February Issue of Health Affairs Examines Racism in Health Care


The February issue of Health Affairs offers a comprehensive look at peer-reviewed research at the intersection of racism and health care.

It includes a holistic overview of how systemic racism influences the health of underserved populations, including the need to acknowledge the central role of racism in the national discourse on health care inequities (Braveman, Zambrana).

A series of studies provides empirical evidence of racism in the health care system. One study examines how structural racism and sexism shape employment for Black women in the US health care system, finding that Black women have the highest probability of working in the lowest-wage and most hazardous jobs, including in long-term care and as licensed practical nurses or certified nursing assistants (Dill). Another finds that higher levels of felony disenfranchisement—the denial of voting rights because of a felony conviction—are associated with greater depression and difficulty performing daily living activities, and that felony disenfranchisement is more prevalent for Black residents (Homan).

Analyses and first-person narratives share the experiences that underrepresented individuals have in a structurally racist health care system that too often leave people unheard. These commentaries and analyses examine how colonialism and racism preserve inequities for Fillipinx/a/o Americans, the third-largest Asian American group in the US (Sabado-Liwag); how the grouping of all Asian Americans together into data systems leads to poor data quality and stereotypes that perpetuate disparities (Yi); and case studies on how the generational trauma of colonization and genocide continues to affect the health of American Indians and Alaska Natives today (Solomon).

Overview on Structural Racism in Health Care

  • The Intellectual Roots Of Current Knowledge On Racism And Health: Relevance To Policy And The National Equity Discourse; Ruth Enid Zambrana of the University of Maryland and David Williams of Harvard University.
  • Systemic And Structural Racism: Definitions, Examples, Health Damages, And Approaches To Dismantling; Paula Braveman of the University of California San Francisco and coauthors.

Empirical Evidence on Racism in Health Care

  • Structural Racism And Black Women’s Employment In The US Health Care Sector; Janette Dill of the University of Minnesota and Mignon Duffy of the University of Massachusetts Lowell.
  • Sick And Tired Of Being Excluded: Structural Racism In Disenfranchisement As A Threat To Population Health Equity; Patricia Homan of Florida State University and Tyson Brown of Duke University.

Unheard Voices

  • Addressing The Interlocking Impact Of Colonialism And Racism On Filipinx/a/o American Health Inequities; Melanie Sabado-Liwag of California State University and coauthors.
  • The Mutually Reinforcing Cycle Of Poor Data Quality And Racialized Stereotypes That Shapes Asian American Health; Stella Yi of NYU Grossman School of Medicine and coauthors.
  • The Generational Impact Of Racism On Health: Voices From American Indian Communities; Teshia Arambula Solomon of the University of Arizona and coauthors.

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ABOUT HEALTH AFFAIRS:

Health Affairs is the leading peer-reviewed journal at the intersection of health, health care, and policy. Published monthly by Project HOPE, the journal is available in print and online. Late-breaking content is also found through healthaffairs.org, Health Affairs Today, and Health Affairs Sunday Update.

Project HOPE is a global health and humanitarian relief organization that places power in the hands of local health care workers to save lives across the globe. Project HOPE has published Health Affairs since 1981.

Health Affairs podcasts go beyond the journal’s pages to bring you insightful discussions on the latest news and research affecting health policy. Our newest podcast, Health Affairs Pathways, explores the health care system through storytelling – from investigative journalism and health policy explainers to long-form interviews. On our flagship podcast, A Health Podyssey, Editor-In-Chief Alan Weil interviews the leading researchers and influencers shaping the field’s big ideas. Join Health Affairs editors on Health Affairs This Week as they discuss the week’s most pressing health policy news. All in 15 minutes or less.

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