dr. kathryn bass

The Current State of Our World

Apr 2, 2020

This month, I felt it was imperative to address current events and the role the medical community plays. We are living in a moment that will define our history as a nation, and the time has come for us as a whole to evaluate the process and make systematic changes to address our shortcomings, which contribute to inequality.

The Office of Disease Prevention and Health Promotion has recently released a study on the social determinants of health. The organization identified five elements that contribute to the inequity: economic stability, education, health and healthcare, neighborhood and built environment, and social and community context. The ODPHP feels that discrimination falls into the latter, and has discussed its effects on health.

“Discrimination can be attributed to social interactions that occur to protect more powerful and privileged groups at the detriment of other groups,” they write. “While not all stressful experiences negatively affect health, or occur because of discrimination, many do impact health and can be related to discrimination.”

Further development of the relationship between discrimination and health finds residential segregation as a key contributor to health. Again, the ODPHP points out the negative effects. “Residential segregation, disparities in access to quality education, and disparities in incarceration rates are some specific forms of structural discrimination. Residential segregation is a form of structural discrimination in the housing market. Residential segregation is a major cause of differences in health status between African American and white people because it can determine the social and economic resources for not only individuals and families, but also for communities. Residential segregation also affects disparities in access to quality education.Most school districts generate their income locally through property taxes, so residential segregation by income translates into very different possibilities for funding across school districts.Children who enroll in low-quality schools with limited health resources, increased safety concerns, and low teacher support are more likely to have poorer physical and mental health.”

This is far from a new concept. In 2015, the periodical PLOS ONE published a research piece titled, Racism as a Determinant of Health: A Systematic Review and Meta-Analysis. The study found, “The following health outcomes were included: (1) negative mental health (depression, anxiety, distress, psychological stress, negative affect, post-traumatic stress (PTS) and post-traumatic stress disorder (PTSD), somatization, internalizing, suicidal ideation/planning/attempts, other mental health symptoms such as paranoia and psychoticism, and general mental health); (2) positive mental health (self-esteem, life satisfaction, control and mastery, wellbeing, positive affect); (3) physical health (blood pressure and hypertension, overweight-related measures, heart conditions and illnesses, diabetes, high cholesterol, and miscellaneous/mixed measures of physical health); and (4) general health (including both physical and mental health, or unspecified as physical and/or mental health; e.g., feeling unhealthy).”

Obviously the research has indicated a correlation between the racism and quality health, and something must be done immediately to stem the tide. We must, as a nation, resolve to focus our attention on solutions for this issue. Eliminating segregation and poverty will take time and deep systematic evolution. Our current system views healthcare as a privilege instead of a basic human right, and because of that, the impoverished are routinely kept from receiving the care and attention they need. Until this bias is addressed, the cycle will continue to play out the way that it has for centuries. The time has come for change to be made so that every person has the same access to quality healthcare, so that each may experience life, liberty, and the pursuit of happiness as freely as the next.