Experts: Racism at root of public health gap between whites, people of color
Public health professionals and scholars have written for decades about systemic racism being a major cause of Americans who are Black, Hispanic or Native American having poorer health and life expectancy than whites.
The intense focus on race relations after George Floyd’s killing and the disproportionate impact of the COVID-19 pandemic on people of color have brought the issue even more into the forefront, with a growing number of cities and states declaring racism a public health crisis.
Tekisha Dwan Everette, an assistant clinical professor in social and behavioral sciences at the Yale School of Public Health, has been leading the call in Connecticut to recognize racism’s role in overall health as executive director of Health Equity Solutions in Hartford. “To me it becomes clear that there is a problem here, and first we have to name the problem. And once we name the problem, we can fix it,” she said.
“All the research shows that when you’re a person of color that you are more than likely experiencing stress in your daily life related to covert and overt racism,” she said. It comes from being followed in a store or “when you see a police car and don’t know what the outcome is going to be from people who are supposed to protect the public,” she said.
In August 2019, the American Academy of Pediatrics declared, “Racism is a social determinant of health that has a profound impact on the health status of children, adolescents, emerging adults, and their families.”
According to the Robert Wood Johnson Foundation, “Health varies markedly by income within every racial group, and racial or ethnic differences can be seen at each level of income. These patterns are seen across a wide range of health conditions. At the same time, findings from studies in the U.S. and other countries have found that perceived racial/ethnic bias—and the resulting toxic stress — makes an additional contribution to racial or ethnic disparities in health.”
While overtly racist words and actions increase the stress and trauma people of color experience, it is the institutionalized racism in society that is most to blame, Everette said.
“It’s not about the people. It’s about the policies, environment and systems that are creating the environment in which people are living and working and causing some of the conditions we are seeing,” she said.
Historic redlining of neighborhoods, cementing segregation in cities, is one root cause. Schools, which in Connecticut are financed by property taxes, are unevenly supported, leading to lower education levels, poorer chances at good jobs and a lack of affordable health insurance, she said.
The impact on health is huge, and the COVID pandemic has put a spotlight on how social inequities affect health. According to the Centers for Disease Control and Prevention, Native Americans have the highest age-adjusted rate of the disease, 5.5 times that of whites. Blacks follow at 4.4 times the rate and Hispanics at four times.
Black women die of pregnancy-related causes at almost 3.2 times the rate of white women, and the problem is not solely a factor of income. Such deaths “for black and [American Indian/Alaskan Native] women with at least some college education were higher than those for all other racial/ethnic groups with less than a high school diploma,” the CDC has stated.
White people can expect to live three years longer than Black people, though Hispanics’ life expectancy is three years more than whites’, according to the CDC. And Blacks are twice as likely to be killed by police as whites, despite comprising 13 percent of the population, according to a Washington Post study. Hispanics are almost twice as likely as whites to be victims of police killings.
More than 20 cities and counties and at least three states, Michigan, Ohio and Wisconsin, have declared racism a public health crisis, according to the Pew Charitable Trusts. Windsor, Hartford, Bloomfield and West Hartford have done so, and others are considering taking such action, according to the Connecticut Mirror.
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