Deeming racism a public health crisis may be new, but within public health research and advocacy, racism’s broad and devastating impact on Black Americans is well-recognized.
No health disparities are quite as profound as those between Blacks and whites, shows decades of research across ages, ethnicities, sexual orientations and socioeconomic statuses.
Compared to whites, Black Americans receive less overall health care and have a lower life expectancy, more than double the rate of infant mortality and higher death rates from a multitude of health threats, including pregnancy-related complications, cancer, homicide and now COVID-19.
As U.S. states, counties and cities declare racism a public health crisis, it’s important to realize that lasting solutions will require vast societal change at both the cultural and institutional levels, said Tasleem Padamsee, assistant professor of health services management and policy.
“African Americans and other people of color are subject to so many additional stressors, resource limitations and external constraints that all of these things turn up way downstream in their health outcomes,” Padamsee said. “And that is a result of the many different ways that race is structured into our society.”
When it comes to common contributors to poor health like poverty, unemployment, less education and pollution exposure, Black Americans consistently bear disproportionate burdens. So it’s unfortunately no surprise that Padamsee’s research is uncovering more racial health disparities among women at high risk for breast cancer, she said.
Understanding how high-risk women make decisions about genetic testing, prevention and early detection is a newer area of study, Padamsee said. Her work comes at a time when women and doctors have — in theory — access to more prevention information, improved testing and early, effective treatments. But she’s found that African American women face more challenges than white women in managing breast cancer risk, both in information gathering and insurance coverage for tests and procedures. This is troubling as Black women are 40% more likely to die from breast cancer than white women, despite similar diagnosis rates, she said.
“These are all fundamental injustices in policy and health care that stem from how the whole society is structured to advantage certain groups over others,” Padamsee said. “We don’t always have to know where our research will go or what the policy impact will be, but if we can identify where we’re falling down, we can recommend change.”
Health disparities between Blacks and whites are actually wider at higher income levels, according to research led by sociology professor Cynthia Colen.
For those seeking to dismantle institutional racism, academic research is just one approach, Padamsee said. People can help spur change through educating themselves, participating in social activism or even something as little as having a conversation, because all these things will build together to put pressure on those in power, she said.
“We need to keep changing people’s hearts, minds, behaviors, policies and actions,” Padamsee said. “How many people are willing to stand up with African Americans, and how long are they willing to be standing?”
For JaNelle Ricks, assistant professor of health behavior and health promotion and an expert in sexual and reproductive health disparities, racism is a lot about power.
“The bottom line is that the majority group has the power and they’re wielding that power for their benefit against other minority groups, who are suffering in many different ways,” Ricks said, adding she has hope for the current uprising. “In the past we’ve seen cycles of protesting, and then that gets quelled and we go back to the status quo or see some incremental change over time. But I would love to see enough people being moved by this latest fire to actually make some radical change.”
Ricks examines how societal factors coalesce to affect health outcomes. She recently led a study that found Black men who had been incarcerated reported recent sexual behaviors more risky than those who had never been in jail. African American men are much more likely to be incarcerated than white men. They’re also at higher risk for HIV/AIDS and other STDs.
Similar attempts to untangle the complex, cumulative effects of oppressive societal systems on health is underway at the college’s Social Epidemiology to Eliminate Disparities lab, led by Assistant Professor of Epidemiology Shawnita Sealy-Jefferson. Here, researchers are seeking solutions to the disproportionate infant mortality rate among Black women — which is especially pronounced in Columbus.
The first social epidemiologist at Ohio State, Sealy-Jefferson joined the college in 2018 and quickly established an undergraduate course in social epidemiology examining how the distribution of advantages and disadvantages in society reflect the distribution of health and disease.
“In public health we have a moral imperative to fight for social justice,” Sealy-Jefferson said.