Skip to main content Accessibility help
×
Hostname: page-component-cd9895bd7-jn8rn Total loading time: 0 Render date: 2024-12-23T19:13:24.591Z Has data issue: false hasContentIssue false

Introduction

An American Dilemma: Racial Disparities in Health – Past and Present

Published online by Cambridge University Press:  07 September 2023

Louis A. Penner
Affiliation:
Wayne State University, Michigan
John F. Dovidio
Affiliation:
Yale University, Connecticut and Diversity Science, Oregon
Nao Hagiwara
Affiliation:
University of Virginia
Brian D. Smedley
Affiliation:
Urban Institute, Washington DC
Get access

Summary

The chapter is concerned with racial health disparities in the United States. These disparities are large, significant, and persistent. Black Americans are much more likely to become ill and to die from their illnesses than are White Americans with the same illnesses. Black Americans’ poorer health reflects health disparities that have social, economic, or political causes rather than biological differences between the two groups. The root cause of these racial health disparities is anti-Black racism, which includes individual racism (negative thoughts about and feelings toward Black people) and systemic racism (societal standards, cultural values, and formal laws that systematically disadvantage Black Americans). Both kinds of racism have very long histories in the United States and continue to pose significant threats to the health of and the healthcare received by Black Americans. Specifically, individual and systemic racism cause: (1) chronic stress, which produces physiological and psychological responses that threaten a person’s health; (2) racial housing segregation, which creates poor and under-resourced Black neighborhoods, containing numerous environmental threats to the residents’ health; (3) inequities in the quality of medical care received by Black patients and White patients; and (4) disparities in socioeconomic status, the strongest single correlate of a person’s health status in the United States.

Type
Chapter
Information
Unequal Health
Anti-Black Racism and the Threat to America's Health
, pp. 1 - 37
Publisher: Cambridge University Press
Print publication year: 2023

