Racism’s Impact on African American Seniors: Care Tips

4 min read

Recent killings of Ahmaud Arbery, Breonna Taylor, and George Floyd have renewed national attention on racial injustice and its devastating toll on Black lives. These events have also highlighted longstanding inequities in health and aging that disproportionately affect African American older adults.

As a geropsychologist based in Atlanta—a city with a deep history tied to slavery and the Civil Rights Movement—I work with many African American seniors who endured experiences such as indentured servitude, sharecropping, Jim Crow laws, disenfranchisement, and segregation. Those historical traumas, combined with current-day racism and violence, create cumulative race-related stress that profoundly harms both physical and mental health among older Black adults.

Health disparities are visible across many conditions. Some of the most striking examples include cardiovascular disease, cancer, dementia, and more recently, COVID-19:

Cardiovascular disease: Research indicates that African Americans face a significantly higher risk of dying from cardiovascular disease than Whites at the same age.
Cancer: Overall cancer mortality for African Americans is higher than for other racial and ethnic groups for many major cancers.
Dementia: Black adults are more likely to receive a diagnosis of dementia compared with White adults, and are often less likely to receive adequate information and education about the condition from providers.
COVID-19: Reporting has shown that nursing homes with substantial numbers of Black and Latino residents were more likely to be affected by COVID-19 than facilities with predominantly White residents, and African American deaths from COVID-19 have been higher than expected relative to population share.

Importantly, the higher rates of illness are not explained by race itself, but by the social, economic, and systemic factors linked to race. Health disparities research shows that risk factors contributing to disease frequently go unrecognized or untreated because of provider bias, institutional racism, and unequal access to quality care. This results in worse health outcomes and higher rates of illness and mortality among African American older adults compared with White counterparts.

Racism-related stress also takes a serious toll on mental health. Persistent exposure to discrimination and traumatic events contributes to depression, anxiety, sleep disturbances, post-traumatic stress disorder, and substance use disorders. For many older Black adults, reminders of past injustices—especially when amplified by current events and media coverage—can reactivate trauma and intensify symptoms.

What we can do

A recent report from the American Psychological Association Office on Aging recommends several practical steps for professionals working with older Black adults. These steps are relevant for clinicians, caregivers, community leaders, and organizations committed to equitable aging care:

Understand the impact of racism. Recognize that racism is a daily lived experience for many African Americans and that it intersects with other forms of discrimination—ageism, classism, sexism, ableism, and heterosexism. Consider how multiple identities shape each person’s perspective and needs.
Listen with empathy. Practice compassionate listening. Allow space for people to describe their experiences without minimizing or dismissing them. Validate feelings and offer support rather than shifting the conversation to politics or abstract debate.
Create safe spaces. Foster environments where conversations about race, culture, gender, sexuality, and socioeconomic background are welcomed. Use open-ended questions, show curiosity, and validate lived experiences instead of engaging in adversarial back-and-forths.
Support and strengthen resilience. Many older African Americans draw on faith, family networks, community ties, and a strong racial identity to cope with adversity. Encourage and build on these protective factors to promote healthy adaptation to stress and trauma.
Celebrate culture. Learn about and include activities that honor African American history, traditions, and cultural practices. Promoting cultural engagement enhances well-being and fosters pride and social connection.
Be mindful of triggers. Current events and media coverage of racial violence can be retraumatizing. Work with older adults to monitor exposure to media, identify triggers, and develop strategies to stay informed without becoming overwhelmed.
Increase self-awareness. Reflect on your own cultural background, assumptions, and potential biases. Tools such as implicit bias assessments can help identify unconscious attitudes. Pursue ongoing training in culturally competent geriatric care, with attention to race-related stress.
Refer to culturally competent mental health services. While many older African Americans have strong coping resources, some will need professional support. When mental health care is necessary, prioritize providers and services that understand cultural context and the history of limited access to care.
Advocate for equity. Systemic racism has limited access to education, jobs, health care, housing, and civic participation for many older African Americans. Advocate for policies and programs that expand access to resources and promote healthy aging and quality of life.

Addressing the cumulative effects of racism on health requires sustained commitment across clinical practice, public health, and community advocacy. By increasing awareness, improving culturally informed care, and working to remove structural barriers, providers and communities can help reduce disparities and support healthier, more dignified aging for African American older adults.

Dr. Regina Koepp is a contributing author for Psychology Today; this article was originally published on 6/8/20.