Racism and health: Examining pathways influencing health outcomes among justice-involved and nonjustice-involved Black and Latine individuals.

The pervasive nature of racism at interpersonal and structural levels remains a significant public health threat, as it contributes to adverse mental and behavioral health outcomes. The biopsychosocial model of racism underscores physiological, cognitive, and emotional mechanisms that influence health outcomes; however, less is known about the distinct mechanisms through which experiences of racism shape health outcomes among Black and Latine individuals who face cumulative disadvantage because of criminal legal system involvement. Black and Latine participants (N = 828; justice involved, n = 343; nonjustice involved, n = 485) completed measures assessing lifetime experiences of racism, race-related stress (anticipatory bodily alarm responses; perseverative cognitions), emotional regulation difficulties, and internalizing (depression, anxiety, posttraumatic stress disorder) and externalizing (alcohol use, cannabis use, substance consequences) health outcomes. Multigroup structural equation modeling was used to examine associations between variables and assessment of group differences. Results revealed that (a) there were significant direct associations between racism experiences and anticipatory bodily alarm responses, perseverative cognitions, and emotional regulation difficulties, (b) associations between anticipatory bodily alarm responses and internalizing and externalizing symptoms were mediated by perseverative cognitions and emotional regulation difficulties, and (c) significant differences in pathways were observed based on justice-involvement status. Findings suggest that justice-involved participants may experience worse health outcomes that may be explained by cognitive, emotional, and physiological mechanisms pronounced by experiences of racism. Together, results necessitate the need for interventions to address the impacts of racism to improve health. (PsycInfo Database Record (c) 2026 APA, all rights reserved).