In an Episode from “New Amsterdam” a doctor explains to a mother that her son’s tumor grew because of internalized racism. Ironically, with all the limitations of the study, it didn't actually even make the claim that racism was the cause. Findings Within this longitudinal cohort study of 1554 individuals, greater cumulative stress across the lifespan and higher inflammation partially mediated elevated mortality among Black participants. The findings underscore the need for policies that address structural racism, alongside treatments that reduce inflammation and limit stress exposure to reduce mortality disparities. We measured stress hormones, found elevated levels in people who died early, and concluded that racism caused the deaths.