 37.68). Findings showed that, after accounting for demographic factors and identity concordance: (a) race concordance did not relate to provider trust, (b) sex/gender concordance was positively linked to trust in medical, mental, and vision healthcare providers, (c) sexual orientation concordance was associated with greater trust in dental and mental healthcare providers, (d) internalized racism and healthcare discrimination were associated with lower provider trust in all settings, and (e) everyday discrimination was negatively linked to trust in dental providers only. These results suggest identity concordance alone is insufficient in fostering trust in healthcare providers, highlighting the need for further research on addressing internalized and systemic racism.

Internalized racism refers to the process by which individuals from marginalized ethnoracial groups internalize and accept beliefs, attitudes, and stereotypes that reinforce the superiority of the dominant ethnoracial group and the inferiority of their own. Using theory-driven conceptualizations of internalized racism, we conducted the first meta-analysis examining its relationship with personal self-esteem. The analysis included k = 117 correlation effect sizes from 54 independent cross-sectional samples, involving 15,548 ethnoracial minority participants from 51 records published between 1982 and 2024. Findings revealed a statistically significant small-to-moderate negative correlation between internalized racism and self-esteem (r = -.22, p < .001). Moderator analyses showed that this association was stronger when internalized racism was self-directed rather than group-directed and when internalized racism manifested as self-hatred rather than the endorsement of negative group stereotypes and narratives. Results also revealed that studies with lower risk of bias yielded stronger effects, as well as mixed evidence of publication bias and little evidence of small-study bias. Critically, exclusive inclusion of cross-sectional studies in this meta-analysis limits causal interpretations, and it remains unclear whether low self-esteem leads individuals to internalize racism or vice versa. Additionally, since our meta-analysis included studies with only ethnoracial minorities, the extent to which these findings extend to ethnoracial dominant groups remains an open question. Collectively, these results offer a deeper understanding of the self-esteem-internalized racism relationship and emphasize the need for further research, particularly those involving non-U.S. populations and those using longitudinal designs. (PsycInfo Database Record (c) 2026 APA, all rights reserved).

We used meta-analytic structural equation modeling to test the internalized racism framework, which posits that internalized racism (IR) is associated with poor health directly and indirectly via stress processes and engagement in health-compromising behaviors. We synthesized correlation effects from 149 studies (141 reports, 38,650 participants, 1982-2024). IR was significantly (p < .05) positively associated with (a) psychological stress (k = 64, r = .18), (b) biophysiological stress (k = 18, r = .10), (c) engagement in health-compromising behaviors (k = 52, r = .16), (d) negative mental health (k = 330, r = .23), and (e) negative physical health (k = 31, r = .09) and significantly negatively associated with (f) positive mental health (k = 50, r = -.19) and (g) positive physical health (k = 14, r = -.08). IR was not associated with (h) overall health (k = 5, r = -.06). After adjusting for covariates (gender, age, ethnoracial group, publication year, peer-review status, and form and evaluative focus of IR), only the associations between IR with psychological stress and with negative mental health remained significant. The association between IR and negative mental health was partially explained by health-compromising behaviors, but not by psychological stress. There was mixed evidence of publication bias, and study quality only moderated the association between IR and positive mental health. Findings support an expanded internalized racism framework, the IR-stress-vulnerability model, which highlights bidirectional relationships among IR, stress, health-compromising behaviors, and health, with implications for addressing IR among minoritized ethnoracial groups. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

For interventions aimed at redressing health disparities in breast cancer to be effective, a clear understanding of the nature and causes of these disparities is required. Our questions were: what is the current evidence for ethnoracial disparities in time-to-treatment initiation and survival in breast cancer, and how are the causal mechanisms of these disparities conceptualized in the literature? A comprehensive systematic search of studies on cohorts of female patients with breast cancer diagnosed with stage I-III was performed. Directed acyclic graphs were used to describe implicit causal relationships between racial/ethnic group membership and time-to-treatment initiation and survival outcomes. This review revealed strong evidence for ethnoracial disparities in both time to treatment and survival among patients with breast cancer. Unmeasured factors identified by the authors highlighted gaps in data sources and opportunities for causal reasoning. Although the existing literature describes ethnoracial disparities, there is very limited discussion of causal mechanisms and no discussion of system-level rather than individual-level effects. Addressing established ethnoracial disparities in breast cancer requires new research that explicitly considers the causal mechanisms of potential interventions, incorporating unmeasured factors contributing to these disparities. Trial registration: PROSPERO identifier: CRD42023391901.

