Health disparities in the United States exist because of a history of systemic racism that is perpetuated by present-day structures, said Camara Phyllis Jones, M.D., M.PH., Ph.D., keynote speaker for the American Society of Law, Medicine & Ethics’ 40th Annual Health Law Professors Conference held June 8-10.
To develop effective policies to achieve health equity, she said, we need to ask “how is racism operating here?” A senior fellow at the Satcher Health Leadership Institute and the Cardiovascular Research Institute at Morehouse School of Medicine, Jones is the immediate past president of the American Public Health Association.
With a focus on health equity, the Center for Law, Health & Society hosted the conference, which is the premier meeting for academics in health law or bioethics in schools of law, health, public health or business.
Disparities in health care are well documented, especially among racial and ethnic groups, both in access to care and the quality of care received. However, Jones said, “differences in our underlying life exposures, opportunities, and stressors make some communities sicker than others in the first place.
“It doesn’t just so happen that people of color in this country are over-represented in poverty while white people are over-represented in wealth. That is not just a happenstance,” Jones said. Rather, racism is foundational in our nation’s history, yet many people are in denial of its continued existence and profound impacts on the health and well-being of the nation.
Health disparities are not simply a function of poverty, Jones said. “Even if I eliminated income inequality today, if I did not address institutionalized racism, in 20 years we would start to see a stratification by race again in terms of income.”
Jones also highlighted the reciprocal nature of racism – it simultaneously advantages some individuals and groups, while disadvantaging other individuals and groups. But, she added, we often fail to recognize how individuals benefit from the whole history of unfair advantage and how that history continues to contribute to the disparities we see in our society today.
Institutional racism is a system of identifiable mechanisms and structures, policies, practices or values which are different elements of decision making, Jones said. The system determines “who’s at the table and who’s not. What’s on the agenda and what’s not.”
It takes the form of disparities in quality housing, employment opportunities, income, differences in access to medical facilities including linguistic access, the disproportionate places of toxic dumpsites in communities of color, and access to information such as health or familial history or legal advice, Jones said. It’s not just things that are being done to people of color, but also things that are not being done.
“Achieving health equity requires valuing all of the individuals in a population equally, recognizing and rectifying historical injustices and providing resources not equally but according to need,” Jones said. Failing to invest in all our communities is a waste of human resources. “Health disparities will be eliminated if health equity is achieved.”
“Dr. Jones is a leading voice on health equity. She challenges each of us to think critically about laws, policies and practices that keep some in our society from reaching their full potential and how we might become agents of change,” said center director and professor Leslie Wolf. “Her keynote emphasized the theme of health equity infused throughout the conference.”
The conference also offered a sneak peek of the exhibit, Health is a Human Right: Race and Place in America, housed at the College of Law and sponsored by the School of Public Health, the Center for Law, Health & Society and the University Library.