Structural racism is a driver of health inequalities, leading to disproportionate suffering and poor health outcomes in Black communities in the United States.
Predominantly black communities have less access to quality care than white communities – Covid-19 exposes undertreatment and deaths Black communities are disproportionately affected. Even before the pandemic, Data Display On average, Black Americans have seven years less life expectancy than non-Black women, and Black mothers are 3.5 times more likely to face maternal death than non-Hispanic white women and 3 to 4 times more likely to experience non-Hispanic white women pregnancy and childbirth complications.
But the health crisis in the black community is not just because of a lack of medical care.Much of it also stems from well-documented racial disparities and prejudices, such as around pain perception and Treatment recommendations. As recently as 2016, a study found that a surprising number of first- and second-year medical students mistakenly Black people believed to have a higher tolerance for pain and thicker skin than non-blacks, causing many to downplay symptoms and failing to treat black patients fairly.
These attitudes and inequalities don’t just affect black families who are born and die—they create lifelong deficits and have lasting effects on future generations. Poor health resulting from social, economic, environmental and behavioral determinants of health, combined with long-term pressures from permanent, systemic racism, lead to educational challenges and frustrations for children, and difficulties due to health problems and reduced life expectancy maintain employment.
It would be an understatement to say that the lived experiences of black people tend to be more stressful than their non-Hispanic white peers. Structural bias and discrimination affect health and health outcomes. These stressors prevent blacks and black communities from reaching their full potential and prevent communities from achieving equality by promoting a high level of reliance on community-based social services to meet basic needs.
While improving access to quality social care is critical to turning things around, real change must come from system transformation and a collective will to invest in historically underserved populations. Large-scale systemic change requires the implementation of new policies and programs, as well as new infrastructure that values social care, promotes health equity, and ultimately eliminates systemic structural racism.
Health disparities not only affect individuals and communities, but also have significant economic consequences. in 2009, Racial disparities cause $60 billion in excess health care costswhich is expected to reach $363 billion by 2050.
Here are some strategies to consider as we work to promote health equity and address poor health outcomes rooted in structural racism:
Expose the history behind the racist policies and practices that harm the Black community today.
Racial disparities and inequalities do not happen by chance. They were intentional because black citizens were systematically excluded from society. Long Island, for example, was one of the most racially segregated places in America, in part because Robert Moses’ urban planning and infrastructural design in the 1920s saw black neighborhoods torn from the ground to make room for parks, bridges and Roads give way, often cutting off public transportation to these communities and preventing people who live there from accessing parks and beaches.
Structural racism exists today because of specific choices made in the past and present. Often, our attention is focused on addressing disparities and inequalities at the individual and community levels, and at the macro level little attention has been paid upstream to addressing the structures of perpetual inequality today.
Collect data to define the problem.
While many of us see these inequalities every day, in order to drive change, we must be able to demonstrate to policymakers, healthcare providers and other stakeholders their devastating consequences. To do this, we must use systems to track other contextual data related to the utilization of social care services and to measure and evaluate the effectiveness of interventions.
It is critical to ensure that communities have the resources and infrastructure to collect these data and then compare them to what is happening in nearby or similar communities to demonstrate and adequately define differences.
Translate that data for the layman.
Data analysis is often an academic discussion that often creates obstacles for those with the right insights. We need to do more to engage communities in translating and providing contextualized information to ensure community health data is actionable, meaningful and can be used by all stakeholders to address the needs and priorities of the communities they serve .
There are still a surprising number of people who think racism is not a problem in America. We must overcome these misunderstandings with clear, evidence-based insight.
Regain trust in the healthcare system.
The black community has a deep-seated mistrust of the health care system, and for good reason: In addition to race-based prejudice and misunderstanding, they have suffered unspeakable atrocities as the subject of inhumane experiments. Black individuals are more likely to delay or avoid healthcare due to distrust and the presence of crisis levels in many communities, thus driving higher ED utilization and long-term health problems.
As we work to regain the trust of the Black community with fair and equitable treatment, we should also prioritize quality social care services needed to provide additional support and reinvest clinical spending in housing, outdoor spaces, schools and youth services, employment opportunity and so on.
It is well known that the social determinants of health (SDoH) – the conditions under which we live, work, study, play and pray – play a key role in our current health, our health potential, and economic and career development opportunities. Everything from income and access to healthy food, to community infrastructure and accessibility, affects our ability to thrive.
To overcome race-related health and social care inequities, we must focus on improving SDoH in Black communities to support the critical role they play in promoting health and well-being across the lifespan. If we can deliver better quality and more equitable physical, mental and social care right from the start, we can foster lifelong well-being and help break the cycle of perpetually poor health in individuals and communities. While we cannot restore the past, we can improve our options for the future.
Photo: Angelina Child, Getty Images
