Hate crimes hurt: State-level hate crime rates and racial health disparities

Despite the growing prevalence of hate crimes in the United States, little is known about whether and how state-level institutional and cultural climates surrounding bias-motivated violence pattern health and health disparities. This study conceptualizes state-level hate crime rates as composite indicators of these climates-reflecting the underlying incidence, institutional recognition and reporting, and political-cultural context-and examines their association with individuals' mental and physical health. Linking FBI Hate Crime Reporting Program data with individual-level data from the Behavioral Risk Factor Surveillance System (2011-2023) (n = 3,827,446), we first document substantial variation in hate crime rates across states and over time. Using two-way fixed effects models, we find that higher state-level hate crime rates are associated with more days of poor mental and, to a lesser extent, physical health, with associations concentrated among Black respondents and little evidence of associations among White or Hispanic respondents. By contrast, state-level violent crime rates show weak, racially undifferentiated associations with health, underscoring that state hate crime climates likely operate through distinct pathways from general crime rates to shape health risks. Taken together, findings are consistent with the notion that state-level hate crime rates capture a meaningful dimension of institutional and cultural context relevant to population health, with especially concerning implications for the health of historically marginalized populations, particularly Black Americans.