As a result of their intersecting race and sexual identities, gay and bisexual cisgender Black American men experience distinct forms of discrimination and internalized stigma that contribute to their disproportionate health burden. Espousing maladaptive health attitudes-such as reluctance to seek professional health care-may also contribute to these outcomes. In a cross-sectional online study, we examined the direct and indirect associations between two forms of intersectional discrimination-racism in the lesbian, gay, bisexual, transgender, and queer (LGBTQ+) community (LGBTQ+ racism) and heterosexism in racially marginalized communities (people of color heterosexism)-and attitudes toward seeking (a) psychological help, (b) medical help, and (c) HIV testing, via internalized heterosexist racism. Our sample included 281 cisgender gay and bisexual Black American men (M-age = 29.73). Results revealed no direct associations between both forms of intersectional discrimination and all three attitudes. However, internalized heterosexist racism explained the relationship between both forms of intersectional discrimination and (a) fears about HIV testing and (b) attitudes toward seeking psychological help: more experiences of intersectional discrimination were associated with greater internalized heterosexist racism, which was then associated with (a) greater fear about HIV testing and (b) greater reluctance toward seeking professional psychological help. Additionally, when considered in the same statistical model, people of color heterosexism was a stronger correlate of internalized heterosexist racism than LGBTQ+ racism. This study has implications for using the intersectionality framework to examine factors that influence health attitudes among cisgender gay and bisexual Black American men, contributing to the growing literature on discrimination and internalized stigma.

Black Americans experience stereotyping when receiving care, harming the therapeutic relationship and likely contributing to inequities in hypertension management. Although patients have described these experiences, there is limited understanding from clinicians’ perspectives. We conducted an Interpretive Description study with 30 Minnesota family medicine physicians between July and September 2023 to explore the assumptions associated with hypertensive Black patients, as perceived by the clinicians. Transcripts were analyzed and themes developed using thematic analysis with inductive and deductive approaches. Participants observed that they, or their colleagues (1) viewed Black patients as having hypertension that was more challenging to manage due to factors outside the clinicians’ control, and (2) changed their approach to Black patients’ hypertension management in response to assumed difficulty. Participants viewed Black patients as less willing and able to manage their hypertension due to mistrust and biological, behavioral, and social factors. Perceived barriers to hypertension management overlapped with what participants described as stereotypes of Black patients, and a few participants acknowledged that clinicians may convey their lower expectations of Black patients through disinvestment in their care. Participants viewed Black patients as having greater challenges with hypertension control due to factors that were seen as being indiscriminately assumed of these patients, potentially resulting in reduced clinician engagement. As such, clinicians must balance their knowledge of population-level disparities with an individualized approach to patient care. To reduce stereotyping of Black patients, it is crucial to pay closer attention to how population-level differences are discussed and applied.

The "tough Black man" is expected to be physically strong, emotionally restrictive, resilient, and self-reliant. However, to date, limited research has examined the correlates of endorsing beliefs about the "tough Black man" among Black U.S. American men. To address this gap, this research examines the sociodemographic (i.e., age, sexual identity, income, education, and relationship status), race-related (i.e., racial identity, internalized racism, everyday discrimination, and race stigma consciousness), and psychological (i.e., self-esteem, locus of control, resilience, and depression symptoms) correlates of endorsing "tough Black man" beliefs in an internet-obtained sample of 329 Black U.S. American men (Mean age = 37.22). Multiple regression analysis showed that a more positive racial identity, greater internalized racism, and higher race stigma consciousness-but not everyday discrimination experiences-were associated with greater endorsement of "tough Black man" beliefs. Multivariate regression results showed that greater endorsement of "tough Black man" beliefs was associated with greater resilience, greater internal locus of control, and more depression symptoms, but not self-esteem. Last, exploratory findings showed that endorsing beliefs about the "tough Black man" did not vary by age, income, education, relationship status, or sexual identity. This study has implications for understanding Black masculinities, along with the psycho-social and psychological correlates of internalizing intersecting race and gender stereotypes among Black U.S. American men. Together, our research provides the opportunity to expand knowledge about how internalized stigma processes, beliefs about Black manhood, and the social-structural factors that might explain it, contribute to poor health among Black U.S. American men.

