While the COVID-19 pandemic continues to plague the world, current and past killings within the Black community by law enforcement officers are making it clear that racism is a public health issue of pandemic proportions. The seriousness of this is made evident through efforts by Black-led organizations and protestors, both of whom are demanding change for people of color (POC). For information on these current events and the groups working to cultivate change, read our post Police Brutality: A Public Health Issue.
Police brutality against POC must end to decrease the loss of lives within these communities and improve the state of their mental health. Racism has also slipped into other areas of society and is having significant and severe impacts on the health and life expectancy of Black communities. In this post, we outline the role that systemic and individual racism play in the health of Black communities and their members.
Letting the Numbers Speak
At present, Black individuals represent 13.2% of the population within the U.S. This population is susceptible to many health issues, causing Black Americans to stand out from other groups. According to data from multiple sources, obesity, diabetes, cancer, heart disease, and asthma affect a disproportionate number of individuals within the Black community.
Almost half of those who identify as Black experience obesity. This is a health issue that may be closely correlated with the fact that Black individuals are 80% more likely to be diabetic than individuals of other ethnicities and are more likely to have high blood pressure which, over time, may cause them to be at risk for stroke. Men are 30% more likely to have high blood pressure than their white counterparts, while women are 60% more likely.
Patterns emerging in women’s health suggest that Black women are at a higher risk for contracting and dying from breast cancer than members of other racial groups. These women have a 1 in 31 chance of dying while white women have a 1 in 37 chance. Black women are also more likely to die of cervical cancer.
Assigning Responsibility
While some health issues may be genetic, many are caused or exacerbated by systemic racism, individual racism, infrastructure issues, socioeconomic challenges, and inequality.
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Food Deserts
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In terms of infrastructure, many Black communities are situated in areas that are considered food deserts. The location of several of these communities was not chosen by its members but forced upon them through government-run public housing projects. A disproportionate number of Black individuals become reliant on this type of affordable, but low-quality housing, or find themselves in under-funded communities and neighborhoods due to financial constraints caused by systemic racism.
These areas have limited supermarkets and grocery stores, meaning communities have limited access to fresh produce and healthy options. What little fruits, vegetables, and other whole foods are available often have a high price tag.
High whole food prices and limited access mean that they are reliant on fast food chains and corner stores for their meals and groceries. This means individuals are consuming heavily processed foods, which are saturated in sugar, sodium, and fat. A diet like this can cause obesity and its associated health complications like high blood pressure and diabetes, many of which are prevalent among members of the Black community.
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Income Inequality
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Socioeconomic status plays another role in the health of Black individuals. The present wage gap that sits between POC and white individuals can contribute to financial constraints. Financial concerns in combination with poor healthcare, often mean that members within the Black community may not get the medical attention they need and deserve. According to one study, 1 in 5 Black individuals said they put off seeing a medical professional in the past year because they could not afford it. Only 1 in 9 white individuals reported putting off medical care for the same reason.
Individuals may avoid annual physicals or cautionary screenings, electing to save their money for times when they are sick or choosing to spend their money on essentials like food and housing. Preventative healthcare and screenings can detect health concerns like cancer, giving the patient a greater chance of survival. For women of color, preventative screenings could decrease the number of breast cancer and cervical cancer-related deaths.
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Racial Representation Among Physicians
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Finally, the quality of healthcare can contribute to the health of the Black community. Racism in healthcare can mean deprioritizing the care of Black individuals. This would not be an issue if the physician population represented the ethnicity of its surrounding community. As mentioned, 13.2% of the U.S. population is Black. Just 4% of practicing physicians identify as African American, meaning a majority of Black patients receive care from someone they may not as easily relate to, or identify with. Often, the health outcome for patients is better when they receive care from someone who looks like them. This can improve communication and trust. In one study, pairing Black patients and Black physicians together led to more detailed notes, an increase in preventative screening, and decreased the mortality in Black patients by 19%!
Moving Towards Equality
To improve the health of the Black community, changes at the federal, state, local, and individual level must be made. Such changes will not eliminate racism or public health issues caused by systemic and individual racism, but they can lead to some improvements. These changes will require supermarkets and grocery stores to be built in food deserts, prices of whole foods sold in these locations to be affordable, and those with the lowest incomes in the area taken into consideration.
To encourage individuals to attend routine physicals and prioritize medical screening, insurance needs to be reformed, specifically in areas of the south where Medicare and Medicaid have less coverage.
Lastly, medical schools should be more selective when it comes to accepting applicants for degree and specialization training. They should work towards having a student body that is more representative of the country’s population. This will foster greater connection and communication between patients and physicians and can lead to improvements in patient outcomes and, thus, public health.
Although these changes require extensive planning and funding, they need to be prioritized. The health and happiness of the Black community have been put on hold for too long. Now is the time to reform.
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