An American Dilemma: Racial Disparities in Health – Past and Present
Published online by Cambridge University Press: 07 September 2023
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.
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