Internalized racism is associated with adverse mental and physical health among Black Americans. Adding to this literature, this research examined two complimentary mechanisms that might explain these associations. The psychological weathering hypothesis tested the indirect effect of internalized racism on limited physical functioning via feelings of hopelessness. The physical weathering hypothesis tested the indirect effect of internalized racism on feelings of hopelessness via limited physical functioning. We also examined gender as a moderator. We recruited 778 Black American men (N = 329; Mage = 37.22, SDage = 13.35) and Black American women (N = 449; Mage = 37.96, SDage = 15.55) to participate in an anonymous web-based survey. Results showed that internalized racism was positively correlated with limited physical functioning and feeling of hopelessness, but that gender did not moderate either direct effect. In addition, results showed support for the psychological weathering hypothesis, such that greater internalized racism was associated with more feelings of hopelessness, which was then associated with greater limited physical functioning. Results also showed support for the physical weathering hypothesis, such that greater internalized racism was associated with greater limited physical functioning, which in turn was associated with more feelings of hopelessness. Gender did not moderate either indirect effect. These findings suggest that internalized racism is perhaps a source of race-based stress that might increase risk of adverse health via physical and psychological weathering processes. More research is needed to better understand and address internalized racism among Black American men and women.

Abstract Background While there have been notable improvements in the social conditions of sexual and gender identity minority individuals in Guyana, recent research has identified the persistence of structural heterosexism and discrimination, including the reluctance of the Guyanese government to repeal colonial-era “anti-gay” laws that govern sexual behavior. In this qualitative study, we employed a theoretical framework integrating the Social Determinants of Health, Well-being Domains Theory, and Intersectional Minority Stress Theory to explore the positive and negative experiences of individuals from sexual and gender identity minority groups residing in Guyana. Methods Four focus groups were convened that included adult non-heterosexual men, women and transgender persons (Total N = 45). The focus groups prompted discussions about participants’ experiences in various life domains, including social, interpersonal, vocational, healthcare, housing, public spaces, socio-political contexts, significant life events, and personal successes. We used thematic analysis to identify recurring patterns and themes in the participants’ discussions, providing a structured framework for understanding and interpreting their experiences in the specified life domains. Results Major positive themes included non-governmental organization support, family acceptance and healthy habit adoption to cope with stress. Negative themes included transportation inaccessibility, job discrimination, and lack of governmental support. Conclusion The Guyanese sexual and gender identity minority community is resilient and productive, despite enduring centuries-old social norms in Guyana that ostracize them. They have developed community resilience through the support of NGOs and past government initiatives, yet there remains a significant need for further efforts to achieve social parity. Collaborative initiatives involving both governmental and civil society organizations can play a vital role in dismantling the barriers.

