In order to understand the impact of race on mental health, it is important to appreciate what race is as well as the factors connected to race that influence health and mental health status. Race has been defined in terms of phenotypic characteristics, including shape of eyes and nose, hair color and texture, and skin color. While these features are biologically determined, race is actually a social concept related to how people are classified on the basis of their physical appearance (1). Race is related to, but distinct from, ethnicity, which is defined as the characteristics of a group of people who share common national, linguistic, religious, or racial heritage, and from culture, which comprises the perspectives, world views, actions, and mores of a group of people (2).
The four major racial groups in the United States are people of European descent or Caucasian; people of African descent, also referred to as black people; people of Asian and Pacific Island heritage; and people of Native American, Native Hawaiian, and Native Alaskan groups. People of mixed race are a growing population in the United States, and they are faced with significant challenges regarding how they are to identify themselves. People of Hispanic or Latino descent, more accurately referred to as an ethnic group, are the largest "minority"; they represent a broad spectrum of racial heritage, including European, African, and Native American contributions and mixtures of these racial categories. The four major nonwhite racial and ethnic groups will be referred to here as people of color. The term minority is not used, for two reasons. First, minority has a pejorative connotation despite its reference to numerical representation relative to the Caucasian population. Second, minority is becoming a misnomer given the fast-paced growth of populations of color; for example, as of 2005, four states—California, Hawaii, New Mexico, and Texas—were identified as having majorities of people of color. In many ways, populations of people of color are emerging majorities.