Black History Month: Structural racism is a driver of health disparities

This February, during Black History Month, the American Heart Association is encouraging Black women to Reclaim Your Rhythm and take control of their mental and physical well-being. For years we’ve been striving to ensure everyone has an optimal, just opportunity to be healthy. But this is not the reality for many people of color and others whose health suffers because of social factors beyond their control.

In fact, in New York City, people in some under-resourced ZIP codes have shorter life expectancies than their neighbors just a few miles away. And around the country, people in often-remote rural areas face significantly higher death rates from heart disease and stroke.

COVID-19 has illuminated these unacceptable health disparities and worsened the problems. The pandemic and economic hardships have disproportionately harmed the health of Black, Latino and Native American people.

Structural racism is a driver of health disparities, report declares

The nation’s history of structural racism must be acknowledged as a driver of health problems and shortened lives for Black people and other racial and ethnic groups, says an American Heart Association report that seeks to spark action to fix the problem.

The idea that racism adversely affects an individual’s health is not new, said Dr. Keith Churchwell, president of Yale New Haven Hospital, who led the writing group for the advisory. For example, racism has been shown to lead to stress, depression and long-lasting, cumulative damage to the body and brain.

“Structural racism has been and remains a fundamental cause of persistent health disparities in the United States,” declares the presidential advisory. It offers a summary of the historical context of structural discrimination, connects it to current health disparities and looks for ways to dismantle or mitigate its continuing effects.

Structural racism refers to “the ways in which society is set up in such a way that advantages and opportunities are preferentially given to those of one race rather than to another,” said co-author Dr. Mitchell Elkind, immediate past president of the American Heart Association for 2021-22, a neurologist at New York-Presbyterian/Columbia University Irving Medical Center in New York City. “We have to change the underlying structure that allows that to happen.”

We know things like high blood pressure, diabetes and smoking lead to cardiovascular disease, Elkind said. And higher rates of those problems in some groups lead to health disparities. For example, Black people in the United States are much more likely to die from heart disease or stroke than their white counterparts.

Structural racism is “an important, fundamental driver” of such differences, he said. Which means doctors, scientists, policymakers and others have a role in addressing it.

“The consequences of racism in the past persist in such a way that certain racial and ethnic groups still live in poor neighborhoods that have less green space, that have poor air quality, have a more dangerous environment that may preclude exercise and healthy behaviors, may have less nutritious food options, and certainly suboptimal educational experiences,” Elkind said. “These things have not gone away.”

The American Heart Association is committed to advancing health equity — which can exist only when all people can have the opportunity to enjoy healthier lives. We’re removing barriers to health through work in communities, scientific research, advocating for healthy policies and more. Please join us on this critical journey.

For information about the American Heart Association’s commitment to health equity please visit heart.org/healthequity