Racism and its Impact on Health
When African-American respondents were asked about their own personal experiences regarding discrimination:
Dr. Anita Somani is an OB/GYN and current Past-President of the CMA
32% say they have personally experienced racial discrimination when going to a doctor or a health clinic; 22% have avoided seeking medical care out of concern about discrimination;
60% say that they or a family member have been unfairly stopped or treated by police; 31% have avoided calling the police when in need to avoid potential discrimination;
45% say they have been discriminated against when trying to rent or buy a house;
27% say they avoid day-to-day tasks like using a car or participating in social events.
(Robert Woods Johnson Foundation, 2017)
A large and growing body of research shows that the day-to-day experiences of African-Americans create physiological responses that lead to premature aging (meaning that people are biologically older than their chronological age). Or, as described in the American Behavioral Scientist, “experiences of racial discrimination are an important type of psychosocial stressor that can lead to adverse changes in health status and altered behavioral patterns that increase health risks.”
As physicians we know the statistics-
Dr. Sherita Golden, chief diversity officer at Johns Hopkins describes the increased incidence of Covid-19 in people of color and the disproportionate mortality rates.
African-Americans live sicker and die sooner than whites in America. Heart disease is the number one cause of death in the United States and middle-aged black males and females have death rates that are about twice as high as their white counterparts. Elevated death rates are also evident for cancer, stroke, diabetes, kidney disease, maternal death—the list goes on. In fact, every 7 minutes, a black person dies prematurely. That’s more than 200 black people a day who would not die if the health of blacks and whites were equal.
So, what are those day to day experiences that lead to premature aging? One of the biggest ones is chronic stress. I’ve never worried about my son going for a jog or playing music too loud or going to a store or church. But when I look at this list which is a list of wrongful deaths over several years, I wonder how have we failed so many for so long?
We can't go jogging (#AmaudArbery).
We can't relax in the comfort of our own homes (#BothemJean and #AtatianaJefferson).
We can't ask for help after being in a car crash (#JonathanFerrell and #Renisha McBride).
We can't have a cellphone (#StephonClark).
We can't leave a party to get to safety (#JordanEdwards).
We can't play loud music (#JordanDavis).
We can't sell CD's (#AltonSterling).
We can't sleep (#AiyanaJones)
We can't walk from the corner store (#MikeBrown).
We can't play cops and robbers (#TamirRice).
We can't go to church (#Charleston9).
We can't walk home with Skittles (#TrayvonMartin).
We can't hold a hair brush while leaving our own bachelor party (#SeanBell).
We can't party on New Years (#OscarGrant).
We can't get a normal traffic ticket (#SandraBland).
We can't lawfully carry a weapon (#PhilandoCastile).
We can't break down on a public road with car problems (#CoreyJones).
We can't shop at Walmart (#JohnCrawford) .
We can't have a disabled vehicle (#TerrenceCrutcher).
We can't read a book in our own car (#Keith Scott).
We can't be a 10yr old walking with our grandfather (#CliffordGlover).
We can't decorate for a party (#ClaudeReese).
We can't ask a cop a question (#RandyEvans).
We can't cash our check in peace (#YvonneSmallwood).
We can't take out our wallet (#AmadouDiallo).
We can't run (#WalterScott).
We can't breathe (#EricGarner).
We can't live (#FreddieGray).
This is a list of the people we have heard about but what about the daily injustices and slights that others experience. It wouldn’t surprise me to hear that for every name on this list there are hundreds of others who suffered the same fate without anyone knowing or experienced a near miss or whose health has suffered as a result.
As physicians we need to set the bar higher. We can start by trying to understand the stresses that people of color deal with every day. White Fragility by Robin DiAngelo discusses why it’s so hard for white people to talk about racism.
The article I have shared here gives us 65 different things we can do for racial justice. Pick one or two or even all 65 and consider doing them. Think of the change we can bring in our community if we set the bar higher and start with evaluating our own biases. The COVID pandemic is bringing the disparities in health care to the forefront and we need to evaluate and create policy that will improve these differences.