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Health policy research, commentary, and analysis

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John,

Today we released the February issue of
Health Affairs
, dedicated to the
theme of Racism and Health.

You can find information on the related events, podcasts, and a video
interview with Harriet Washington
, author of Medical
Apartheid, on this page dedicated to the issue
. The video will launch
on February 8.

At 6:15pm ET today, join us for a live LinkedIn event

moderated by Amanda Michelle Gomez of DC public radio's WAMU on how
structural racism continues to affect Black residents in the District of
Columbia.

Follow the discussion on the issue's research through the hashtag
#RacismAndHealth on Twitter and LinkedIn.

Read The Full Issue

Racism is the reason for large, sustained health inequities in the US.
Four overview articles in this month's Health Affairs orient the
reader to the complex relationship between racism and health. Other
articles provide new evidence, analysis, and narratives on the topic.

Ruth Enid Zambrana and David Williams describe the rich empirical
foundation

for the conclusion that racism is a determinant of health that must be
addressed to achieve health equity.

Paula Braveman and coauthors describe the path from systemic racism to
poor health and provide examples of dismantling racism
.
Ruqaiijah Yearby and coauthors explore the racist roots of past and
present health policy

as it relates to coverage, financing, and quality.

Rachel Hardeman and coauthors describe methodological approaches to
measuring structural racism and its health effects
.

A Health Affairs Forefront article

published in conjunction with the issue provides my observations on
producing a thematic issue on racism and health.

Read The Full Issue

Health Care

Using machine learning techniques to examine electronic health records
at an urban academic medical center, Michael Sun and colleagues find
that Black patients are 2.54 times as likely as White patients, after
sociodemographic and health characteristics are adjusted for, to have
negative descriptors such as "nonadherent" or "agitated"

in their history and physical notes.

Analyzing workforce data, Janette Dill and Mignon Duffy find that more
than one-third of foreign-born Black women are employed in the health
care sector

and that Black women overall "are heavily concentrated in low-wage jobs
in the long-term care sector and in hospitals." They trace these
findings to a history of structural racism in labor markets.

In an article and accompanying online StoryMap, Jan Eberth and coauthors
illustrate that rural ZIP codes with the largest shares of Black or
American Indian/Alaska Native residents are significantly farther from
many hospital services

than rural ZIP codes with large majorities of White residents.

Shekinah Fashaw-Walters and coauthors report that Black, Hispanic, and
low-income home health patients have lower use of high-quality home
health agencies, on average, than their White and higher-income
counterparts, even when living in neighborhoods with similar racial and
income characteristics
.

Kevin Nguyen and coauthors examine Medicaid managed care enrollee survey
data

and find that "compared with White enrollees, racial and ethnic minority
enrollees reported significantly worse experiences on all four [quality]
metrics, and disparities were primarily driven by different experiences
of care for minority enrollees within the same plan."

Read The Full Issue

Community Experience

Through focus groups and interviews of Black women in the South,
Terri-ann Thompson and coauthors reveal that when it comes to access,
utilization, and quality, "experiences of racism were evident across the
sexual and reproductive health lifespan

and across a range of reproductive health services: abortion,
contraception, prenatal care, maternal care, and preventive care."

Patricia Homan and Tyson Brown determine that "residing in states with
higher levels of racialized [electoral] disenfranchisement was
associated with more depressive symptoms
,
more functional limitations," and more difficulty performing daily
living tasks among Black people than among White people.

Katherine Theall and colleagues find that neighborhoods in New Orleans
with high rates of police encounters, after other characteristics are
controlled for, face health risks, including significantly higher rates
of smoking, poor physical health, low physical activity, violent crime,
and domestic violence
.

Christopher King and coauthors explore how structural racism is tied to
residential segregation in Washington, D.C., with social, economic, and
political disenfranchisement of Black residents yielding large health
inequities by race and place
.

Melanie Sabado-Liwag and coauthors analyze the role racism and
(neo)colonialism historically and currently play in the health
disparities experienced by Filipinx/a/o Americans
.
They argue that these disparities can be understood as manifestations of
historically exploitative labor experiences, intergenerational trauma,
and the model minority myth, among other factors.

