User:BSchilling/RacismHealth

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
See also: Social determinants of health

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