Edited by Corona Zhang
High disease rates and poor health amongst Black Americans is tied to a history of low socioeconomic status, decreased health access, and years of discrimination as a result of systemic racism (Mays, Cochran, Barnes). Additionally, genetic predisposition to disease amongst Black Americans is driven by economic factors and disparities; high fat levels and kidney disease are examples of how those three factors can work synergistically to produce illness (Cooper).
One factor that leads to increased risk of disease is the effects of high stress due to lifelong discrimination (Mays, Cochran, Barnes). Even amongst people who made $175,000 a year or more, people who are Black are more likely to have health issues than people who are white (Khazan). Lifelong high stress can lead to a higher risk of chronic diseases and a shorter life (Mays, Cochran, Barnes). This phenomenon of early health decline due to social disadvantage has been identified as the weathering hypothesis (Geronimus).
An additional barrier is the discrimination in the healthcare system. Black Americans have reported that they have been talked to rudely, ignored, or were talked down to by healthcare providers (Health Policy Institute). Additionally, Black Americans reported not being understood by their healthcare providers. They believe that if they were a different race, they would be treated better. Related to this, there is a lack of diversity in healthcare professionals (Health Professionals for Diversity Coalition). Diversity in healthcare professionals is important because it gives patients the freedom to pick a provider they feel comfortable with. Black Americans report being more satisfied and having received better treatment when they receive care from someone of the same race or ethnic group (Health Professionals for Diversity Coalition).
Another factor that increases the risk of disease is lack of access to fresh, high quality and nutritious food. Lack of access to fresh food is associated with obesity and diet-related lifelong diseases like Type 2 Diabetes. People with low socioeconomic status are more likely to live in a “food desert”, which is an area with a low availability of fresh food (Diaz-Granados). About 39% of Black children live in poverty compared to 14% of White and Asian children (American Psychological Association). Healthy food also tends to cost more, which is also a barrier to access (Diaz-Granados). However, “food apartheid” is the most accepted term because it highlights the fact that lack of food access is tied to policies and practices that originate from anti-Blackness (Bryne). Neighborhoods that are majority Black have less stores and lower quality food than majority white neighborhoods (Bryne).
Lacking health insurance can also determine health (Healthy People 2020). People who are uninsured are more likely than those with insurance to put off healthcare or not seek healthcare at all (Garfield, Orgera, Damico). Lack of insurance is associated with a higher risk of death (Wilper, Woolhandler, et al). High proportions of people of color, compared to white people, do not have a steady access to care and do not have health insurance (Health Policy Institute). For example, in 2019 about 9.8% of white people had no health insurance compared to 13.6% of Black people (Rudden). Though Connecticut has the highest percentage of residents that are insured, the coverage is not equal across socioeconomic and racial groups (Health Coverage).
Hazardous living environments can also contribute to higher risk of disease. Examples of hazardous living environments are contaminated water, indoor smoke, lack of a steady food supply, unsafe chemicals, and improper sanitation. When talking specifically about environmental pollutants, environmental racism
is used to describe the unjust burden of water, air and waste problems disproportionately imposed on communities of color in the U.S. (Bullard cited by Chand). Neighborhoods which are majority people of color and people with low incomes are disproportionately targeted by companies when selecting where to put their hazardous waste and polluting factories (Erickson). About 56% of people who live near toxic waste are people of color (Covert). Black people are twice as likely to live without modern sanitation and drinking water than white people (Covert). Black children are more likely to grow up in a disadvantaged area than white children (Campbell). People living in a disadvantaged area are more likely to have health problems like asthma and diabetes (Campbell). Overall, in some places like Baltimore, there is a 20-year gap in the life expectancy of Black people versus white people (Khazan).
(This blog piece is an abridged version of a powerpoint presentation named “Health Disparities as a Result of the African and Caribbean Diaspora by Alpha Zeta Omega UConn Student Pharmacists February 2020 which can be found at https://docs.google.com/presentation/d/1lQSA5EBGl3MS8brYETXnFki2dItOYgTiNDlcpE_U6iQ/edit?usp=sharing)
Citations
American Psychological Association.(2020). Ethnic and Racial Minorities & Socioeconomic
Status. American Psychological Association. Retrieved from
Bryne C. (04 July 2019). It’s Great That We Talk About ‘Food Deserts’- But It Might Be Time
To Stop. Retrieved from https://www.huffpost.com/entry/food-desert-problem-access-
Campbell AF. (25 July 2016). Gas Leaks, Mold, and Rats: Millions of Americans Live in
Hazardous Homes. The Atlantic. Retrieved from
Chand N. (08 January 2018). Environmental Racism: what is it? And why does it matter?
Imagine, The University of Utah. Retrieved from
https://diversity.utah.edu/environmental-racism/
Cooper RS, National Institute of Health. (2004). Genetic Factors in Ethnic Disparities in
Health, Critical Perspectives on Racial and Ethnic Differences in Health in Late Life.
National Academies Press (US).
Covert B. (18 February 2016). Race Best Predicts Whether You Live Near Pollution. The
Nation. Retried from https://www.thenation.com/article/politics/ilhan-omar-dismantle-
Cultural Competence in Health Care: Is it important for people with chronic conditions?
Health Policy Institute. https://hpi.georgetown.edu/cultural/
Diaz-Granados S. (17 March 2018). The Food Gap: Income Inequality and Disease Disparity.
Harvard Political Review. Retrieved from https://harvardpolitics.com/culture/food-gap/
Erickson J. (19 January 2016). Targeting minority, low-income neighborhoods for hazardous
waste sites. Michigan News, University of Michigan. Retrieved from
Garfield R, Orgera K, Damico A. (25 January 2019). Primer- Key Facts About Health Insurance
and the Uninsured Amidst Changes to the Affordable Care Act. Kaiser Family
Foundation. Retrieved from https://www.kff.org/report-section/the-uninsured-and-the-
Geronimus A. T. (1992). The weathering hypothesis and the health of African-American
women and infants: evidence and speculations. Ethnicity & disease, 2(3), 207–221.
Health Coverage. (2018). Uninsured Rate by Race and Ethnicity. Live Stories. Retrieved from
Health Professionals for Diversity Coalition. Fact Sheet: The Need for Diversity in the Health
Care . Health Professionals for Diversity Coalition. Retrieved from
Healthy People 2020.(2020). Social Determinants of Health. HealthyPeople.Gov. Retrieved
Khazan O. (July/August 2018). Being Black in America Can Be Hazardous to Your Health. The
Atlantic. Retrieved from https://www.theatlantic.com/magazine/archive/2018/07/being-
Rudden J. (29 June 2020). Percentage of U.S. Americans without Health Insurance by
Ethnicity 2010-2019. Statista. Retrieved from
Wilper AP, Woolhandler S, Lasser KE, McCormick D, Bor DH, Himmelstein DU. (December
2009). Health Insurance and Mortality in US Adults. American Public Health Association,
99(12), 2289-2295.
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