Race is often used as a descriptor of disease burden in epidemiology and helps to determine where health disparities exist so that they may be addressed through public health programs and policy. However, it is important to differentiate between race as a descriptor and race as a risk factor. Increasing evidence points to structural and institutionalized racism and racial trauma as risk factors that contribute to socioeconomic, epigenetic, and transgenerational consequences that result in minority health disparities.
Consider the following statement: “Race is not a risk factor and should not be used in public health data collection.” Discuss the ethical and public health implications of this statement. When might collecting data on race perpetuate institutional racism leading to health disparities and when is it necessary to improve public health? What structural and institutional factors in society contribute to racial health disparities? What policies and system changes are required to dismantle institutionalized racism and reduce minority health disparities? Consider ethical issues related to respect for persons, beneficence, and justice as described in The Belmont Report.
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Jun 15, 2022, 6:26 PM
In research that I have done regarding maternal mortality and specifically the incidence hypertensive disorders in pregnancy, mainly preeclampsia, being African American was described as a risk factor. Due to social economic disparities, culture, and other factors such a history of hypertension lead to African Americans having a higher risk factor. Study after study suggests this, but certainly not as a descriptor.
But that is not to say that racism does not exist in healthcare. As discussed by Williams et al. (2019) that structural racism determines differential access to health and resources that drive disparities in care. Studies have shown that segregation does not equate in better health. communities separated by race still tend to fare worse when it comes to diseases such as heart disease. Policies have been made based on difference, where separate is not equal. Racial discrimination or perceived discrimination affects the outcome of health due to trust issues or perceived notions regarding the individual being treated.
Williams & Cooper (2019) suggest that we use what we know to decrease health care institutional racism by creating communities of opportunity. But to do this, societal systems that create inequities such as education, housing, work, and other areas that address early education, childhood poverty, enhanced economic opportunities, and better housing. There are many strategies but building political will to address these things has to be addressed for the public to have better health outcomes. It is the Christian thing to do. We must find a way to increase public empathy, not just for moments but sustainably overtime.
Williams, D., R., Lawrence, J., A., Davis, B., A. (2019). Racism and health: Evidence and needed research. Annual Review of Public Health ,40(1), 105-125. https://doi.org/10.1146/annurev-publhealth-040218-043750
Williams, D. R., & Cooper, L. A. (2019). Reducing Racial Inequities in Health: Using what we already know to take action. International journal of environmental research and public health, 16(4), 606. https://doi.org/10.3390/ijerph16040606
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