By Chloe Reichel
Racism was embedded in the founding of the United States and has persisted in virtually all aspects of our society through the present day.
In 2020, structural racism was made especially apparent in the disproportionate toll the COVID-19 pandemic has taken on communities of color, which can be traced back to the social determinants of health, and in grotesque displays of police violence, such as the killings of Breonna Taylor, George Floyd, Ahmaud Arbery, and Elijah McClain.
Racism is the public health issue of our time, after having been woefully un- or under-addressed for centuries. The following posts, which were published on Bill of Health this year, highlight some of the most pressing issues to confront, as well as potential ways forward.
Colleen Campbell’s “Racial Inclusivity in COVID-19 Vaccine Trials,” remains relevant as the COVID-19 vaccination campaign rolls out in the U.S. Her piece explains the history that undergirds medical distrust in Black communities — a justified distrust based on medical racism and violations of research ethics — which may hinder efforts to vaccinate the most at-risk populations for severe COVID-19.
“Years before George Floyd begged to be released from under the knee of Officer Derek Chauvin, Barbara Dawson, a fifty-seven year old Black woman, died begging a police officer, John Tadlock, not to remove her oxygen mask,” Michele Goodwin writes. In her devastating piece, Goodwin describes the threats Black women face in their daily lives, both within and outside the health care system.
In “COVID-19 and Women in the US Criminal Legal System,” Cynthia Golembeski and her co-authors unpack the disproportionate health and economic inequities that incarcerated women of color face.
The lasting legacy of Buck v. Bell, the Supreme Court decision that upheld Virginia’s Eugenical Sterilization Act in 1927, lies mainly in its “broad devaluation of the lives of people with disabilities and people of color,” Jasmine E. Harris writes in her analysis of the case.
COVID-19 has sparked another pandemic in the U.S., Seema Mohapatra writes — the pandemic of xenophobia.
“Starting as early as January 2020, when most Americans were not feeling the daily effect of this pandemic as they are now, many Asian Americans were already starting to face discrimination, from people avoiding them in grocery store aisles to more violent hate crimes,” she explains. “Instead of trying to extinguish racist attitudes, the Trump administration has actually spearheaded ways to ‘other’ Asian Americans.”
Kimani Paul-Emile calls attention to an “often forgotten, front-line workforce” in the COVID-19 pandemic: low-paid essential health care workers, like nursing assistants and long-term care facility workers. This group “earns very little money, has few protections, and is largely Black and Brown and female,” and faces a slew of occupational hazards, including increased risk of exposure to the virus, and discrimination from patients on the basis of their race or ethnicity.
In “Why Justice is Good for America’s Health,” Dayna Bowen Matthew sets out a roadmap for how social institutions can advance health equity.
And Jenna Becker highlights the potential of a specific intervention — telehealth — to promote health equity in “How Telehealth Can Reduce Disparities.” Telehealth has exploded during the COVID-19 pandemic, and for those who have access to the necessary technology and digital infrastructure, it may lower barriers to care.
In “A Critical Race Perspective on Social Risk Targeting in the Health Care Sector,” Brietta R. Clark explains how risk targeting — a strategy used to identify individuals for social interventions — might backfire.
“Risk targeting — even if well-intentioned — can trigger fears of continuing discrimination, surveillance, and punitive action by the same systems upon which current social interventions may depend. Well-meaning interventions promoting healthier eating, better parenting, and stricter compliance with physician recommendations may not feel that different from interventions that have treated marginalized groups as inherent risks to be managed or contained,” Clark writes.
Architects of interventions designed to promote health equity should keep these insights at top of mind in their work.