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Health policy research, commentary, and
analysis
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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."
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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.
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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.
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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.
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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.
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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.
Health Affairs, 1220 19th Street, NW, Suite 800, Washington, DC 20036, United States
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