User:BSchilling/RacismHealth

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Social determinants of health



Institutional racism in the healthcare system

Automatic White bias in medical education
Only White people could go to medical school and practice medicine.

Still majority white doctors

In-group empathy
Racial Bias
Legacy of slavery and colonialism in medical education
Black people feeling pain
Higher prevalences of diseases being treated as natural
See also: Slavery hypertension hypothesis

Things that are actually taught at medical school


Anti-racism movement in medical system

Social determinants of health

Resources
Socioeconomic status
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3442603/ differences across race in SES contribute to differences in health outcomes - racial disparities in health
Racism
Health outcomes of experiencing even subtle acts of racism: increased risk of heart disease, clinical depression, LBW infants, poor sleep, obesity, mortality https://healthequity.globalpolicysolutions.org/wp-content/uploads/2016/12/RacismasSDOH.pdf
https://www.healthaffairs.org/do/10.1377/hblog20200220.518458/full/
Documented among AA, Arab Americans, Asian Americans, Latinos, Native Americans
Insurance
Types of jobs that provide health insurance - who holds them?
66% White, 46% black, 41% Latin, 36% AI/AN covered by employee-sponsored health insurance https://www.americanbar.org/groups/crsj/publications/human_rights_magazine_home/health-matters-in-elections/racial-and-ethnic-disparities-in-employer-sponsored-health-coverage/
Black people most likely to fall into Medicaid gap (income too high for Medicaid eligibility but not high enough to take advantage of subsidies under marketplace plans
Insurance is a barrier to preventative care, disease management, screenings, access to prescriptions
Uninsured rated by race/ethnicity (2018): https://www.kff.org/uninsured/state-indicator/rate-by-raceethnicity/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D
White: 8%
Black: 11%
Hispanic: 19%
Asian/NH/PI: 7%
AI/AN: 22%
Multiple races: 8%
Housing
People of color over-represented among homeless population. (ref). Homelessness creates barriers to care: https://www.ncbi.nlm.nih.gov/books/NBK218231/
Connection between homelessness and health https://nhchc.org/wp-content/uploads/2019/08/homelessness-and-health.pdf
Homelessness complicates healthcare access: https://www.ncbi.nlm.nih.gov/books/NBK218236/
Distance from doctor
Incarceration
Racial and Ethnic Disparities in incarceration: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3546523/
Immigration status
Insurance
Documentation and insurance


Homelessness among Native American populations:

Disproportionately high: https://www.huduser.gov/portal/sites/default/files/pdf/HNAIHousingNeeds.pdf
https://www.npr.org/2018/07/21/631089441/grappling-with-native-american-homelessness
African Americans: Disproportionately high homelessness: https://nhchc.org/wp-content/uploads/2019/08/health-homelessness-and-racial-disparities.pdf
https://nlihc.org/resource/study-finds-significant-racial-disparities-homelessness-rates
https://www.pewtrusts.org/en/research-and-analysis/blogs/stateline/2019/03/29/a-pileup-of-inequities-why-people-of-color-are-hit-hardest-by-homelessness


Social determinants of health[edit]

See also: Social determinants of health

Social determinants of health are conditions of a person's circumstances that affect their health outcomes [1]. These include social environment, physical environment, and access to services. Many social determinants of health differ across races and have impacts on health outcomes [2].

  1. ^ "NCHHSTP Social Determinants of Health". CDC NCHHSTP. CDC. Retrieved 17 October 2020.
  2. ^ (NEED)