Health Care in Black and White…

By Stephanye R. Clarke


The Emancipation Proclamation. The Civil Rights Act of 1964. The Affordable Care Act — neither of these sweeping acts/laws have been able to undo a rather disheartening reality: there will always be racial and ethnic health disparities. Sigh.

Last month NPR featured a story of how the practice of redlining shaped resources and opportunities of Connecticut cities. We also know, based on a large body of research that factors such as built environment, food insecurity, education, lack of access to reliable transportation, safe affordable housing and quality health care are connected directly to health status.

Yesterday The Atlantic published an article titled: America’s Health Segregation Problem: Has the country done enough to overcome its Jim Crow health care history?

The short answer is no. As the article points out,

“Racial differences in almost every health outcome—from infant mortality to life expectancy—are obvious and pronounced, especially between white people and black people… Yet segregation in health care is rarely discussed in those terms, and its importance in shaping the larger narrative of race in America is often ignored.”

Racist laws, policies and practices have created a legacy of warped and/or missed opportunities for many Americans. I write about this often and it is difficult to always be optimistic. Writing a sentence that reads: “Despite our best, albeit fragmented, efforts I am unsure about whether or not this legacy can be undone” is more difficult than I can express.

Here is what I know: until we are really able to have deep and uncomfortable conversations about how racism continues to structure where people live, how they live, how they are educated, how healthy/unhealthy people are, data will continue to reflect gaps in education, income and health status. Until we insist that policies no longer unfairly advantage some while unfairly disadvantaging others, nothing will change.

So here we are—at an impasse. Most of my blogs focus on health equity framework, by way of addressing social determinants of health and policy change. I write about this often—not much has changed. However, I believe if we don’t talk about it, meaningfully, nothing changes.

I’ll continue to do my little part to contribute to the conversation with the hope that recommendations will be made and that policies and practices will be crafted and enacted so that my opening sentence is proven wrong. I will need loads of help though—who’s in?

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