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Background <p>Racial Trauma Health Theory (RTHT) posits that multiple, intersecting forms of racism—structural, interpersonal, and internalized—across key domains such as housing, healthcare, education, and employment, accumulate causing multiplicative effects on health over time through both direct and indirect social and emotional pathways.</p> Objective <p>Employing path analysis, we translate a theoretical framework into a statistical model to evaluate the significance of key pathways and empirically test the application of data to RTHT.</p> Methods <p>The study is a secondary data analysis of the Black sample from years 7,15, 20, and 30 of the CARDIA Study. We constructed a four-stage Structural Equation Model (SEM) based on theoretical assumptions of the RTHT and previous empirical research.</p> Results <p>The statistical model showed a good fit to the theoretical model based on multiple fit indices. The R<sup>2</sup> values indicate modest proportions of the explained variance for general health and emotive factors. Although racism has no direct effect on general health, through the path X-M1-M2-Y indicated by the theory, it has a significant negative indirect effect on general health. Every standard deviation increase in racism will lead to a 0.020 standard deviation decrease in general health (<i>p</i>&lt;.05) indirectly. According to the model, every standard deviation increase in racism leads to a standard deviation increase of 0.177 in adverse social outcomes. Every standard deviation increase in adverse social outcomes leads to a 0.585 standard deviation increase in emotive responses and a 0.134 standard deviation decrease in general health. Every standard deviation increase in emotive responses leads to a 0.191 standard deviation decrease in general health.</p> Conclusions <p>Our analysis emphasizes the importance of indirect pathways between exposure to racism and poor health through adverse social and emotional outcomes. These findings not only highlight racism as a fundamental driver of health disparities in African Americans but they illuminate social and emotional mechanisms through which racism operates to adversely affect health outcomes in African Americans. This has critical implications for mental health services and community-level interventions aimed at addressing racial oppression.</p>

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Mapping Social and Emotional Pathways from Racism to Adverse Health: Applying Racial Trauma Health Theory to the Coronary Artery Risk Development in Young Adults (CARDIA) Study

  • 期刊论文

  • 发表日期：

    2026年4月22日

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  • Raja Staggers-Hakim,
  • Pu Zhao

摘要

Background

Racial Trauma Health Theory (RTHT) posits that multiple, intersecting forms of racism—structural, interpersonal, and internalized—across key domains such as housing, healthcare, education, and employment, accumulate causing multiplicative effects on health over time through both direct and indirect social and emotional pathways.

Objective

Employing path analysis, we translate a theoretical framework into a statistical model to evaluate the significance of key pathways and empirically test the application of data to RTHT.

Methods

The study is a secondary data analysis of the Black sample from years 7,15, 20, and 30 of the CARDIA Study. We constructed a four-stage Structural Equation Model (SEM) based on theoretical assumptions of the RTHT and previous empirical research.

Results

The statistical model showed a good fit to the theoretical model based on multiple fit indices. The R2 values indicate modest proportions of the explained variance for general health and emotive factors. Although racism has no direct effect on general health, through the path X-M1-M2-Y indicated by the theory, it has a significant negative indirect effect on general health. Every standard deviation increase in racism will lead to a 0.020 standard deviation decrease in general health (p<.05) indirectly. According to the model, every standard deviation increase in racism leads to a standard deviation increase of 0.177 in adverse social outcomes. Every standard deviation increase in adverse social outcomes leads to a 0.585 standard deviation increase in emotive responses and a 0.134 standard deviation decrease in general health. Every standard deviation increase in emotive responses leads to a 0.191 standard deviation decrease in general health.

Conclusions

Our analysis emphasizes the importance of indirect pathways between exposure to racism and poor health through adverse social and emotional outcomes. These findings not only highlight racism as a fundamental driver of health disparities in African Americans but they illuminate social and emotional mechanisms through which racism operates to adversely affect health outcomes in African Americans. This has critical implications for mental health services and community-level interventions aimed at addressing racial oppression.