The Paradox of White Americans’ Mental Health

Are White Americans’ poor mental health outcomes caused by Whiteness?


Although White Americans fare better than other racial groups on a number of health outcomes (e.g. infant mortality, age-specific mortality), their poorer performance on several mental health indicators raises intriguing questions. A forthcoming article in Social Science and Medicine presents a new framework which conceptualizes Whites’ health outcomes as a function of Whiteness and the U.S. racial system.

Sociologist Jennifer A. Malat of the University of Cincinnati and two colleagues developed a framework that accounts for the role of Whiteness in White Americans’ health. The authors define Whiteness as “a system that socially, economically, and ideologically benefits European descendants and disadvantages people in other groups.”

Photo Credit: Neil Moralee, “Burnished metal and beards.” Flickr

In developing their framework, Malat and her team used a social-determinants of health approach, which focuses on external (vs. individual) contributors to health, such as social, political, economic, environmental, and other structural factors. Past MIA newsroom reports on the role of social welfare, social connection, and racism in mental health reflect a social-determinants of health perspective.

“The ideologies of whiteness and capitalism repeatedly draw our attention away from comprehensive social policies that would improve health and toward individualistic explanations for health inequities (e.g., genetic differences, personal responsibility, and health behaviors).”

Malat et al. note that although most measures indicate that White Americans possess better physical health than their counterparts of color, Whites’ relatively poor performance on some mental health indicators and their lower overall health standing internationally warrant further investigation. One striking illustration of Whites’ poorer mental health outcomes is the fact that they have the highest suicide rate amongst all U.S. racial groups.

In 2014, Whites’ suicide rate was three times that of Blacks. In terms of international health comparisons, in 2014 the U.S. ranked 35th for life expectancy at birth; when adjusted using racial health data, White Americans’ life expectancy ranks 34th, trailing behind that of countries such as Cuba, Lebanon, and Greece.

Malat et al.’s framework accounts for the ways in which factors such as social policy and dominant racial narratives might contribute to these health outcomes. For example, the authors argue that racially-driven resistance to social programs such as welfare results in a weak system of social and economic safeguards for everyone in the U.S., regardless of race. While this outcome disproportionately affects people of color, it also harms Whites, who are greater in number.

“Restrictive social policies have grown from beliefs about the undeservingness of people of color. The result most commonly harms whites, who, in contrast to the perceptions of many Americans, constitute the plurality of the poor.”

The authors suggest that a weak social safety net combined with racial doctrines that cause White Americans to expect economic and social achievement may put Whites at greater risk during difficult periods, such as an economic recession.

In support of this hypothesis, Malat et al. highlight a 2015 study which found that middle-aged White Americans with a high school education or less experienced rising mortality rates between 1999 and 2013. In contrast, their black and Hispanic peers experienced falling mortality rates during this same period. The causes of death behind increasing mortality rates (e.g. suicide, drug and alcohol poisoning, chronic liver diseases) as well as self-reported data showing declines in mental health and an ability to carry out daily activities, and increased chronic pain suggest that emotional distress and despair played a part in rising mortality rates.

To explain what might have caused and/or compounded this distress, Malat et al. refer to prior research showing that Whites and higher SES individuals have greater difficulty “positively” handling stress due to “loss of status.” This may be because Whites’ “belief in meritocracy” causes them to blame themselves for a job loss, for example, rather than outside factors. Black Americans, however, are more likely to consider the structural causes of their difficulties, which serves to protect mental health in the face of challenging socioeconomic circumstances.

In closing, the authors write:

“While this paper has detailed some negative effects of whiteness on the health of whites, research clearly shows that it harms people of color more often. In order to improve health for all, whiteness and its ideological, economic, and social consequences should be carefully delineated and systematically dismantled.”



Malat, J., Mayorga-Gallo, S., Williams, D. R. (2017), The effects of Whiteness on the health of whites in the USA, Social Science & Medicine. Advance online publication. (Link)

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Rebecca Troeger
MIA Research News Team: Rebecca Troeger is a doctoral student in the Counseling Psychology program at the University of Massachusetts Boston and has a Master’s degree in Psychology. Her work explores how Western psychology can move towards valuing other cultures' knowledge more deeply. She is also interested in the impact of social support and community life on mental health and anti-racism interventions.


  1. “Are White Americans’ poor mental health outcomes caused by Whiteness?” Are you stupid? of course not. The poor “mental health” outcomes for all races are due to a failed DSM paradigm of care. Today’s DSM is a classification system of the iatrogenic illnesses that can be created with the psychiatric drugs, not a classification system of real “genetic” diseases, “like diabetes.”

