ADVANCING RACIAL EQUITYClosing gaps in health and disease risk means tackling the root cause of such disparities — racism. 

That was a main take-away from APHA’s new Advancing Racial Equity webinar series, which launched earlier this week with its first installment on “Racism: The Ultimate Underlying Condition.” During the webinar, panelists discussed ways to combat racism at both social and institutional levels, as well as the effects of racism on the health of black Americans. 

“Inequities within the COVID-19 pandemic and the uprising over police violence underscore racism as an ongoing public health crisis that needs our attention,” said panelist Georges Benjamin, MD, APHA’s executive director, in his opening remarks. “Silence and turning a blind eye are no longer acceptable if we want to make meaningful progress toward racial and health equity.” 

A growing body of research finds racism is associated with a range of poor health outcomes and inequities. For example, studies find that experiences with racism contribute to increased hypertension and allostatic load among African Americans, said panelist Amani Allen, PhD, MPH, executive associate dean at the University of California-Berkeley School of Public Health. Allostatic load refers to wear and tear on the body, or the cumulative effects of frequent and chronic stress. 

“Although the body's stress response process is a natural form of adaptation, it's meant to be transient or temporary,” Allen said. “Prolonged circulation of stress hormones can become toxic to our bodies, compromising our body's ability to regulate key biological systems.” 

Racism is also at the core of racial inequities in the COVID-19 pandemic, such as higher hospitalization and death rates among black patients, said panelist Camara Phyllis Jones, MD, PhD, MPH, an APHA past president and a senior fellow and researcher at Morehouse School of Medicine. 

“We are more likely to become infected because we're more exposed and less protected,” Jones said. “Once infected, we're more likely to die because we're more burdened by chronic diseases with less access to health care. And all these things are very much tied into racism.”

Jones used an allegory to illustrate how racism shapes people’s opportunity for good health and well-being. She told a story about going to a restaurant late at night with friends. The restaurant owner turned the “Open/Closed” sign on the door to read  “Closed” shortly after they entered. 

“What that meant was that other hungry people, just a few feet away from me but on the other side of the sign, would not be able to come in and sit down,” she said. “That is when I understood that racism structures open/closed signs in our society — that racism structures a dual reality.”

At the same time, people who get to sit at the “table of opportunity” — those who only see the “Open” side of the sign — often fail to acknowledge or understand the systemic disadvantage faced by those who only see the “Closed” side. In other words, Jones said, it is difficult for people to recognize the harmful systems from which they personally benefit. 

“That's part of your privilege — not to have to know,” she added. “But once you do know, you can choose to act. So it's not a scary thing to name racism. It's actually an empowering thing.”

A recording, transcript and presentation slides from “Racism: The Ultimate Underlying Condition” are now available for download. Stay tuned for information on upcoming webinars in APHA’s Advancing Racial Equity series. Upcoming topics include police violence, maternal health, housing and violence.

Webinars from APHA’s 2015 series on the Impact of Racism on the Health and Well-Being of the Nation are also still available for download and are recommended listening. For more health equity resources, visit APHA’s Racism and Health page.