Race, biology, and health care: reassessing a relationship

Recent reports reaffirm huge disparities in the health of blacks compared to other Americans. These disparities persist in part because of the current attempt by health policy makers to frame racially based health differences in non-racial terms. Yet an historical analysis shows that since ancient times, blacks have been the victims of racism in the biomedical sciences; health-system discrimination and deprivation; and later, medical and scientific exploitation. Race- and class-based structuring of the health delivery system has combined with other factors, including physicians' attitudes conditioned by their participation in slavery, and the scientific myth of black biological and intellectual inferiority, to establish a "slave health deficit" that has never been corrected. Until the persistent institutional racism and racial discrimination in health policy, health delivery, and medical educational systems are eradicated, African-Americans will continue to experience poor health outcome.