Hate and the Health of Populations | Milbank Quarterly

Photo by Hakan Erenler via Pexels

Photo by Hakan Erenler via Pexels

During 5 days in October 2018, 3 acts of terror starkly reminded the country once again of the pernicious consequences of hate. Between October 22 and 26, Cesar Sayoc, a supporter of President Trump, is reported to have mailed at least 14 improvised explosive devices to critics of Trump, including 2 former US presidents, current and former Democratic party legislators, and career government professionals who held leadership posts during previous administrations. On October 23, Gregory Bush attempted to enter the predominantly African American First Baptist Church of Jeffersontown, Kentucky, and, failing to gain access, killed 2 African Americans in a nearby Kroger supermarket. Most horrific of all, on October 27, Robert Bowers, entered the Tree of Life Synagogue in Pittsburgh, Pennsylvania, armed with an AR-15 assault rifle and killed 11 congregants and wounded 2 others.

Each of these incidents of terror appears to have been motivated by hatred, on the perpetrators’ part, of groups that were different from them. Sayoc mailed personally packaged explosive devices to individuals perceived to be enemies of the president, his inspirational figure. Bush’s shooting victims were African Americans. Bowers trained his weapons on persons of Jewish faith as they worshiped. All 3 incidents represent targeted efforts to kill those who were other than the perpetrators themselves. All three occurred in the context of a multiyear rise in hate crimes, particularly featuring incidents directed against Jews, Muslims, and LGBT people, among others. The year 2017 witnessed the largest 1-year increase in anti-Semitic incidents since auditing began more than 40 years ago.

Against this backdrop, there should be little question at this point that hate is a powerful motivator of harm against others. The direct consequences of hate—including violence, discrimination, and marginalization of out-groups—are associated with poor health. Apart from the direct physical harm they inflict, hate-induced actions are associated with substantial mental illness effects. Racism and discrimination themselves produce negative health consequences, as does out-group marginalization, including Islamophobia.

Unlike inmost nations, hate speech is constitutionally protected in the United States. No hate speech laws currently exist. That does not mean, however, that those of us in population health should accept hate speech. Recognizing that hate is a determinant of health puts the issue squarely within the remit of the population health community, pushing us to consider what we can do to address hate. We suggest 4 steps in this regard.

Read full piece at Milbank Quarterly.