Research and Intervention on Racism as a Fundamental Cause of Ethnic Disparities in Health

  • Date: Jan 01 2001
  • Policy Number: 20017

Key Words: Racism

The American Public Health Association,

Understanding that in the United States, ethnic disparities in health have persisted during the 20th century and even increased for certain health outcomes, despite major advances in public health, biotechnology, and economic prosperity and wealth;1-7 and

Understanding that “race”-associated differences in health outcomes are routinely documented in this country but the basis of those differences remains poorly explained, and many investigators simply statistically adjust for “race” or restrict their studies to a single “racial” group rather than vigorously investigating the basis of those differences;8-9 and

Understanding that “race” is not a biological measure reflecting innate differences but a social construct capturing the social classification of people in a “race”-conscious society,10-17 and that present day inequalities between so-called “racial” groups are not consequences of their biological inheritance but are products of historical and contemporary sociopolitical and economic systems;18-20 and

Understanding racism as the system of structures, processes, and values that results in differential outcomes by “race”, and that racism is manifest on cultural, institutional, interpersonal, and internalized levels;21-23 and

Acknowledging that ethnic disparities in health may arise on three levels: 

  1. Differences in social, political, economic, or environmental exposures that result in differences in disease incidence;24-26 
  2. differences in access to physical and mental health care including preventive and curative services;27-30a and
  3. differences in the quality of care received within the physical and mental health care delivery system;31-39 and

Acknowledging the importance of identifying the underlying causes of ethnic disparities so that these disparities can be most effectively addressed; and

Realizing that the perception of the occurrence and extent of ethnic disparities in health and health care differs between white and ethnic minority populations in the United States;40 and that many people in the United States believe that racism is no longer a problem, while others deal with its manifestations daily;41-43 and
Recognizing that the science on racism as a risk factor for adverse health outcomes in the United States is still scant but growing;10-12,25-26,44-47 and

Recalling that in 1965, the American Public Health Association passed a resolution on “The Health of Minorities and the Relationship of Discrimination Thereto,”48 and further recalling that in 1974, the American Public Health Association passed a resolution on “Racism in the Health Care Delivery System” which states, “Minority health, as affected by institutional racism, can only improve when efforts from the entire complex of human and public services are purposefully applied to accomplish that specific goal”;49 and

Recognizing that the American Public Health Association has also previously condemned the expression of racism in other countries;50-51 and

Cognizant that Mayor Bob Knight of Wichita, Kansas has called for a National Campaign Against Racism as President of the National League of Cities that challenges and assists city and town governments in becoming Cities Striving to Promote Racial Justice;52-53 and

Noting the Department of Health and Human Services’ Initiative to Eliminate Racial and Ethnic Disparities in Health by the Year 2010 and recognizing this as an opportunity to investigate and address the underlying causes of these disparities;54 and

Recognizing that the American Public Health Association has recently joined with the Department of Health and Human Services in a national Campaign to Eliminate Racial and Ethnic Health Disparities;55 and 

Cognizant that the recent congressional passage of the Minority Health and Health Disparities Research and Education Act of 2000, which established a National Center on Minority Health and Health Disparities at the National Institutes of Health, provides an opportunity for coordinated research on the impacts of racism on health,56 therefore:

  1. Reaffirms previous American Public Health Associations policies that have condemned racism and its impacts on health and health care;
  2. Commends the National League of Cities on their efforts to launch a Campaign to Promote Racial Justice;
  3. Calls on the President and the Congress of the United States to endorse a National Campaign Against Racism;
  4. Calls on the Congress to fund the Institute of Medicine to prepare a report that summarizes our current knowledge on the impacts of racism on health and, by analyzing the processes that mediate these impacts, identifies points of intervention;
  5. Calls on the Department of Health and Human Services to explicitly address racism as a part of its national Initiative to Eliminate Racial and Ethnic Disparities in Health by the Year 2010;
  6. Calls on the Centers for Disease Control and Prevention, the Agency for Healthcare Research Quality, the Health Resources and Services Administration, and the National Institutes of Health to place a high priority on research on the impacts of racism on the health and well-being of the nation;
  7. Calls on the Congress of the United States to appropriate funds for investigating the impacts of racism on the health and well-being of the nation;
  8. Calls on the Congress of the United States to appropriate additional funds for developing evidence-based programs to eliminate ethnic health disparities; and
  9. Calls on the President and the Congress of the United States to recognize and promote legal redress for discrimination in health and health care.

References

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