Colorism and Health Inequities among Black Americans: A Biopsychosocial Perspective

The mechanisms generating skin-tone-based health inequities among ethnic Black Americans remain poorly understood. To address this gap, our study advances a novel biopsychosocial model of embodied colorism-related distress. We test this model with survey and biomarker data from a community sample of working-age Black adults from Nashville, Tennessee (2011-2014; N = 627). Relying on self-rated, interviewer-rated, and discordant skin tone measures, our analyses reveal that Black adults who perceive themselves as dark-skinned tend to have a lower sense of mattering and shorter telomeres, a biomarker of accelerated cellular degradation and aging, relative to their peers who perceive their skin to be lighter. These patterns hold across various social contexts and regardless of interviewer-rated skin tone, indicating that subjective skin tone may be a particularly robust gauge of colorism-related stress processes. Our study reveals critical and previously unexplored biopsychosocial mechanisms linking colorism to health inequity.