日志
Racism And Discrimination Are A Key Public Health Threat—But Overlooked And Dis
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Racism And Discrimination Are A Key Public Health Threat—But Overlooked And Dismissed Using Poor Science, Researchers Warn
TOPLINE
Racism, xenophobia and discrimination have a profound impact on health but are largely overlooked and erroneously dismissed with low-quality science, according to a series of papers published in the Lancet on Thursday, which point to the large disparities witnessed during the Covid-19 pandemic as illustrating the need for significant change to tackle the root causes of health inequalities.
KEY FACTS
Racism, xenophobia and discrimination play a much more central role in driving health inequalities than widely recognized, the researchers argue, including by directly activating the body’s stress and hormonal responses and by laying the groundwork for factors associated with poor health through shaping the living environment and limiting access to opportunities for education, work and recreation.
Health inequalities are usually explained by pointing to the socioeconomic differences between groups and by appealing to unchangeable genetic differences, but researchers said this argument is incomplete and inaccurate.
They said pinning health disparities on genetic difference between different ethnic groups and races relies on “biologically arbitrary” differences and flawed, inaccurate and unfounded notions of racial difference.
Such arguments show “eugenic thinking lives on” in medicine today, the researchers said.
Socioeconomic differences—such as wealth, access to healthcare, housing quality and education—are key drivers of health inequality, the researchers note, but are unable to fully explain the extent of health disparities.
The researchers call for racism, xenophobia and discrimination to be widely recognized as key drivers of health inequalities around the world, adding anti-racist health interventions like education programs, to reduce prejudice towards discriminated groups and improve cultural sensitivities among health providers, could confront structural barriers.
KEY BACKGROUND
Though contexts differ around the world, health disparities among different ethnic and racial groups are universal. Globally, Indigenous groups typically suffer from poorer health, malnutrition and lower life expectancy. In the U.S., Black Americans have higher death rates and disproportionately higher rates of conditions like diabetes, heart disease and high blood pressure. Maternal death rates among Hispanic and Black women in the U.S. are also higher. The Covid-19 pandemic illustrated and exacerbated health disparities. On a global level, vaccines and treatments were—and still are—concentrated in wealthy Western countries. In those countries, marginalized groups often bore the brunt of the pandemic, being infected and dying at higher rates.
SURPRISING FACT
The health effects of discrimination on one generation can ripple across to others, which the researchers said has been under-recognized due to the erroneous assumption that population differences have a genetic cause. Development and health can be affected by parenting, the researchers note, which can be affected by physical or mental health. Discrimination can even lead to epigenetic changes, the researchers said, potentially heritable alterations to a person’s DNA that can influence the development of their children.
CRUCIAL QUOTE
Dr. Sujitha Selvarajah, a clinical doctor at University College London and one of the authors, said that although discrimination affects health in numerous ways it is often “challenging to measure because the effects of discrimination can appear over long periods of time.” Evidence does support the idea that the direct and indirect effects of discrimination, rather than assumed and flawed notions of racial differences, are “a significant driver of racial health inequities around the world,” Selvarajah added. “We call for the unequivocal recognition of racism, xenophobia, and discrimination as fundamental determinants of health, as is already the case for political, social, and economic factors.”