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Du Bois, W. E. B. (1899). The Philadelphia Negro: A social study. University of Pennsylvania Press.Google Scholar
Aguilar, L. (2020, May 21). Detroit population continues to decline, according to census estimate. Bridge Michigan. www.bridgemi.com/urban-affairs/detroit-population-continues-decline-according-census-estimateGoogle Scholar
Smitherman, H. C., Jr., Kallenbachm, L., & Aranha, A. N. F. (2020). Dying before their time III: 19-Year (1999–2017) comparative analysis of excess mortality in Detroit. Commissioned by Detroit Area Agency on Aging. www.docdroid.com/w7ygR0O/dying-before-their-time-iii-daaa-2020-final-pdf#page=13Google Scholar
Hill, L. & Artiga, S. (2022, August 22). COVID-19 cases and deaths by race/ethnicity: Current data and changes over time. Kaiser Family Foundation. www.kff.org/coronavirus-covid-19/issue-brief/covid-19-cases-and-deaths-by-race-ethnicity-current-data-and-changes-over-time/Google Scholar
Bassett, M. T., Chen, J. T., & Krieger, N. (2020). Variation in racial/ethnic disparities in COVID-19 mortality by age in the United States: A cross-sectional study. PLoS Medicine, 17(10), e1003402. https://doi.org/10.1371/journal.pmed.1003402Google Scholar
Lahut, J. (2020, April 7). Fauci says the coronavirus is “shining a bright light” on “unacceptable” health disparities for African Americans. Business Insider. www.businessinsider.com/fauci-covid-19-shows-unacceptable-disparities-for-african-americans-2020-4Google Scholar
Whitaker, B. (2021, April 18). Racism’s corrosive impact on the health of Black Americans. CBS News. www.cbsnews.com/news/60-minutes-disease-black-americans-covid-19-2021-04-18/Google Scholar
Hood, R. G. (2001). The “slave health deficit”: The case for reparations to bring health parity to African Americans. Journal of the National Medical Association, 93(1), 15. https://pubmed.ncbi.nlm.nih.gov/12653374Google Scholar
American Medical Association. (2020). The AMA’s strategic plan to embed racial justice and advance health equity. www.ama-assn.org/about/leadership/ama-s-strategic-plan-embed-racial-justice-and-advance-health-equityGoogle Scholar
Coates, T. -N. (2015). Between the world and me. One World.Google Scholar
Roediger, D. R. (n.d.) Historical foundations of race. National Museum of African American History & Culture, Smithsonian. https://nmaahc.si.edu/learn/talking-about-race/topics/historical-foundations-raceGoogle Scholar
The Pastor’s Workshop. (n.d.). Sermon quotes on race. https://thepastorsworkshop.com/sermon-quotes-on-race/Google Scholar
Turner, A. L., Laveist, T. A., Richard, P., & Gaskin, D. J. (2020). Economic impacts of health disparities in Texas 2020: An update in the time of COVID-19. Altarum. www.episcopalhealth.org/wp-content/uploads/2021/01/Econ-Impacts-of-Health-Disparities-Texas-2020-FINAL-002.pdfGoogle Scholar
Ayanian, J. Z. (2015, October 1). The costs of racial disparities in health care. Harvard Business Review. https://hbr.org/2015/10/the-costs-of-racial-disparities-in-health-careGoogle Scholar
Farmer, P. (2013, June 5). Investigating the root causes of the global health crisis: Paul Farmer on the TED Book, The upstream doctors. TEDBlog. https://blog.ted.com/investigating-the-root-causes-of-the-global-health-crisis-paul-farmer-on-the-upstream-doctors/Google Scholar
Glantz, M. J., Chamberlain, M. CLiu, Q., Hsief, C.-C., Edwards, K. R., Van Horn, A., & Recht, L. (2009). Gender disparity in the rate of partner abandonment in patients with serious medical illness. Cancer, 115(22), 52375242. https://doi.org/10.1002/cncr.24577CrossRefGoogle ScholarPubMed
Carlson, R. H. (2001). Study: Women with brain tumors have 10 times rate of divorce as men with brain tumors. Oncology Times, 23(8), 63. https://journals.lww.com/oncology-times/Fulltext/2001/08000/Study__Women_with_Brain_Tumors_Have_10_Times_Rate.24.aspxGoogle Scholar
Lippmann, W. (1922). The world inside and outside and the pictures in our head. In Lippmann, W (Ed.), Public Opinion (pp. 332). Macmillan Press. https://doi.org/10.1037/14847-001Google Scholar
Over, H., Eggleston, A., Bell, J., & Dunham, Y. (2018). Young children seek out biased information about social groups. Developmental Science, 21(3), e12580. https://doi.org/10.1111/desc.12580Google Scholar
