PUB 540 What structural and institutional factors in society contribute to racial health disparities?

PUB 540 What structural and institutional factors in society contribute to racial health disparities?

PUB 540 What structural and institutional factors in society contribute to racial health disparities?

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.

 

References

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 health16(4), 606. https://doi.org/10.3390/ijerph16040606 

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Race is a strong hold of our society in which we live. Race and genetic make-up often determine how we view situations, and it creates a point for a sense of bias to become present (Silverman-Lloyd and Bishop, 2021). Racism exists in our society in various forms such as beliefs (spiritual rituals), discrimination (belief that all are not created equal) and prejudice (exemplified by those who cannot be racist). Studies have shown that race plays a vital component in economic development, and access to care.  Removing race as a risk factor in public health data collection would be detrimental to the communities that certain health conditions are more prevalent. This will create a greater gap of between disparities (William and Rucker, 2000). Not considering race as a risk factor would be unethical and immoral to the communities, and the people in which we.  Removing race as a risk factor would infringe on the seven principles of public health ethics:  maleficence, beneficence, health maximization efficiency, respect for autonomy justice and proportionality.

Within the social structure of the society in which we live it has been proven through scientific studies that minorities, and economically disadvantage are not offered the same level or quality of healthcare. Structural and institutional racism determines how we live, what resources, and directly impacts the health of the nation.

 

The Belmont Report elaborates on the ethical principles. It speaks on the key terms “Do no harm” which correlates with the seven principles of public health.  Policies related to healthcare initiatives advocate for human rights and non-racial distributions of resources.

 

 

References:

 

Office for Human Research Protections (OHRP). “The Belmont Report.” HHS.gov. June 16, 2021. Accessed June 14, 2022. https://www.hhs.gov/ohrp/regulations-and-policy/belmont-report/index.html.

 

Silverman-Lloyd, L. G., Bishop, N. S., & Cerdeña, J. P. (2021). Race is not a risk factor: Reframing discourse on racial health inequities in CVD prevention. American journal of preventive cardiology6, 100185. https://doi.org/10.1016/j.ajpc.2021.100185

 

Williams, D. R., & Rucker, T. D. (2000). Understanding and addressing racial disparities in health care. Health care financing review21(4), 75–90.

Unfortunately, race was one of the concepts created when United States were founded. I appreciate the opportunities

PUB 540 What structural and institutional factors in society contribute to racial health disparities
PUB 540 What structural and institutional factors in society contribute to racial health disparities

and my ancestors before me that made a drastic difference in public health such as John Snow and Edward Jenner. Race itself is not a risk factor but due to institutional racism, it created a large gap of health disparities of people. For example, African-American schools get less funding than other schools. Certain areas that are mainly populated by blacks are considered low in property value. When the Tuskegee experiment happened in Alabama back in the 1932 to 1972, the goal was to study how syphilis reacted in the poor African-American male population. The government agency that funded the study wanted to compared the results to that of the Caucasian population. Hardeman et al. (2018) research study mentions that institutionalized racism play an important role of the various barriers of health equity. There is a lack of how institutionalized racism play a huge role in health outcomes of minority races. Truthfully, there will not be any policies that will dismantled racism because racism will never go away. Our society will gauge one another using race and socioeconomic status and class.

According to the Belmont report, there are three basic ethical principles: respect for persons, beneficence, and justice. Our American society has failed to uphold these three ethical principles due to the Tuskegee experiment. Overall institutionalized racism does not care about ethical principles.

References:

Hardeman, R. R., Murphy, K. A., Karbeah, J., & Kozhimannil, K. B. (2018). Naming Institutionalized Racism in the Public Health Literature: A Systematic Literature Review. Public health reports (Washington, D.C. : 1974)133(3), 240–249. https://doi.org/10.1177/0033354918760574

Racial and ethnic disparities in health have been largely documented and the causes are both numerous and diverse. Unfortunately, disparities in health care have been shown to play a substantial role. According to Jones (2010). The moral problem of health disparities exists along lines of race/ethnicity and socioeconomic class in US society” He argued that we should work to phase out these health disparities because their continuation is a morally wrong and should be addressed. Jones suggested “Making progress toward the goal of eliminating disparities will require widespread, reliable, and consistent data about the racial and ethnic characteristics of the U.S. population. This information is needed to identify the nature and extent of disparities, to target quality improvement efforts, and to monitor progress. Tracking the racial and ethnic composition and changing health care needs of different populations is vital if our health care system, which includes both public health and the delivery of personal health care services, is to fulfill its essential functions. Measurement, reporting, and benchmarking are critical to improving care.” Perhaps, some structural and institutional factors such as poverty and lifestyle behaviors, social environments and limited access to clinical preventative screenings and services have contributed to racial health disparities. Nevertheless, increasing awareness of racial and ethnic disparities in health care within the community (National Research Council, 2004).

References

 

National Research Council (2004). Panel on DHHS Collection of Race and Ethnic Data; Ver Ploeg M, Perrin E, editors. Eliminating Health Disparities: Measurement and Data Needs.The Role of Racial and Ethnic Data Collection in Eliminating Disparities in Health Care. Retrieved from: https://www.ncbi.nlm.nih.gov/books/NBK215740/

 

Jones, C (2010). The moral problem of health disparities. Am J Public Health. Retrieved from: S47-S51. doi:10.2105/AJPH.2009.171181