Association of cultural racism with mental health outcomes among US adults during 2018–2021

Abstract

Cultural racism, the ideologies, values and systems that enable racial oppression, remains underexplored in relation to mental health. Using the Behavioral Risk Factor Surveillance System dataset between 2018 and 2021, we linked an empirical cultural racism factor derived from seven state-level indicators to mental health among 1,292,787 US adults (weighted 52.2% women); overall, 19.5% reported a history of depression, and respondents averaged 4.3 poor mental health days monthly. Here we show that each one unit (s.d.) increase in cultural racism factor was associated with higher risk for depression (3% overall; up to 25% among Native Hawaiian/Pacific Islanders) and poor mental health days (3% overall; up to 14% among Hispanics). Associations were strongest among racial minorities and adults under 65 years and did not differ significantly by sex. These findings suggest that cultural racism may contribute to psychological distress, underscoring the need for further research and policy action. In this study, the authors analyze data from 1,292,787 US adults, revealing that increased cultural racism factors correlate with heightened depression risk and poor mental health days, particularly among racial minorities, highlighting the urgent need for targeted interventions.