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  2. so…at this point in American culture…”whiteness” comes w/ a price? interesting. given that the vast majority of -all- Americans, of all races, are amongst the 99% in a society w/ out of control (and growing…) inequality, one must wonder if the issue is “whiteness” per se, or rather…the increasingly high costs associated with false consciousness.

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  3. Thank you for this article; these are startling statistics that deserve proper attention.

    The fact that white American “mental health” is dramatically worse than others is a critical point for Psychiatry to address; why are they silent on this issue? Psychiatry proposes that “mental health” problems are medical (biological); why are white psychiatrists not primarily investigating (or apparently even concerned) about their own biological (or genetic) failings?

    These statistics prove “mental health” problems are not biological (or support an extreme anti-white prejudice).

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  4. When “mental illness” is trendy, and to dissuade a person from pursuing a path in “mental illness” is thought of as “stigmatizing” that person, what’d you expect? We no longer have patients, instead we have “consumers”. “Ill mental health” is now a form of “success”, a thing wildly applauded in white society.

    Perhaps it has something to do with that “false consciousness”. yeah_I_survived, was alluding to in the first comment above.

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  5. I think the underlying issue is that we live in a culture that is fundamentally based on oppression. While oppression affects people of color more severely, the fact is that ALL of us operate under some degree of oppression, whether from being female, being children, being elderly, being poor or even working class, or whatever. Even powerful white males experience oppressive conditions, because in order to keep their dominance, they have to agree to operate within certain very restrictive and dehumanizing rules, including being expected to fully support the oppression of others lower on the economic/power scale than themselves. This is easily seen when a kid in school stands up for the “weird kid” or the gay kid or the bully’s victim – even if that kid is not in a despised group, s/he quickly becomes the victim of bullying him/herself as soon as s/he steps outside of the expected behavior of the dominant culture. This will only change when folks band together and realize that the dominant culture itself is the problem, and that bullies can’t bully when the group rises together in resistance.

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  6. i think white people, because we/they are white, are more likely to go along with the 1%-ers “American Dream,” pick yourself up your boot straps, life is what you make of it, etc…all those myths that make up the American secular religion.

    being low(er) status and white can make for a rough time, because you’re technically in the (still) dominant group, but..odds are fairly certain you’ll never “make it big,” etc. w/ the “middle class slide” and the downward mobility of so many…well, no wonder drug overdoses and suicides are on the increase.

    Mental Health, Inc. of course is society’s pseudoscientific, quasi-religious enforcement arm. they’ll label you and prop you up (“help”) if you come in with sufficient status and they can make $$$ off your “problems.” if you come in stigmatized, low status, etc…buh bye. Homeless shelters, “treatment” in prison and jail, maybe a group home, perhaps a state hospital in some areas. maybe minorities are just less indoctrinated into the BS, so they don’t get screwed quite as much (on the whole) ?

    it doesn’t help that we live in an increasingly isolated, anomic culture…and Mental Health, Inc. is telling us that its –our– problem, –our– defective brain cells, etc.

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  7. “Whiteness” as a concept was invented by the ruling class of the American Colonies after Bacon’s Rebellion and other uprisings in which African chattel slaves and “freedmen” teamed up with European indentured servants (i.e., slaves by “contract”). These oppressed and exploited groups recognized that they had more in common with each other than they had with their masters, and the masters couldn’t abide that, so the masters invented “whiteness” as a psychological wage (as opposed to a real wage) for poor and working class European Americans in order to divide the oppressed.

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  8. Years ago I read “The Pearl” by Steinbeck. Kino, the poor fisherman begs the doctor to see his child when the baby has a fever. The snobbish doctor refuses due to lack of $$$. Kino’s wife treats their son with a native herbal remedy and he begins to recover.

    Soon after Kino discovers a valuable pearl. The doctor shows up and heavily doses the baby with medicine. The child has a relapse and takes weeks to get better.

    More money means better access to quack treatments!

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  9. Thank you for this very important article. We need to pay a lot more attention to the role of racism in psychiatric oppression. It isn’t that long ago that we were called ‘a race of mental defectives.’ Race theory erases individuality by attributing negative, biologically-based characteristics to every member of a designated group.

    At the core of psychiatric oppression lies the racist claim that ‘mental illness’ is a biological defect, that a psychiatric label will tell you everything you need to know about a person, and that everyone who shares a label is the same. That is racism.

    If we acknowledge the racist core of psychiatric oppression, we could link with other groups and organizations fighting different forms of racism. Working together, we would have a greater ability to demolish the biomedical model that oppresses us all. Common cause for mutual benefit.

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