Quillian, L., Pager, D., Hexel, O., & Midtbøen, A. H. (2017). Meta-analysis of field experiments shows no change in racial discrimination in hiring over time. Proceedings of the National Academy of Sciences, 114(41), 1087010875. https://doi.org/10.1073/pnas.1706255114Google Scholar
Sun, M., Oliwa, T., Peek, M. E., & Tung, E. L. (2022). Negative patient descriptors: Documenting racial bias in the electronic health record. Health Affairs, 41(2), 203–211. https://doi.org/10.1377/hlthaff.2021.01423Google Scholar
Desai, M. U., Guy, K., Brown, M., Thompson, D., Manning, R., Johnson, S., Davidson, L., & Bellamy, C. (2023). “That was a state of depression by itself dealing with society”: Atmospheric racism, mental health, and the Black and African American faith community. American Journal of Community Psychology. https://doi.org/10.1002/ajcp.12654Google Scholar
History.com Editors. (2021, March 26). Jim Crow Laws. History.com www.history.com/topics/early-20th-century-us/jim-crow-lawsGoogle Scholar
Wilkerson, I. (2010). The warmth of other suns: The epic story of America’s great migration. Vintage Press.Google Scholar
Jim Crow Museum of Racist Memorabilia. Examples of Jim Crow Laws - Oct. 1960 – Civil Rights. Ferris State University. www.ferris.edu/htmls/news/jimcrow/links/misclink/examples.htmGoogle Scholar
Romero, S. (2018, January 28). Indian slavery once thrived in New Mexico. Latinos are finding family ties to it. New York Times. www.nytimes.com/2018/01/28/us/indian-slaves-genizaros.html?hp&action=click&pgtype=Homepage&clickSource=story-heading&module=second-column-region&region=top-news&WT.nav=top-newsGoogle Scholar
Black, S. S. (2008, December 1). American Indian tribes and structural racism. Poverty & Race Research Action Council. www.prrac.org/american-indian-tribes-and-structural-racism/Google Scholar
Office of the Historian, Foreign Service Institute, United States Department of State. Chinese Immigration and the Chinese Exclusion Acts. https://history.state.gov/milestones/1866-1898/chinese-immigrationGoogle Scholar
Abdul-Jabbar, K. (2020, May 30). Op-Ed: Don’t understand the protests? What you’re seeing is people pushed to the edge. Los Angeles Times. www.latimes.com/opinion/story/2020-05-30/dont-understand-the-protests-what-youre-seeing-is-people-pushed-to-the-edgeGoogle Scholar
New York Times. (2022, August, 12). More Black former N.F.L. players eligible for concussion payouts. www.nytimes.com/2022/08/12/sports/football/nfl-concussion-settlement-race.htmlGoogle Scholar
McMinn, S., Carlsen, A., Jaspers, B., Talbot, R., & Adeline, S. (2020, May 27 ). In large Texas cities, access to coronavirus testing may depend on where you live. National Public Radio. www.npr.org/sections/health-shots/2020/05/27/862215848/across-texas-black-and-hispanic-neighborhoods-have-fewer-coronavirus-testing-sitGoogle Scholar
The Editorial Board. (2013, August 12). Racial discrimination in stop-and-frisk. New York Times. www.nytimes.com/2013/08/13/opinion/racial-discrimination-in-stop-and-frisk.htmlGoogle Scholar
ACLU Massachusetts. (n.d.). Enduring racist stop and frisk. www.aclum.org/en/ending-racist-stop-and-friskGoogle Scholar
Stolper, H. J., J. (2018, April 16). The enduring discriminatory practice of stop & frisk. Community Service Society. www.cssny.org/news/entry/stop-and-friskGoogle Scholar
Balko, R. (2020, June 10). There’s overwhelming evidence that the criminal justice system is racist: Here’s proof. Washington Post. www.washingtonpost.com/graphics/2020/opinionss/systemicracism-police-evidence-criminal-justicesystemGoogle Scholar
Racial and Identity Profiling Identity Board. (2021). Annual report. https://oag.ca.gov/sites/all/files/agweb/pdfs/ripa/ripa-board-reportt-202.pdfGoogle Scholar
Griffith, D. M. (2019, September 13). What racism is and is not. www.vanderbilt.edu/crmh/What_racism_is_and_is_not.pdfGoogle Scholar
Hoffman, K. M., Trawalter, S., Axt, J. R., & Oliver, M. N. (2016). Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proceedings of the National Academy of Sciences, 113(16), 42964301. https://doi.org/10.1073/pnas.1516047113CrossRefGoogle ScholarPubMed
