In recent weeks there has been a lot of public discussion about whether psychological research findings can be reproduced. Underneath this concern are other lurking questions such as: Is the science of psychology objective? Is it representative of people's realities? What can psychological research tell us about people's experiences?
My colleague Tal Peleg-Sagy and I wanted to find out. In a set of studies that will be published in the academic journals Death Studies and Transcultural Psychiatry, we reviewed all the scientific literature on grief and loss published between 1998-2014 that included African Americans. We were interested in exploring what research exists on African Americans and grief and if these studies included the participant's socioeconomic status, education, and ethnicity. This is important information because social and financial class impacts how well people cope with grief.
Our results were surprising. Although African Americans make up 13% of the population, out of thousands of studies on grief, only 31 published papers focused exclusively on African Americans experiences' of loss. We found only 28 additional studies that included African Americans and whites together in their research.
Even more distressing than the small number of studies was the focus of the research. Articles that were solely on African Americans overwhelmingly focused on homicide, parental loss, and reproductive losses. For example, out of the 31 studies that looked at African Americans, 13 focused on homicide. The over-emphasis on research caused by traumatic loss may have to do with the fact that African Americans are more likely to experience the murder of a loved one than whites in the United States, however, this is just one out of many types of losses this community may experience and does not explain the research imbalance.
The research that used mixed ethnic samples, on the other hand, tended to focus on general grief processes such as widowhood. The skewed focus on homicide in the African American population, especially in the context of so few studies on this population as a whole, can create stigmatized knowledge, including the impression that African Americans predominantly die of violent murder. It also creates enormous gaps in psychologist's knowledge about the normal grieving process for African Americans and what may or may not assist them when they are mourning or when family members are at end of life.
The second concern arising from our review was the lack of reporting of contextual information including socioeconomic status, education, and ethnicity in the study design. There is robust evidence to indicate that mental health symptoms vary by culture, social class, and by education. Sociodemographic factors are especially pertinent when studying grief and loss. For example, one study that looked at complicated grief in a representative survey of more than 2500 participants found that the prevalence rate of the disorder was 13% among low-income participants, as compared to approximately 4% among higher income participants, indicating that socioeconomic status is a significant factor in post-bereavement distress. This information is important to include so that researchers can assess whether bereavement distress is caused by a financial burden or social factors rather than as a result of an ethnic or cultural difference.
We wish that our findings were unique. Sadly, this is not the case in both psychological research and clinical practice. For example, in research on therapists, one study led by Professor Ora Nakash found that clinicians (who usually belong to a socially advantaged group) were twice as likely to give the wrong diagnosis of mental illness when their patients came from a disadvantaged ethnic minority background. This cultural mismatch, potentially caused by bias or lack of knowledge due to the little or no published research can result in these groups receiving poorer mental health services.
The issue of ethnic minority representations including African Americans in the research literature has been an ongoing concern for psychologists. Despite persistent calls for researchers to be more inclusive of ethnic minorities in their studies, our review found that little has changed over the last twenty years at great detriment to the field of Psychology as a whole. By selecting non-diverse research samples, we are producing inadequate and limited knowledge about the mental and emotional health of non-white Americans.