Systemic racism and U.S. health care

Area of Science:

• Social science
• Public health
• Health equity

Background:

• Systemic racism and white racial framing have historically oppressed Americans of color since the 1600s.
• Racially exploitative medical and public health practices reinforced this framing and structural discrimination.
• Contemporary research highlights persistent racial differentials in medical practices and institutional bias.

Purpose of the Study:

• To assess decades of empirical research on racial dimensions in U.S. health care and public health.
• To demonstrate the continuing reality of systemic racism within these institutions.
• To inform strategies for addressing racial disparities in health and healthcare.

Main Methods:

• Systemic racism theory as a primary analytical framework.
• Review of historical literature on medical and public health practices.
• Examination of contemporary research on racial differentials and clinician/patient perspectives.

Main Results:

• Historical and ongoing systemic racism, rooted in slavery and segregation, perpetuates racial disparities.
• Institutionalized discrimination and racialized framing limit access to socioeconomic resources and adequate healthcare for people of color.
• Significant racial differentials persist in medical practices and patient/physician experiences.

Conclusions:

• Addressing racial disparities requires acknowledging and confronting the U.S.'s white-racist history and present realities.
• Effective public policies can enact structural changes to reduce racial and class differentials in health.
• Systemic racism theory provides a necessary paradigm for understanding and rectifying health inequities.