Why Racial Justice Matters for Our Health
Kassandra I. Alcaraz, PhD, MPH; The Johns Hopkins University and The Sidney Kimmel Comprehensive Cancer Center
Tiffany L. Carson, PhD, MPH, FTOS; Moffitt Cancer Center
Patricia Rodriguez Espinosa, PhD, MPH; Stanford University School of Medicine
Adati Tarfa, PharmD, MS; University of Wisconsin-Madison School of Pharmacy
Headline-making events in recent years—including police violence against Black Americans and the disproportionate burden of COVID-19 in communities of color—have called for renewed attention to racial injustices in our society. Although the media put a spotlight on the need for greater racial justice in recent years, these types of patterns of violence and disparities neither new nor rare. In fact, racial justice has been a focus of behavioral medicine for a long time.
Why is Structural Racism a Health Problem?
Structural racism is one of many social determinants of health, which are the circumstances in which people are born, live, work, play, and age. It is developed and preserved through society’s policies, institutions, and systems.
Structural racism is particularly harmful because it is designed and endorsed by systems that should be protective, safe, and bias-free such as the educational and healthcare systems. Although most people agree that racism is harmful, many do not realize its negative effects on health.
What is Being Done About Racial Injustices and Health Concerns?
Behavioral medicine professionals have helped us understand and address some of the effects of structural racism on health. Let’s look at a few examples.
- Compared to their non-Hispanic white counterparts, patients from racial/ethnic minority groups face greater healthcare challenges such as poorer access to high-quality care (including mental health care), more difficulty accessing pain medication, and longer wait times for treatment. Many behavioral medicine experts work with or within clinical settings to help ensure the healthcare system benefits every patient, for example, by collecting information on patients’ social histories to better understand additional factors that can influence prevention or treatment. This information is used to help patients change unhealthy behaviors while considering their specific needs, including those due to unjust social circumstances beyond their control.
- Residential segregation is a type of structural racism that limits fair access to high-quality housing, schools, health care, jobs, and more. Research shows that residential segregation is one reason why Black Americans generally have poorer health than White Americans. For example, Black-segregated neighborhoods often have inadequate built environments (man-made facilities and structures like parks and bike paths) that make physical activity difficult or unsafe. Behavioral medicine experts are leading the way in providing access to, or creating, more appropriate and safer spaces in communities so everyone can be physically active.
- Individuals from racial/ethnic minority groups are more likely than others to have food insecurity, which is limited or uncertain access to adequate food. Research shows that food insecurity is related to conditions like diabetes. Behavioral medicine professionals are instrumental in shaping policies that are making produce more readily available for patients with chronic conditions like diabetes (where food is a key component of management). In some places, individual or group health programs are led by behavioral medicine professionals to help people who receive food assistance make healthy dietary choices.
These are a few examples, but many more exist.
How Can You Help to Improve Racial Justice and Health?
Here are some ways you can contribute to better racial justice and health:
- Do not assume everyone has equal access to resources that can improve or maintain their health.
- Learn about your personal biases (blind spots we all have) and use that knowledge to promote fairer work, education, or neighborhood environments.
- Do not hesitate to make stress management and self-care a priority when faced with racism-related stress, and encourage others to do the same.
- When interacting with the healthcare system, speak up about issues like racism that might affect health or health care to advocate for yourself, your family members, and others.
- Communicate and demonstrate anti-racist attitudes and actions in your spheres of influence such as your social circle, place of employment, and local community.
- Become a champion and ally by supporting health policies that address structural racism and other social determinants of health.
Putting It All Together
Structural racism is unjust because it unfairly advantages some groups while unfairly disadvantaging other groups. Acknowledging that structural racism negatively affects health among some racial/ethnic groups does not mean people’s personal health behaviors and decisions are also not important.
However, structural racism presents certain groups with greater challenges to being healthy compared to others. Racial justice is achieved when people from all racial/ethnic groups are included fairly and justly in society to “participate, prosper, and reach their full potential”16 and when “racial disparities in health, education, wealth, and other areas do not exist”. Recognizing how personal choices and social determinants of health like structural racism affect health can help us develop not only a more just society but also a healthier one.