As noted, the experience of self-reported discrimination is not a magic bullet that captures all of the psychosocial stressors necessary to estimate the contribution of racism-generated stressors to disparities in health. Perceived discrimination is only one way by which racism generates stress. Institutional discrimination can generate multiple stressors that can adversely affect health. For example, institutional discrimination in employment and residential contexts can trigger elevated exposure to traditional stressors, especially those linked to social and economic deprivation, including unemployment and underemployment. A large federal survey found that even after adjustment for a broad range of demographic, SES, and health status factors blacks were more likely than whites to report six economic hardships (unable to meet essential expenses, pay full rent or mortgage, pay full utility bill, or had utilities or telephone shut off or was evicted from one’s apartment; Bauman 1998). Similarly, because of the distinctive residential environments created by segregation, racial minorities are also exposed to elevated levels of neighborhood stressors and violence. Taking institutional discrimination seriously will require renewed focus on racial differences in traditional stressors: violence, criminal
