Perceived Discrimination and Immunological Aging: A Systematic Review of Cellular and Molecular Markers

Perceived discrimination is a chronic social stressor that increases the risk of disease. While prior research has linked discrimination to adverse biological health outcomes, the cellular and molecular mechanisms underlying these associations remain understudied.

We conducted a systematic review and identified 32 empirical studies that met the inclusion criteria examining the relationship between self-reported discrimination experiences and markers of immunological aging, focusing on telomere length, gene expression profiles, and immune cell composition.

Findings consistently showed discrimination to be associated with accelerated telomere shortening; altered transcriptional activity, particularly within proinflammatory and antiviral pathways aligned with the Conserved Transcriptional Response to Adversity; and shifts in immune cell populations indicative of immune aging and heightened inflammatory activity. Despite this growing evidence, the dominance of cross-sectional designs, limited racial/ethnic diversity in study populations, and narrow focus on select immune markers restrict generalizability and mechanistic clarity.

We emphasize the need for longitudinal research, broader immune phenotyping, and rigorous modeling of behavioral and physiological mediators to elucidate how discrimination drives chronic immune dysregulation. Advancing this field is essential for understanding the biopsychosocial pathways linking discrimination to disease.