Global Health and Racism
9.07.2017
Racism is an ideology and prejudice that directly or indirectly emphasises that one group is inherently superior to another. It is an intentional or unintentional distinction, conduct, action, inaction or predisposition towards people based on their ethnicity and characteristics such as accent or manner of speech, name, clothing, diet, belief and leisure preferences. Being a socially constructed term, racism can prove difficult to define. However, it is easily reflected in racial jokes, slurs, hate crimes, presumptions, attitudes and stereotypical beliefs. In many cases, these reflections have become unconsciously assimilated over time as true, and have formed systematic, institutional and structural foundations in the societies. Racism can occur at any level including, individual, families and communities, leading to disparities in many areas of life such as health, economy, social class and education, to name a few.
Racism is a major problem because it is very common and affects lives on a daily basis. Many disparities between ethnic groups can most likely be attributed to racism. A national survey in the United Kingdom (UK) revealed that about 40% of participants would discriminate against ethnic minorities. In 1999, an estimated 282,000 crimes committed in the UK were motivated by racial discrimination. Racism inspires fear in about one-third of people from ethnic minorities causing them to constrain their lives, thereby stifling their opportunity to contribute fully to the future and growth of their societies.
Some studies have shown an association between racism, morbidity and mortality and that it may be of etiologic importance in the development of illnesses or diseases (McKenzie, K. (2003) Karlsen S, Nazroo J., 2002, Karlsen S, Nazroo J., 2002). Cross sectional studies in the United States show associations between perceived racial discrimination and hypertension, birth weight, self related health, and sick days. Additionally, victims of discrimination were more likely to have respiratory illness, hypertension, long term limiting illness, anxiety, depression, and psychosis in a recent study from the UK. Racial biases and cultural insensitivity among doctors have been linked to poor communication with patients, dissatisfaction with care and decreased global health outcomes. The risk of mental illness was seen to increase in people who believed that most companies were discriminatory. Furthermore, racism may be associated with illness at an ecological level since a 1% increase in racial disrespect in a state in the US was associated with an increase of 350.8 per 100 000 in “black” all cause mortality.
It is important to note that racism, being a social construct with confounders that may not properly be accounted for, is a difficult concept to measure. At such, most the studies done are only secondary analyses, even though it seems well established that discrimination at multiple levels influences health. Furthermore, the different ways that racism is reflected such as through interpersonal violence, institutional discrimination, or socioeconomic disadvantage, have different damaging effects on health, notwithstanding of the health indicator used.
On a final note, the starting point to effectively address racism and racial discrimination is to acknowledge it’s existence, and then fight it through public education and advancement of human rights.
So, if you ever thought, “what on earth racism does racism have to do with health?… now you know, and you’re welcome!