Racism, COVID-19, and Health Inequity in the USA: a Call to Action
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Racism, COVID-19, and Health Inequity in the USA: a Call to Action Crista E. Johnson-Agbakwu 1,2,3,4 Dean V. Coonrod 2,3,4
&
Nyima S. Ali 2,3,4 & Corrina M. Oxford 5 & Shana Wingo 6 & Emily Manin 1 &
Received: 16 July 2020 / Revised: 27 October 2020 / Accepted: 10 November 2020 # W. Montague Cobb-NMA Health Institute 2020
Abstract The current national COVID-19 mortality rate for Black Americans is 2.1 times higher than that of Whites. In this commentary, we provide historical context on how structural racism undergirds multi-sector policies which contribute to racial health inequities such as those highlighted by the COVID-19 pandemic. We offer a concrete, actionable path forward to address structural racism and advance health equity for Black Americans through anti-racism, implicit bias, and cultural competency training; capacity building; community-based participatory research (CBPR) initiatives; validated metrics for longitudinal monitoring of efforts to address health disparities and the evaluation of those interventions; and advocacy for and empowerment of vulnerable communities. This necessitates a multi-pronged, coordinated approach led by clinicians; public health professionals; researchers; social scientists; policy-makers at all governmental levels; and local community leaders and stakeholders across the education, legal, social service, and economic sectors to proactively and systematically advance health equity for Black Americans across the USA. Keywords COVID-19 . Health disparities . Health inequality . Structural racism . Advocacy
Structural racism, as defined by Bailey et al. is “the totality of ways in which societies foster racial discrimination through mutually reinforcing systems” which “in turn reinforce discriminatory beliefs, values, and distribution of resources.” It is the underlying cause of health disparities (including COVID-19) [1]. Structural racism has its origins in the transatlantic slave trade and continues today: Black Americans are disproportionately affected by poverty, a fallible public school system, unsafe neighborhoods, food deserts, mass incarceration, police brutality, maternal and infant mortality, obesity,
* Crista E. Johnson-Agbakwu [email protected] 1
Southwest Interdisciplinary Research Center (SIRC), Arizona State University, Phoenix, AZ, USA
2
Obstetrics and Gynecology, Valleywise Health, University of Arizona College of Medicine, Phoenix, AZ, USA
3
Creighton University School of Medicine, Phoenix, AZ, USA
4
District Medical Group, Phoenix, AZ, USA
5
Maternal Fetal Medicine/Critical Care Medicine, NewYork-Presbyterian Hospital, Clinical Obstetrics and Gynecology—Weill Cornell Medical College, Cornell University, New York City, NY, USA
6
Arizona Oncology, Phoenix, AZ, USA
and chronic health conditions, to name a few [2]. These issues have compounded synergistically in what some refer to as the COVID-19 “syndemic,” but they are not new [3]. Politicians, legislators, policy-makers, economists, educators, public health professionals, and local communit
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