From Cape Coast to COVID-19: Tracing Health Inequities Through Racialized Space, Collective Trauma, and Slavery Era

Legacies of slavery and colonialism continue to shape contemporary health disparities, disproportionately affecting marginalized communities. This study examines how structural racism rooted in the transatlantic slave trade and reinforced by enduring racial hierarchies persist health inequities, particularly during public health crises like COVID-19. This research explores the intersection of historical structural segregation such as slavery as critical determinants of health disparities.

We applied qualitative analyses of a focus group based on participants' experiential observations at Ghanaian heritage sites. University students from the U.S. (n=5, mean age = 19.8, 60% male, all white) and Ghana (n=8, mean age = 26, 62% male, all African) visited the Cape Coast slave dungeon. Two hours after the visit, participants engaged in a focus group to share their emotional and cognitive responses, regarding the contrast between the enslaved Africans' living conditions and those of European colonizers. They also reflected on how these historical contexts could relate to structural pathways influencing COVID-19 disparities. The session was recorded, transcribed, and analyzed, guided by the collective cultural trauma framework.

Emerging themes included: structural racism fosters health-compromising contexts and behaviors; body fluids as micro-transmission mechanisms linking racism to health outcomes; internalized domination and inferiority, and the need to confront structural racism to address racial health disparities.

Findings reveal that structural racism perpetuates health-compromising conditions and fosters medical mistrust and race-based hierarchy to (re)produce health disparities. Structural and population-level interventions are needed to promote health equity and accelerate the SDG goals such as good health and well-being.