Environmental conditions that influence health, referred to as the social determinants of health, are driven by structural racism. Many of the social determinants lead to poor health outcomes. These include the conditions in which people are born, live, play, work and age. Racism and poverty/socioeconomic disadvantage are two social determinants that contribute to worse health outcomes in the U.S.

Robinson and his four siblings were raised by their mother after their father abandoned the family when Robinson was an infant. His mother worked long hours as a housekeeper. The Robinsons encountered racism as a Black family in a mostly white neighborhood, and they endured name-calling and taunts from neighbors, who summoned the police to their home without reason.

These traumatic events, including being abandoned by a parent and enduring verbal or physical abuse from others, are known as adverse childhood experiences, or ACES. ACES and other lifetime adversities can have negative effects on one’s health as an adult, leading to higher risk of conditions like depression and heart disease. Robinson’s childhood and adolescence increased his risk for poor health later in life.

Researchers have identified collective coping as as one of the key strategies Black Americans use to deal with racism-related stress. But Robinson did not have access to collective support from other Black baseball players until MLB teams slowly began signing Black athletes months after his debut with the Dodgers. He was carrying the burden alone, except for the support of his wife and Rickey, until other Black players were hired and Dodgers began openly supporting him.

Though Robinson’s illnesses were diagnosed in early adulthood, they could have had their roots in childhood. Adverse social and physical conditions as well as limited access to and poor quality of health care serve as barriers to illness prevention and treatment, limiting the ability to protect one’s health. Experiences of racial trauma and discrimination like those Robinson experienced are linked to smoking, unhealthy eating habits and alcohol use, decreased trust in health care providers, increased cardiovascular risks and negative cardiovascular outcomes.

Experiences of racism and discrimination are painful, sometimes daily, occurrences for many people of color. These include things like being followed in stores, receiving poor service in restaurants and being stopped by police.

We know that Robinson’s experience in the majors was not his first exposure to racism and discrimination. As a lieutenant in the U.S. Army, he sat next to a fellow officer’s wife on a bus at the Fort Hood, Texas base in July 1944. The woman was Black; however, her skin color was light. The bus driver was not pleased. He told Robinson to move to the back of the bus. Robinson refused. Robinson was shackled, arrested and court-martialed. Robinson later was acquitted and given an honorable discharge.

Over time, these repeated stressful episodes can lead to cardiovascular disease by increasing what is called allostatic load. When a person repeatedly experiences the stress of racism, high levels of the stress hormone cortisol are released in the body. Elevated cortisol can lead to high levels of blood sugar, as seen in diabetes, and high blood pressure. Robinson had both diabetes and high blood pressure after years of enduring what was likely a high allostatic load.

Some researchers believe allostatic load may be one reason why high blood pressure is more prevalent and more severe among Black Americans than White Americans.

The reasons for worse health among Black individuals goes beyond physiological responses to racism – it can be racism itself. Black patients also receive less frequent and poorer-quality health care than whites, even when severity of disease, quality of insurance, occupational status and level of education are controlled for.

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