Committed to Ending White Silence
The killing of George Floyd, and other recent, similar tragedies, have (again) made the systemic racism and oppression in the U.S. impossible for anyone to ignore. But for African Americans, it has always been an unavoidable reality of daily life.
Over the past few years, scientists have been studying how the social experience of race translates directly into disparities in health. They believe that chronic stress may be one of the key ways that racism contributes to these disparities.
Inflammation is the root of most modern, chronic diseases like diabetes and heart disease, which black people suffer disproportionately from. For example, one study of black women found that stress from frequent racist encounters is associated with chronic, low-grade inflammation.
Other studies have found similar results, and one study found that even the expectation of a racist encounter increased stress and stress-related emotions.
All of this research points to a fundamental truth: it’s impossible to separate the social and racial issues that are demanding our attention from our individual health and well-being.
Social Determinants of Health
Obviously one of the biggest misconceptions about health is that it is purely an individual choice.
It’s true that each of us bears responsibility for the actions we take on a daily basis. And these actions can either promote, or detract from, our health and well-being.
But it’s also true that our health is also determined by our environment and the context in which we live.
These “social determinants of health” include things like air and water quality, access to healthy food, exposure to environmental toxins, socioeconomic status, education, neighborhood, physical environment, and race.
As civil unrest related to the killing of George Floyd by police intensifies, it’s worth reflecting on the inescapable—yet often hidden—connection between health and social inequality.
A large body of evidence has shown that social determinants of health have a powerful influence on us as individuals. For example:
- Despite the obvious progress we’ve made in the last few decades, the U.S. remains a racially segregated country. Wealthy areas have three times the number of supermarkets than poor areas, and white neighborhoods have four times as many supermarkets as black neighborhoods.
- Children born to parents that didn’t complete high school are less likely to have access to sidewalks, parks or playgrounds, and are more likely to be obese than kids born to parents with more education.
- Chronic stress—caused by poverty, racial discrimination, lack of social support, and other factors—has strong negative effects not only across an individual lifespan, but also across successive generations.
- People living in poor neighborhoods breathe more hazardous air particles than people in wealthier neighborhoods.
Coronavirus has also exposed how systemic inequality impacts individual health. COVID-19 has had a disproportionate impact on African American communities across the U.S.
According to the CDC, almost a third of coronavirus infections have affected black Americans, though blacks represent only 13 percent of the U.S. population.
The social determinants of health I mentioned above are almost certainly the primary driver of this imbalance. African Americans are more likely to live in poverty, to have limited access to healthcare, to live in stressful conditions, and, as a result, to have the pre-existing conditions like hypertension and diabetes that increase the severity of COVID-19.
What does this have to do with the civil unrest that is sweeping across America right now?
We need to do More
This blog was in part inspired by a powerful video that Trevor Noah, host of The Daily Show, published on Facebook the other day. I highly recommend watching it—especially if you are a white person of privilege, like I am.
I am now reading Trevor’s autobiography about growing up in apartheid South Africa and am deeply moved by his insight and compassion. In this video, he does a masterful job of connecting the dots between coronavirus, chronic disease, and racism. He asks us important questions which will give you a critical perspective on the current riots.
One way to contribute to health and wellbeing for all is to learn more about racism and its effects. I recommend Resmaa Menakem’s work. He has a book, free online courses, and much more on his website.
For white people seeking a better understanding of race and racism:
- Check out the podcast Seeing White
- Read Bryan Stevenson’s book Just Mercy and his Equal Justice Initiative
- Read White Fragility by Robin DiAngelo
Please Hold Us Accountable
We invite you to question our language, choices and assumptions. Ask us where we spend our money, who we hang out with and what we do in our free time and how we are participating in being anti-racist. Check our blind spots.
We strive to make our clinic a safe and inclusive space. Let us know how we are doing and what we need to do to change to make our clinic feel this way for you. We want to hear from you.
Yours in health~