Through the practice of storytelling, Teshia Arambula Solomon and
coauthors characterize the health effects of structural racism and
epigenetic trauma on American Indians and Alaska Natives
.
Drawing on wisdom from their communities, the authors make
recommendations to deconstruct institutionalized racism to benefit
American Indian and Alaska Native people.

Stella Yi and coauthors describe poor-quality data infrastructure and
biases in the health care sector

fueled by stereotypes about Asian Americans and elucidate how these
examples of structural racism act independently and reinforce one other
to harm health outcomes.

Acknowledgments

Health Affairs thanks Rachel Hardeman of the University of Minnesota and
José Figueroa of Harvard University, who served as theme issue
advisers.

We also thank the Robert Wood Johnson Foundation
, the California Wellness Foundation
, the W. K. Kellogg Foundation
, the Episcopal Health Foundation
, and the New York State Health
Foundation for their financial
support of this issue.

Read The Full Issue

Get the most out of your subscription today by checking out the current
and past issues
.

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Watch This Video

For this special issue dedicated to Racism and Health, Health Affairs
wanted to not only publish original research, analyses, and commentaries
but also launch a video component
to set the foundation of
the issue, introduce an interactive element to the research, and reach a
new audience that does not currently read the journal.

Starting tomorrow, watch Health Affairs' Director of Health Equity
Vabren Watts and American Medical Association's Chief Health Equity
Officer Aletha Maybank interview Harriet Washington, author of Medical
Apartheid, on the history of racism in medicine and research.

Thanks to our partners Awill Productions
and Sagetopia
, who were indispensable for their video and
graphic design skills, respectively.

Watch the Video

Get Interactive

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In the February issue, Jan Eberth and coauthors examine disparities in
access to a range of health care services, including hospital-based
services.

They found that migration patterns, both voluntary and forced, and
territorial acquisitions have resulted in the concentration of
minoritized racial and ethnic groups in defined areas.

The authors put together an accompanying interactive map to give readers
a deeper look into their empirical research findings and an
understanding the geographical impacts of racism on health care service
use.

The StoryMap - a digital map built through ArcGIS - can be found on our
Racism and Health webpage.

View the StoryMap

Attend these Events

Join Health Affairs for free virtual events
! In addition to the new
issue of the journal, we produce a variety of events that relate to the
research and bring health policy professionals up to speed on the latest
in health policy research.

On February 8, we are hosting
a
virtual symposium
at
which panels of distinguished authors and experts will present their
work from the February issue.

On February 22, join Michael Sun at a Journal Club event as he discusses
his research paper, "Negative Patient Descriptors: Documenting Racial
Bias In The Electronic Health Record
."

On February 28, Health Affairs is hosting a Policy Spotlight event with
the Centers for Medicare & Medicaid Services' Meena Seshamani.

Visit The Full Events Schedule

Listen to this Podcast

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Alongside the issue release, we invite authors from the issue to speak
with Editor-in-Chief Alan Weil on our A Health Podyssey podcast, which
features interviews with leading and up-and-coming researchers in health
services and health policy.

Don't miss the latest episodes where George Wehby discusses his research
on state-level mask mandates and racial and ethnic disparities in dental
service use
or
Kayte Spector-Bagdady on racial diversity and inclusion in precision
medicine and big data
.

A new episode with Michael Sun discussing his research on racial biases
hiding in EHRs

will go live tomorrow morning.

Subscribe on Apple Podcasts
,
Spotify , or
wherever you listen to catch all of the #RacismAndHealth episodes this
month.

Listen Now

Read The Full Racism and Health Issue

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About Health Affairs

Health Affairs is the leading peer-reviewed journal
at the intersection of health,
health care, and policy. Published monthly by Project HOPE, the journal
is available in print and online. Late-breaking content is also found
through healthaffairs.org , Health Affairs Today
, and Health Affairs Sunday
Update .  

Project HOPE is a global health and
humanitarian relief organization that places power in the hands of local
health care workers to save lives across the globe. Project HOPE has
published Health Affairs since 1981.

Copyright © Project HOPE: The People-to-People Health Foundation, Inc.

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