“Racism is a system of structuring opportunity and assigning value based on the social interpretation of how one looks (which is what we call “race”), that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities, and saps the strength of the whole society through the waste of human resources.”

Camara Phyllis Jones, MD, MPH, PhD
APHA Past-President

INTRODUCTION

On Monday, May 25th, 2020, George Floyd, an African American man in his 40s was killed while in police custody in Minneapolis, Minnesota in the United States. These scenarios have become all too familiar, with numerous generations of Black families being able to share first hand stories. 

Only a few months earlier in February, Ahmaud Arbery, an unarmed 25-year-old man was viciously gunned down in the street, a scene that resembled a chase for an escaped slave. This has sparked outrage across the country and in other cities across the world. For centuries, the Black community has experienced systemic racism and discrimination, particularly at the hand of White people who have been in a historical position of power still to this day.

Recent research has framed racism as a public health emergency and highlights evidence of health disparities across the world along racial lines. Systemic inequalities in multiple institutions, such as law enforcement, housing, education, and health, lead to poorer health outcomes. Addressing systems that oppress racial minorities are critical to reducing health inequalities as well as preventing further tragedies like the murder of George Floyd  (Andrews, 2021; Mendez et al., 2021).

In their two-part podcast series, the Public Health Insight team tackles Racism, the Black Experience, and the Perpetual Fight for Equality. They are joined by three special guests all working in the health arena. 

In this blog we will review:

• Racism, Prejudice and Discrimination
• Police Brutality and Other Public Health Impacts of Racism
• Addressing Racism: Where We Are and Where do We Go from Here?

Racism, Prejudice and Discrimination

The terms racism, prejudice, and discrimination are intertwined and often used interchangeably by the media, although they are distinct from each other.

Racism is a belief that an individual’s race determines that person’s capacities, capabilities, and character. This is often used to distinguish a person as superior or inferior to another along racial lines. Prejudice is a preconceived judgment of a person that is not based on evidence or reason. Discrimination is the unjust treatment of a person based on specific characteristics such as race, sex, gender, age, sexual orientation, etc. Racism tends to describe an individual’s beliefs, while prejudice and discrimination are common outcomes and actions stemming from racism.

Police Brutality and Other Public Health Impacts of Racism

Police violence is a significant cause of premature death in American Black men (Jones-Eversley et al., 2020). Research shows that fatal policing in the United States is used disproportionately against people of colour, with the mortality rate more than three times higher in Black people than in White people (The Lancet, 2021). 

The workplace culture within the police force in the United States follows a more hostile model compared with many other Western democracies. The police are often viewed as an armed force against the population while marginalised populations are criminalised (Jones-Eversley et al., 2020; The Lancet, 2021).

The police culture does not exist in isolation. Racism does not start and end with the police, but is learned at home, in schools, and within communities. Addressing the issue of police brutality and the overrepresentation of Black deaths in police custody must incorporate a holistic approach, addressing how policies in all areas of life place minorities at a disadvantage.

The term systemic racism refers to racism that is entrenched in a society’s laws, social structures, and regulations. These can impact a person’s access to employment, health care, housing, education, and political representation – all of which are also linked to health outcomes and risks. This is exemplified by the reduced life expectancy, higher infant mortality rates, and increased burden of certain diseases like diabetes and heart disease among Black individuals when compared with their White counterparts (Maness et al., 2020; Mendez et al., 2021). 

Addressing Racism: Where We Are and Where do We Go from Here?

George Floyd’s murder sparked protests across the United States and around the world while highlighting the ongoing efforts of the Black Lives Matter (BLM) campaign – a movement that works to draw attention to the disproportionate number of Black people injured and killed by police. The BLM movement was kindled by the acquittal of George Zimmerman who killed unarmed Black teenager Trayvon Martin in 2012 and has provided a platform to highlight systemic racism that disadvantages Black people and other people of colour.

While BLM and other grassroots movements that work towards social justice have facilitated conversations about race, systemic racism, and the health disparities that exist along racial lines, progress has been slow. Incidents such as George Floyd’s murder inspire initial outrage and calls for action followed by corporate displays of solidarity and political promises of change. Public attention then shifts to other pressing issues and progress stagnates until another tragic incident occurs.

The loss of momentum makes garnering public support for addressing systemic racism difficult. Further, the conversations around racial disparities and white privilege, the societal benefits afforded to White people over non-White people, can be uncomfortable and often lead to defensive reactions or devolve into political debates.

There is cause for optimism. As of September, 2021, support for the BLM movement has shown to have remained unchanged in the past year which demonstrates that people are still conscious of the movement despite the shift in media focus away from George Floyd and police violence (Horowitz, 2021). There have been multiple calls for racism to be declared a public health crisis in the United States, a move that can help facilitate legislation and policy change to tackle inequalities at a systemic level (Andrews, 2021; Mendez et al., 2021).

Moving forward, widespread societal change is needed to counteract ongoing racism. Further research into the impacts of existing policies on health disparities can help inform future legislation in order to dismantle existing systems that prevent the advancement of racial minorities (Maness et al., 2020). Identifying racism as a problem is a positive step that needs to be followed by tangible action and implementable solutions.

Key Takeaways

• Racism is embedded in laws, regulations, and policies impacting everyday life through multiple avenues such as access to housing, education, health care, and other key areas.
• The prejudice and discrimination stemming from unchecked racism has caused wide health disparities along racial lines.
• Black Lives Matter (BLM) and other grassroots organisations have provided a needed platform to highlight the disproportionally violent outcomes that Black people face when interacting with the police. They also bring to light the everyday challenges posed by the organisational structures that were historically designed to prevent minorities from succeeding.
• Classifying racism as a public health crisis can help facilitate widespread systemic change to counteract the health disparities caused by systemic racism. 

Continuing public engagement is critical to maintaining the momentum of important movements such as BLM which place pressure on political leaders to address racism. One step in engaging the public is promoting education around the systems in place that disadvantage people of colour. To that end, the Public Health Insight team has recommended a list of materials that provides important context for many of the discussions about the role of race in the justice and other systems.

Materials recommended by the Public Health Insight team and contributing guests for those interested in learning more about the impacts of systemic racism:

• When They See Us, a limited series directed by Ava DuVerney, 2019
• American Son, a film directed by Kenny Leon, 2019
• Just Mercy, a film directed by Destin Daniel Cretton, 2019
• White Fragility, a book by Robin DiAngelo, 2018
• 13^th, a documentary by Director Ava DuVerney, 2016
• Fruitvale Station, a film directed by Ryan Coogler, 2013

Book recommendations for those interested in learning about the impact of race on health:

• Toxic Communities: Environmental Racism, Industrial Pollution, and Residential Mobility by Dorceta Taylor, 2014
• Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present by Harriet A. Washington, 2008
• Medical Bondage: Race, Gender, and the Origins of American Gynecology by Deirdre Cooper Owens, 2018
• The Immortal Life of Henrietta Lacks by Rebecca Skloot, 2010

Written by: Malissa Underwood, BSN, MPH