“A public health emergency is racism”

The recognition that racism is a mass health concern is a topic for which BMC Public Health is soliciting submissions for its collection. Racism causes economic and social inequality and has been shown to have an impact on mortality, morbidity, and general well-being.

Image source: Public Health Insider

The main causes of racial disparity must be addressed, and well-thought-out, strategic, and long-lasting efforts must be taken to prevent racial prejudice while addressing the underlying reasons.

There is ample evidence of racial disparities in wellbeing and health. For instance, there are persistent racial disparities in chronic diseases like diabetes and hypertension, COVID-19 cases, hospitalizations, and deaths, maternity and infant health (such as maternal mortality and premature delivery), and COVID-19 cases (1–6). These racial injustices are a product of subjugation throughout history and the present. Dismantling oppressive institutions and practices that not only obstruct health and well-being but also contribute to racial health inequities requires acknowledging and recognizing discrimination as a public health concern. Other systems that are crucial for health, such as food systems, education, employment, and housing may also be affected by the designation of racism as a public health concern.

Racism is defined as “state-sanctioned and/or extralegal (meaning not always governed by the law) presentation and exploitation of group-differentiated openness to premature death” and elevates how oppression, privilege, and power work based on racial categorization. Because of white supremacy and institutional racism, the United States’ founding involved acts of genocide, colonization, and land stealing from Indigenous communities.

Moreover, racism can be institutionalized, interpersonal, or personally mediated before becoming internalized (10), with structural racism being the sum of all racism’s manifestations in society.

Interpersonal or personally-mediated racism has been the main focus of empirical research on racism and health (which contains the day-to-day experiences of racism that are adjudicated through individuals and a result of racist systems and institutions). This study shows that daily stressors build up as “wear and tear on the body,” also known as “weathering,” causing personally-mediated racism to work through pressure trails to dysregulated biological systems, resulting in accelerated aging and bad health effects.

Immune function is then dysregulated, the body is unable to achieve homeostasis, sensitivity and exposure to disease are created, and the body’s capacity to maintain health is challenged.

Throughout the past few years, legislation and policy explicitly relating to health and racism have gained prominence. Examples include federal legislation like the Black Maternal Act of 2020 (and of 2021), the Anti-Racism in Public Health Act of 2020, and numerous local and state resolutions citing racism as a public health crisis.

Racism is not an isolated phenomenon. BIPOC persons have little access to power to change the systems in which they must live since federal and state rules and procedures have been developed over time to memorialize and systematize discrimination based on race. As a result, racial prejudice hinders BIPOCs from having a voice or a sense of agency in their lives and affects their access to secure healthcare, education, and employment in every aspect of daily life.

The work of several departments at Cornell Health is influenced by public health professionals, who also contribute to the development of prevention, intervention, and treatment strategies. Our team is aware of and committed to the social fairness imperatives that underpin the work we perform, and we are unwavering in our resolve to eliminate the prejudice, oppression, and discrimination that are ingrained in the American healthcare system.

The service delivery strategy used by Cornell Health is intended to give all students equal access to care, regardless of their insurance status, as well as to offer services and support to the diverse student body. Please learn more about our dedication to diversity and inclusion, as well as how we’re working to lower obstacles to care and promote fair access to health services.

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