Portrait of a Young Girl in Black

Racism: A Longstanding Pandemic Hides in Plain Sight

Your writing seems to have a good deal of political and social influence rather than solid scientific thinking. Such an editorial comment is not unusual when one writes on health and racism. But it makes us wonder. Can health scientists wrap their heads around a pandemic of racism? Or shall we debate the semantics to attach to this widespread plague? This plague has profound effects on the health and lifespan of African Americans. Another new paper links experiences of racial discrimination to the severity of metabolic disease. Thus our impatience with these questions grows.

Life Experiences of 3,870 African Americans

Michelle Cardel and colleagues analyzed data from the Jackson Heart Study. Yes, it’s observational data, so this data is all about associations. And that’s precisely what they found – a robust association between experiences of discrimination and the severity of metabolic syndrome in 3,870 African American Adults. With a bigger dose of discrimination, subjects had objectively more severe symptoms of metabolic syndrome. Cardel et al looked at both everyday discrimination and lifetime experiences. Either way, the relationship was highly significant.

Cardel tells us this is important:

Racism and discrimination experienced by Black Americans should not be a partisan political issue. It is one with profound social, economic, and health ramifications. We now face intersecting crises of racism and the disproportionate effects of COVID-19 on the Black community. This paper adds to a compelling body of evidence. To improve the health of our nation, we need to be dismantling the systemic racism that has such profound effects.

Biological Outcomes, Not Rationalizations

In Health Affairs recently, the editors called for a new standard for writing about racial health disparities. They describe multiple examples of rationalizations about race and health. For years, scholars have written about “mistrust” as the direct effect of the notorious Tuskegee experiment. Mistrust becomes an excuse for poor health outcomes. In fact, the real problem is racism – whole lifetimes of experiencing racism.

But racism is less comfortable for the dominant White culture to acknowledge. So mistrust of medical care served as a surrogate for way too long. This is but one example of ways that health scientists avoid the subject.

Defining a Pandemic

We are all learning that a pandemic is uncomfortable. COVID-19 is disrupting our lives whether we like it or not. Pandemic racism has been disrupting and shortening the lives of Black Americans for centuries.

And yet only now are we beginning to think of racism as a public health crisis. Colorado – a state where neither Democrats nor Republicans dominate – is declaring racism to be a public health emergency. CDC scientists say that the nation’s preeminent public health agency is lagging on this issue because of a toxic culture of racism.

Racism plagues the health of our nation. Can we address it head on? Without worrying that it makes people uncomfortable?

Click here for the paper by Cardel et al and here for the editorial from Health Affairs. For more on the pandemic of racism, click here and here. Finally, we recommend this excellent review of the evidence on racism and health.

Portrait of a Young Girl in Black, painting by Andre Derain / WikiArt

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August 3, 2020