Chen, I., Kurz, J., Pasanen, M., Faselis, C., Panda, M., Staton, L. J., O’Roke, J., Menon, M., Genao, I., Wood, J., Mechaber, A. J., Rosenberg, E, Carey, T., Calleson, D., & Cykert, S. (2005). Racial differences in opioid use for chronic nonmalignant pain. Journal of General Internal Medicine, 20(7), 593598. https://doi.org/10.1111/j.1525-1497.2005.0106.xGoogle Scholar
Eligon, J. (2021, May 30). ‘On that edge of fear’: One woman’s struggle with sickle cell pain. New York Times. www.nytimes.com/2021/05/30/us/sickle-cell-black-women.htmlGoogle Scholar
Central Intelligence Agency. (n.d.). Country comparisons: Infant mortality rate. www.cia.gov/the-world-factbook/field/infant-mortality-rate/country-comparisonGoogle Scholar
Artiga, S., Pham, O., Orgera, K., & Ranji, U. (2020). Racial disparities in maternal and infant health: An overview. Issue Brief. Kaiser Family Foundation. www.kff.org/report-section/racial-disparities-in-maternal-and-infant-health-an-overview-issue-brief/Google Scholar
Hoyert, D. (2022, February) Maternal mortality rates in the United States 2020. Health E-Stats. www.cdc.gov/nchs/data/hestat/maternal-mortality/2020/E-stat-Maternal-Mortality-Rates-2022.pdfGoogle Scholar
Melillo, G. (2020, December 3). US ranks worst in maternal care, mortality compared with 10 other developed nations. The American Journal of Managed Care. www.ajmc.com/view/us-ranks-worst-in-maternal-care-mortality-compared-with-10-other-developed-nationsGoogle Scholar
Green, T., & Hamilton, T. G. (2019). Maternal educational attainment and infant mortality in the United States: Does the gradient vary by race/ethnicity and nativity? Demographic Research, 41(25), 713752. www.jstor.org/stable/26850665CrossRefGoogle Scholar
Aria, E., Tejada-Vera, B., Kochanek, K. D., & Ahmad, F. B. (2022, August). Provisional life expectancy estimates. Vital Statistics Rapid Release www.cdc.gov/nchs/data/vsrr/vsrr023.pdfGoogle Scholar
Scholey, J., Aburto, J. M., Kashnitsky, I., Kniffka, M. S., Zhang, L., Jaadia, H., Dowd, J. B., & Kashyap, R. et al. (2022). Life expectancy changes since COVID-19, Nature Human Behavior 6, 1649–1659. https://doi.org/10.1038/s41562–022-01450-3Google Scholar
National Center for Health Statistics. (2021). Health, United States, 2019. https://www.cdc.gov/nchs/data/hus/hus19-508.pdfGoogle Scholar
Ahmad, F. B., Cisewski, J. A., Miniño, A., & Anderson, R. N. (2021). Provisional mortality data - United States, 2020. Morbidity and Mortality Weekly Report, 70(14), 519522. https://doi.org/10.15585/mmwr.mm7014e1Google Scholar
Asthma and Allergy Foundation of America. (n.d.). Asthma disparities in America. www.aafa.org/asthma-disparities-burden-on-minorities.aspxGoogle Scholar
Centers for Disease Control and Prevention. (n.d.). Risk for covid-19 infection, hospitalization, and death by race/ethnicity. www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.htmlGoogle Scholar
Giaquinto, A., Sung, H., Miller, K. D., Kramer, J. L., Newman, L. A., Minihan, A., Jemal, A., & Siegel, R. L. (2022). Breast cancer statistics, CA: A Cancer Journal for Clinicians (electronic preprint in advance of publication) (72) 524–541. https://pubmed.ncbi.nlm.nih.gov/36190501/Google Scholar
National Institutes of Health. (2016, June 21). Racial disparities in stroke incidence and death. www.nih.gov/news-events/nih-research-matters/racial-disparities-stroke-incidence-deathGoogle Scholar
Shiro, A. G., Pulliam, C., Sabelhus, J. S., & Smith, E. (2022, June 29). Stuck on the Ladder: Intragenerational wealth mobility in the United States. Brookings. www.brookings.edu/research/stuck-on-the-ladder-intragenerational-wealth-mobility-in-the-united-states/Google Scholar
Statista. (n.d.). Percentage of educational attainment in the United States in 2018, by ethnicity. www.statista.com/statistics/184264/educational-attainment-by-enthnicity/Google Scholar
Wilson, K. B., Thorpe, R. J., & LaVeist, T. A. (2017). Dollar for dollar: Racial and ethnic inequalities in health and health-related outcomes among persons with very high income. Preventive Medicine, 96(3), 149153. https://doi.org/10.1016/j.ypmed.2016.08.038Google Scholar

Save book to Kindle

To save this book to your Kindle, first ensure [email protected] is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×