Category: Social Determinants of Health

covid-19 virus.

Health Justice Strategies to Combat the Pandemic: Video Preview with Ruqaiijah Yearby

The Petrie-Flom Center Staff Leave a comment

The Health Law Policy, Bioethics, and Biotechnology Workshop provides a forum for discussion of new scholarship in these fields from the world’s leading experts.

The workshop is led by Professor I. Glenn Cohen, and presenters come from a wide range of disciplines and departments.

In this video, Ruqaiijah Yearby, Seema Mohapatra, Lindsay Wiley, and Emily Benfer give a preview of their paper, “Health Justice Strategies to Combat the Pandemic: Eliminating Discrimination, Poverty, and Health Disparities During and After COVID-19,” which Yearby will present at the Health Law Policy workshop on October 13, 2020. Watch the full video below:

an ambulance parked at the entrance of an emergency department

The Double Bind of Medicine for Racial Minorities

The Petrie-Flom Center Staff Leave a comment

By Craig Konnoth

Medicine often falls short of helping black, indigenous, and people of color (BIPOC). While many individuals successfully invoke medical framing to offer some assistance to address the serious burdens they face — as I explain in a recent article — such efforts have fallen short in the context of racial justice. BIPOC are either subject to hypervisibility — where their medical trait is made a defining characteristic of their existence — or medical erasure, where their medical needs are left unaddressed and ignored.

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Empty hospital bed.

Addressing Health Inequities in End-of-Life Care in the Era of COVID-19

Megan Shen Leave a comment

By Megan J. Shen

Inequities in end-of-life care have been exacerbated by the COVID-19 pandemic, but have yet to receive the same level of attention as some other health disparities brought to the fore recently.

Quality end-of-life care is focused on reducing human suffering and aiding patients in receiving support during the dying process.

Traditionally, poor quality end-of-life care involves the overtreatment of patients, as in the case of continuing to treat incurable cancer aggressively. However, COVID-19 has introduced new challenges in achieving quality care at the end of life. Specifically, it is now more challenging to reduce human suffering at the end of life because of limitations in providing access to two critical resources: (1) medical care that can relieve physical suffering in the dying process and (2) support, such as loved ones, as well as needed psychological, spiritual, and physical support to cope with the existential threat of dying. COVID-19 has made access to both of these a greater challenge for underrepresented minorities.

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computer and stethoscope

How Telehealth Could Improve — or Worsen — Racial Disparities

The Petrie-Flom Center Staff Leave a comment

By Craig Konnoth, JD, M.Phil., Wendy Netter Epstein, JD, and Max Helveston, JD

Despite upping the stakes of America’s partisan divide, the pandemic has prompted bipartisan support for at least one cause — the rapid rollout of telehealth, which allows people to see their doctors by videoconference or telephone.

In last week’s executive order, the Trump Administration reaffirmed its commitment to the use of telehealth. While telehealth may be, in many ways, a panacea for access to healthcare, particularly in COVID times, we should be concerned that patients of color may be left behind.

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Minneapolis, MN / USA - May 26 2020: Black Lives Matter, "I Can't Breathe" Protest for George Floyd.

Expendable Lives and COVID-19

The Petrie-Flom Center Staff Leave a comment

By Matiangai Sirleaf

Two French doctors recently appeared on television and discussed using African subjects in experimental trials for an antidote to the novel coronavirus (COVID-19).

“Shouldn’t we do this study in Africa, where there are no masks, no treatment, no resuscitation, a bit like some studies on AIDS, where among prostitutes, we try things, because they are exposed, and they don’t protect themselves. What do you think?” asked Jean-Paul Mira, head of the intensive care unit at the Cochin Hospital in Paris on April 1, 2020.

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lady justice.

When Health Advice Is Hard to Come by, BIPOC Suffer the Consequences

The Petrie-Flom Center Staff Leave a comment

By Claudia E. Haupt

The COVID-19 pandemic has highlighted the tradeoffs at stake for Black, Indigenous, and people of color (BIPOC) seeking reliable health advice.

