Society. Prejudice, psychological consequences... how racism reinforces health inequalities

The situation is improving, but remains worrying. In its annual report published this Wednesday on the fight against racism, anti-Semitism and xenophobia , the National Consultative Commission on Human Rights (CNCDH) notes that the tolerance index of the French increased in 2024 compared to 2023, going from 62/100 to 63/100. This means that they are more tolerant of Black, Asian, Arab, Roma, Muslim and Jewish people, "despite the dissemination of discourse of mistrust and hatred by certain political and media spheres." Not enough to claim victory, according to the CNCDH, which deplores the fact that "certain prejudices remain widely shared" and "certain minorities continue to be set apart in French society."

“Mediterranean syndrome”

This year, the report—published annually since 1990—has drawn particular attention to the risks that racism poses to the health of those who experience discrimination. A 2024 study of more than 1,500 emergency physicians who were shown photos of people associated with clinical cases showed that, with similar severe symptoms, a Black person was less likely to be classified as “emergency” by doctors than a white person. And therefore less likely to be treated quickly and properly.

"It's a bias held by doctors, mostly unconscious, linked to the 'Mediterranean syndrome,'" explains Claire Lallemand, the report's coordinator. "It's the idea that Black or North African people tend to exaggerate their pain. So when they come to the emergency room, their symptoms are deemed less credible than those of a white person. This is part of a racist historical continuum linked to slavery, according to which Black people were more resilient," she describes, specifying that this "syndrome" was taught in medical schools until the 1960s and 1970s. This resulted in delayed or even non-existent diagnoses, and serious health consequences.

For Black women, it's a double whammy, the CNCDH emphasizes. They are 50% less likely to be assessed as "life-threatening" than a white man, according to the study published in 2024. This can lead to dramatic situations, the report indicates, citing as an example the death in 2017 of Naomi Musenga, whose call was not taken seriously by the emergency services.

Black women are also affected by racist bias during childbirth, the report points out. "This too is documented and linked to long-standing prejudices that Black women exaggerate their pain even though they are used to giving birth," explains Claire Lallemand. She adds: "Women of Mediterranean and African descent undergo more emergency cesareans than white women because they receive less medical care beforehand, due to stereotypes."

Training doctors

The report indicates, supported by studies, that racism can also have significant psychological consequences for victims. And this can happen from a very young age. "The jokes, the mockery... All these microaggressions can cause stress, depression, and even lead to addictive behaviors—drugs, alcohol—among adolescents," notes Claire Lallemand. "And it's a blind spot: when a child isn't doing well, we don't think about racism. We look elsewhere, at the family, in academic results..."

The CNCDH believes that raising awareness among healthcare workers remains the key to combating these racial stereotypes. Currently, racial discrimination that doctors may practice is not addressed in medical student curricula. Only a few pilot training programs on the subject exist, notably at the Sorbonne in Paris.