Research suggests that internalized racial oppression is related to poor health due to its adverse impact on individual core self-evaluation of perceived value, efficacy, and competence (James, 2020). This level of assessment is critical for self-realization and motivation and contributes to self-esteem and self-efficacy. Internalized racial oppression decreases one’s positive perceptions of their core self, potentially revealing itself through devaluing one’s cultural group, adopting American characteristics (e.g., skin lightening, plastic surgery), and accepting negative stereotypes (e.g., superwoman; Banks & Stephens, 2018; Brown et al., 2017).  

Internalized racial oppression is also associated with maladaptive thinking and coping, self-mortification, and low self-worth (Banks & Stephens, 2018). Internalized racial oppression can manifest in negative affect, including powerlessness, hopelessness, confusion, shame, humiliation, fear, and decreases in life satisfaction (Garcia et al., 2019; David, Schroeder, & Fernandez, 2019; Paradies, 2006). These patterns can result in anxiety, depression, significant life strain, avoidance, less problem-solving, and increased perceived stressors that portend poor health outcomes (Gale et al., 2020; James, 2020; Tull et al., 2005).  

IRO-related psychological stress experienced by Black women can lead to an enduring, fluctuating, or heightened flight or fight response. This heightened response increases Black women’s risk for CVD (Brown et al., 2017). The stress response causes a cascade of hormones with potentially adverse physiological outcomes, such as diabetes, obesity, and hypertension, which are risk factors for CVD (Brewer & Cooper, 2014; Collins et al., 2004; Tull et al., 2005). Studies show that when exposed to perceived stressors and maladaptive coping behavior, Black women have an increased risk for cardiovascular disease (Tull et al., 2005). To date, significant correlations exist among internalized racial oppression, psychological distress, and health risks (see Figure 1; Gale et al., 2020; Tull et al., 2005).