While there are legal safeguards to ensure reliable health advice within the confines of the doctor-patient relationship, outside of that relationship, the First Amendment protects bad advice just as much as good advice.

Courts continue to interpret the First Amendment in an expanding, deregulatory manner and the health context is no exception. For example, one novel judicial interpretation challenges previously accepted applications of the police power in furthering public health. In a forthcoming article, “Public Health Originalism and the First Amendment,” my colleague Wendy Parmet and I explore some of the dangers associated with this deregulatory approach.

Overall, the beneficiaries of these recent developments tend to be powerful speakers. The costs have largely fallen on women, as seen for example in NIFLA v. Becerra, and those who lack access to reliable medical advice, who are disproportionately BIPOC. Current First Amendment doctrine thus has the dangerous potential to further exacerbate existing racial disparities in health.

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Empty classroom.

School Discipline is a Public Health Crisis

The Petrie-Flom Center Staff Leave a comment

By Thalia González, Alexis Etow, and Cesar De La Vega

Education is well-accepted as a key social determinant of health. It serves as a strong predictor of chronic disease, social and economic instability, incarceration, and even life expectancy. For example, by age 25, individuals with a high school degree can expect to live 11 to 15 years longer than those without one. Despite such evidence, education policies and practices have not been public health priorities. Too often, policies and practices in schools that create and compound health inequities are narrated and re-narrated as falling outside health law and policy. This is a missed opportunity for collective action to positively impact the future health pathways of children and communities.

In the wake of national protests against racialized police violence and COVID-19’s disproportionate impact on communities of color, the time has come for the health community — from researchers, to public health organizations, to advocates, to health care professionals — to move from simply affirming that racism is a public health crisis, to actively exposing how structural discrimination in education has fueled disparities and deepened the persistence of health inequities.

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Climate protest sign that reads "no nature no future."

Climate Change and Pregnancy: Policies for Impact

Temple University Center for Public Health Law Research Leave a comment

By Cydney Murray

The ongoing, worsening environmental crisis is exacerbating negative pregnancy outcomes associated with climate change.

Exposure to air pollutants, such as smog (ozone) and PM2.5 (another type of air pollution), is linked to impaired fetal growth, increased likelihood of cancer, autism spectrum disorder, stillbirth, and low birth weight. These health consequences have the potential to impact children’s overall quality of life by affecting their brain development, and their susceptibility to disease.

Climate change is worsening this established association, particularly for those living in urban environments with high air pollutant exposure. This disproportionately affects women of color, since they are more likely to live in more highly polluted areas, and already suffer a higher risk of negative pregnancy outcomes.

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redlined map of Los Angeles.

A Critical Race Perspective on Housing and Health

The Petrie-Flom Center Staff Leave a comment
Image from “Mapping Inequality,” American Panorama, ed. Robert K. Nelson and Edward L. Ayers.

By Courtney Anderson

Only 10-20% of health outcomes are attributed to health care. Social, economic, and environmental factors thus account for the vast majority of population and individual health outcomes. And housing encompasses many of these factors, as it largely determines the built environment and exposure to stressors.

Section 801 of the Fair Housing Act declares, “It is the policy of the United States to provide, within constitutional limitations, for fair housing throughout the United States.” This Act was the culmination of racial justice protests, resistance to discrimination and violence, and other aspects of the civil rights movement. Despite the stated intention of this Act, housing remains unequal across the nation.

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A protester holds a sign with a quote that reads: "Pf all the forms of inequality injustice in health care is the most shocking and inhumane."

Structural Racism, Social Determinants, and the Contested Scope of Public Health Law

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By Lindsay F. Wiley

For centuries, public health advocates have understood that our health is shaped by the conditions in which we live and work — conditions public health researchers now refer to as the social determinants of health. Law itself is a social determinant of health. Structural racism and other forms of socioeconomic subordination, which are embedded in our laws and public and private policies, are social determinants of health.

Unfortunately, these statements are not uncontroversial. Commentators have debated whether structural racism and other forms of subordination are social determinants of health, and whether dismantling these forms of subordination is within the legitimate scope of public health law and policy. Critiques run along at least three main lines—semantic, civil libertarian, and progressive.

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