Understanding Black grief as a health disparity

The average life span for Black Americans is 78 years—six years shorter than it is for white Americans. Compared with white Americans, Black Americans are twice as likely to die of heart disease, 50% more likely to have high blood pressure and are likelier to die at earlier ages of all causes.

Health disparities in the Black community are well documented, but what’s less well understood is the emotional toll those dire statistics have on Black Americans, who may be losing loved ones more frequently and at younger ages.

With Black Americans leading shorter and sicker lives, it’s likely they are also experiencing grief more often and earlier in life, making bereavement a health disparity of its own, suggests new University of Arizona research published in Frontiers in Psychiatry.

And that grief may be accompanied by additional physical and mental health challenges. In the short term, grief can be associated with increased inflammation, high blood pressure and lowered immunity. In the long term, it may contribute to cardiovascular problems, difficulty sleeping and unhealthy coping mechanisms.

But personal losses are just one source of grief for Black Americans, say researchers Da’Mere Wilson and Mary-Frances O’Connor with the Grief, Loss and Social Stress Lab in the Department of Psychology in the UArizona College of Science.

In their paper, Wilson and O’Connor write that to understand the unique experience of Black loss, grief and bereavement, it’s also necessary to consider the collective grief Black Americans have suffered as the result of America’s long history of racialization and racial violence. That collective grief continues to be felt today, Wilson said, especially with high-profile cases of racial violence—such as the 2020 murder of George Floyd by a white police officer—repeatedly making headlines.

“Personal loss is a domain where the loss is more of an individual experience, like losing a loved one, whereas collective loss is more of an experience that happens communally,” said Wilson, a doctoral student in psychology. “The George Floyd murder is a good example. It was a personal loss for his immediate family and friends, but it was also a collective loss, in that many Black Americans looked at George Floyd as someone who could be their uncle, could be their brother or could be them.”

Collective grief isn’t often the primary focus of grief research, but it may be a critical component of the Black grief experience, which has been understudied in psychology, Wilson said.

“We have a narrow definition of grief that doesn’t account for more collective losses,” she said. “Collective bereavement, along with personal loss, may have this additive effect of creating a unique experience of loss and grief in the Black American community that isn’t showcased in research so far, because of a lack of representation of Black Americans in research.”

A historical context for collective grief

In their paper, Wilson and O’Connor write that to better understand Black grief, a historical perspective is necessary—one that takes into account the racialization of Black people in America, which has been marked by enslavement, structural inequality, historical and ongoing racial violence, and staggering amounts of loss, including loss of loved ones and community members, loss of land and loss of a sense of safety. All of that contributes to a much more complex picture of grief than is found in existing literature.

In colonial times, enslaved Black Americans were routinely, often violently, separated from their spouses, children and families, while also made to witness violent acts inflicted on other enslaved people. In the Jim Crow era, Black people were regularly beaten or hanged publicly. While it may be tempting to consider these as dark, long-ago chapters in history, it’s critical to recognize the lingering effects of past trauma, Wilson said, as these past experiences help explain why collective grief remains so prevalent in the Black community today.

When the enslaved were torn from their families, they often formed familial bonds, or “fictive kinship,” with one another, seeing each other as brothers and sisters, and aunts and uncles, Wilson said. Fictive kinship continues to some degree in the Black community today, she said.

“Black American community-family ties are much looser, in the sense that we’re more apt to call Black strangers ‘sister’ or ‘brother’ or ‘auntie,’ and this stems from times during enslavement where people were removed from their family of origin, so they might have been ‘adopted’ by the people where they ended up,” Wilson said. “That’s morphed over time to becoming a broader practice in the Black community.”

That sense of kinship is part of why deaths like George Floyd’s are felt so deeply, Wilson said.

“This aptness to look at each other as kin is part of why collective loss is a particular thing in the Black community,” she said. “With George Floyd, you almost feel for him as if he’s family and feel that loss very deeply because of your own ethno-racial identity. There’s also this piece of linked fate and the idea that, ‘What if what happened to George Floyd could happen to me?’ It’s the idea that because of our shared identity, we share the same fate.”

COVID has illuminated grief as a health disparity

In the same year that Floyd was murdered, Black Americans were also suffering disproportionate losses to COVID-19.

“Grief has not been equally distributed during the pandemic,” Wilson said. “Black Americans are almost twice as likely to lose someone to COVID.”

“We were starting to narrow the Black-white life expectancy gap, and it seems that COVID has erased all that progress,” said O’Connor, an associate professor of psychology and author of the book “The Grieving Brain: The Surprising Science of How We Learn from Love and Loss.”

O’Connor said grief research often fails to consider the number of losses a person has experienced and how that might impact one’s health.

“We know that Black Americans are experiencing more deaths of close relatives, and we know that losing three or more loved ones shows up in the thickening of the arteries. So why aren’t we asking how many loved ones have you lost?” she said. “That’s a piece of data that’s just completely missed in the research.”

Wilson and O’Connor say better understanding the unique experience of Black grief could also be relevant for other marginalized communities whose experiences may not be reflected by existing research.

“We have such low representation of Black people in grief research, and because of the kinds of questions we’re asking, we haven’t really captured what the experience is like for this community,” Wilson said. “That could also have far-reaching effects to other communities that have been marginalized and may have experienced grief on a similar level, such as Indigenous populations.”