Racism & Health Equity

Racism

Involves prejudice + discrimination based on race, impacting individuals’ access to resources and opportunities

There are 4 levels

What are the levels of racism?

Internalized racism

acceptance by members of the stigmatized races of negative messages about their own abilities and intrinsic worth

By not believing in others who look like them, and not believing in themselves

How is internalized racism characterized?

1) Embracing of “whiteness“

2) Self-devaluation

3) Resignation, helplessness hopelessness

What are some manifests of internalized racism

Personally-mediated racism

• prejudice

• Discrimination

• Intentional or unintentional

This what most people think when they hear the term ‘racism‘. How I feel about another group

Prejudice

differential assumptions about the abilities, motives, and intentions of others according to their race

Discrimination

differential actions toward others according to their race

Intentional or unintentional; acts of commission as well as omission

Personally-mediated racism can also be

Personally-mediated racism manifests as

Institutional racism

Discriminatory places policies and practices carried out within and between individual public or private institutions based on racialized group membership

• Normative, sometimes legalized

• No identifiable perpetrator

Institutional racism is also

Institutions

Systems are made up of ____?

Institutional racism in one sector

reinforces it in other sectors, forming a large, interconnected system of structural racism whereby unfair discriminatory practices and inequities in the health and criminal justice systems and in labor and housing markets bolster unfair discriminatory practices and inequities in the educational system, and vice versa

Systemic/structural racism

Involvement of whole systems, and often all systems (political, legal, economic, healthcare, school, and criminal justice systems)), including the structures that uphold the systems

Inequitable systems + distribution of resources

Ways in which societies foster racial discrimination

Material conditions + Access to power

Structural/systemic racism manifests both in:

CDC: racism is a serious public health threat

APHA: Racism is a public health area crisis

Why is racism a public health issue?

Who has the power to decide, to act, and to control resources

Dangerous when:

Who is gardener?

Pathways between racism & health (9)

Economic injustice & social deprivation

Environmental and occupational health inequities

• Interpersonal racial discrimination

• Micro-aggressions (sometimes unintentional?)

• Exposure to racist media coverage. including social media

Psychosocial trauma

Targeted marketing of health-harming substances

• Access to health insurance + health--care facilities

• Substandard medical treatment due to implicit or explicit racial bias or discrimination

Inadequate health care

State-sanctioned violence and alienation from property and traditional lands

• Voter restrictions (former felons and through identification requirements)

• voter suppression/intimidation

Political exclusion

Maladaptive coping

• stigma of inferiority

• Physiological arousal

• An impaired patient-provider relationship

Stereotype threats