Pull up your pants. Straighten your hair. Stop using the n-word.

Black Americans have long been told that there is a “right” way to act in order to secure racial equality and individual promotion in the United States. Often, these recommendations are made by other black Americans attempting to mute certain cultural aesthetics in order to make white Americans feel comfortable in their presence. I recently attended a lecture where a middle-aged black American man explained that he yearned for the days when black men “had grace.” He posted a picture of black men circa 1940 in Tuskegee, Alabama, standing in a cotton field wearing pressed white shirts and suspenders.

As journalist Aurin Squire explains, black respectability presumes that “systematic oppression can be overcome if we’re clean, mild, moderate, and economically successful.” Yet in a time when black men are nine times more likely to be shot and killed by the police and people still protest those who point out police brutality, policing the appearance of black Americans is, at best, beside the point.

But the issue isn’t just that respectability is irrelevant. New evidence suggests that the beliefs that inform respectability politics are bad for black Americans’ health.

According to the Journal of Behavioral Medicine, attributing success to personal characteristics instead of biased structural systems may negatively impact black Americans’ health. Nao Hagiwara and her colleagues at Virginia Commonwealth University explored whether the “just world” belief—the belief that the world is a just place where people get what they deserve—would influence the relationship between perceived discrimination and health consequences for 130 black adults.

The psychologists found that participants who both strongly believed that the world was a just place and reported experiencing high levels of discrimination were more likely than other blacks to suffer from chronic illnesses and increased blood pressure. Why? Because respectability politics tells black Americans that what is happening to them in this country is our fault. In other words, we’re to blame for the 9.5% unemployment rate among black Americans, the police who fatally shoot unarmed black men, and the teachers who expect less academic success from black students. If we just pulled our pants up a little higher and turned our music down, the systematic discrimination that informs nearly every sector of American life would disappear. If the world is just, then the injustice we experience in it is on us.

This thought is literally making people sick.

Health care and mental health practitioners should work to educate themselves on the current status of racial issues in the United States. And they should encourage their black patients to reframe how they look at their experiences. An understanding of individual accountability must be supplemented with a more contextual assessment of negative events. This reframing could alleviate the stress that’s associated with the belief that our behavior determines all of our experiences–even in a deeply racist and unjust society.

By seriously considering the social systems and racist encounters experienced by black Americans, health practitioners may help their patients better assess their experiences and select tailored methods for health improvement. Those charged with caring for black lives should be among the first acknowledge that they matter.