Structural barriers, which impede access to healthcare, are often seen as tangible expressions of structural racism. Those who experience more structural barriers to healthcare access are likely to experience poor health. Expanding on this notion, our research integrated the Internalized Racism Framework (James, 2022) with the Structural Vulnerability Framework (Bourgois et al., 2017; Metzl and Hansen, 2014) to explore how encountering barriers to healthcare access influences healthcare seeking attitudes across four health domains: mental, medical, dental, and vision. Our study included a sample of 780 Black American adults (average age = 37.68) who were recruited to participate in an anonymous web-based cross-sectional survey. Our findings revealed that internalized racism explained the direct effect of healthcare access structural barriers on healthcare attitudes in the mental, medical, and vision health domains, but not in the dental health domain. Specifically, the experience of more structural barriers in accessing healthcare (mental, medical, and vision) correlated with heightened internalized racism, which, in turn, was associated with more negative attitudes towards seeking (mental, medical, and vision) healthcare. Notably, our results also showed variations in the frequency and types of structural barriers encountered across the four health domains, along with differences in participants' positive healthcare seeking attitudes. Our findings underscore an urgent need for targeted interventions addressing both structural and internalized racism. Removing healthcare access barriers is crucial for fostering equitable healthcare access for Black Americans. Future research should explore additional factors influencing healthcare seeking attitudes, as well as strategies that mitigate the negative effects of racism on said attitudes.

We introduce internalized heterosexist racism (IHR), or the internalization of damaging stereotypes, harmful beliefs, and negative attitudes about being a sexual minority person of color. We also present the initial development and validation of the Brief Internalized Heterosexist Racism Scale for gay and bisexual Black men (IHR-GBBM), a unidimensional, 10-item measure of IHR. Exploratory factor analyses on an internet-obtained sample of gay and bisexual Black men ( N = 312; Mean age = 30.36 years) show that the IHR-GBBM had evidence of good internal consistency, and good convergent, discriminant, concurrent, and incremental validity. The IHR-GBBM was positively correlated with internalized racism, internalized heterosexism, and discrimination (racist, heterosexist). IHR was also negatively correlated with race stigma consciousness, weakly positively correlated with sexual identity stigma consciousness, but not correlated with either race identity, sexual identity, or social desirability. Hierarchical regressions showed that the IHR-GBBM explained an additional variance of 2.8% and 3.1% in anxiety symptoms and substance use coping, respectively, after accounting for (1) sociodemographics, (2) internalized racism and internalized heterosexism, and (3) an interaction of internalized racism and internalized heterosexism. Older participants and those who were “out” about their sexual identity reported lower IHR. Those who did not know/want to report their HIV status reported greater IHR. Results revealed no sexual identity, sexual position, relationship status, income, education, or employment status differences in IHR. We hope the development of the IHR-GBBM spurs future research on predictors and consequences of IHR. We discuss limitations and implications for the future study of internalized heterosexist racism.

Scholars have documented harm associated with positive stereotypes about groups that experience inequality. We surveyed five samples from the United States to explore antecedents to dominant group endorsement of positive stereotypes about women, gay men, Asian Americans, Black Americans, and Native Americans. We found more liberal participants, and those with more close contact with members of these groups, were more internally motivated to respond without prejudice, which was then associated with greater endorsement of positive stereotypes about women, gay men, Black Americans, and Native Americans. In contrast, more conservative participants were more likely to believe in system legitimacy, which was then associated with greater endorsement of positive stereotypes about women and Asian Americans. We theorize that positive stereotypes are used by dominant group members in divergent ways, sometimes to legitimate inequality and other times with concern about inequality. The latter likely involves naivety regarding the harmful nature of positive stereotypes.

Rates of mental health symptoms, particularly anxiety and depression, have increased significantly in college students in the past decade along with utilization of mental health resources. The COVID-19 pandemic created an additional source of stressors to an already challenging landscape of college transition. COVID-19 has been associated with an increase of anxiety among college students, particularly first year students, entering college in Fall 2020. The shifts in policy (e.g., federal, state, and college) accruing medical data, and vaccine availability between Fall 2020 and Fall 2021 provide an opportunity to examine the role of COVID-19 experiences in the transition to college for these two first-year student cohorts. This study examined two cohorts of first-year students, Fall 2020 and 2021, to better understand the relationship between COVID-19 experiences, psychosocial correlates, and mental health symptoms. Results suggest that for students in our Fall 2020 cohort COVID-19 experiences played a distinct role in the prediction of mental health symptoms while in Fall 2021 COVID-19 experiences did not uniquely contribute to prediction of mental health symptoms. These findings have implications for mental health interventions for first-year students transitioning to college.