By Dr. Nancy Yoon, Chief Medical Officer at Springfield-Greene County Health
Before Black History Month was celebrated in 1976 as part of the nation’s bicentennial, Dr. Carter G. Woodson established Black History Week in 1926 to commemorate and celebrate the contributions to our nation made by people of African descent.
We continue to celebrate Black History Month with his life’s work in mind by celebrating the black scholars, historians, artists, doctors, and political leaders who have shaped the U.S. before, during, and after 1926.
Regarding health, Black History Month plays an important role in achieving health equity because it encourages people to reflect, learn, and be educated on racial injustice which is still very present in systems today, including the healthcare system.
Health Equity and Health Disparities
Back in March 2022, I wrote a blog explaining what Health Equity is. For those reading this article, I want to explain that health equity is when everyone has a fair and just opportunity to reach their full potential for health and well-being.
Unfortunately, obstacles like racism and discrimination, among others, can lead to health disparities. Health disparities are differences in population health status and mortality rates that are systemic, patterned, unjust, and actionable, as opposed to random or caused by those who become ill.
As a result of these health disparities, people across the country in some racial and ethnic minority groups experience higher rates of negative health outcomes like mortality, life expectancy, being uninsured/underinsured, experiencing lack of access to care and more.
For example, within the Black community, babies are more than three times as likely to die from complications related to low birthweight as compared to White babies in the U.S. Additionally, the uninsured rate for Black Americans is higher (12%) compared to White Americans (9%). Black Americans are also more likely to suffer from high blood pressure, heart attacks, and stroke deaths than White Americans. Black Americans are also twice as likely to die from diabetes than White Americans.
Another example of decreased access is around healthy foods. This often depends on your geographical location or where you live. Many neighborhoods across the country don’t have fresh produce or healthier options. This is what we call food insecurity, and it impacts 20% of Black households. This can lead to people eating lower-cost, high-energy foods, which can lead to obesity and increased risk of cardiovascular disease.
Another group that experiences health disparities is Black gay and bisexual men, who are more affected by HIV than any other groups in the United States. Racism, HIV stigma, homophobia, poverty, and barriers to health care continue to drive these disparities. Additionally, poverty and the associated socioeconomic factors — including limited access to high-quality health care, housing, and HIV prevention education — directly and indirectly increase the risk for HIV. Addressing these social and structural barriers and encouraging safe and supportive communities can help improve health outcomes for Black gay and bisexual men.
Black History Month is an opportunity to reflect on the past. Black Americans have historically been discriminated against and denied access to vital resources to improve their health and wellbeing. For example, in 1935, the Social Security Act, which included today’s welfare benefits of unemployment and social security, excluded individuals who worked on farms or as domestic help. These were jobs held predominantly by Black Americans and people of color in this time period.
Though this happened in 1935 and the welfare system has improved, it laid dangerous groundwork for discrimination that can still be seen today, impacting Black Americans from having adequate access to care in the welfare system. This is just one example of the ways structural racism has led to unjust policies in employment, land use, housing and access to healthcare.
Structural racism is a fundamental cause of health disparities due to its differential distribution of the social determinants of health. Within the health care system, there have been historic and current day occurrences of bias and discrimination, leading to mistrust of medical practitioners and systems. This can lead to decreased use of medical services and treatments. Racism also leads to psychological and physiologic stress, which has been shown to have negative effects on mental health, inflammation in the body and allostatic load. These factors all lead to social inequalities and health inequities across the life course.
Health Equity Beyond February
February is a time of celebrating and honoring Black Americans — but we encourage everyone to keep listening and learning about Black History every month, and to acknowledge the history of racism and its current day effects. It’s important for everyone to engage in self-reflection and dialogue around their own biases and stereotypes, including an examination of one’s own intersectional identities and privileges. Increased data collection on racial inequities and the social determinants of health is also needed.
In regard to health equity, Springfield-Greene County Health has been working on embedding health equity in all policies and programs, as well as working on sustainable community partnerships, with community-centered engagement and interventions. One example of this is our community health worker program. Community health workers aim to form relationships and build trust, with the goal of improving the health of all people.
You can take action and start being an advocate this February on your own, too. A few ways that you can engage with health equity include being a positive voice for equity and for health systems transformation, acknowledging and working to repair past harms committed by institutions due to racism, and advocating for health-promoting and trauma-informed public policies. These will all bring us closer to our goal of having thriving, resilient communities with improved health outcomes for all.
For more information about Black History Month, visit blackhistorymonth.gov.
Dr. Nancy Yoon (she/her) is the Chief Medical Officer at the Springfield Greene County Health Department. Dr. Yoon received her medical degree and did her residency (Internal Medicine) and fellowship training (Endocrinology) at Indiana University, and received her Master of Public Health from George Washington University. Dr. Yoon provides medical oversight of the clinical services of the Health Department. Dr. Yoon also participates in administrative planning of community health programs, collaborates with community partners, and works with the Health Department’s communications team to provide education and guidance on a variety of health topics.