Workshop Summary on Structural Racism/Discrimination: Impact on Minority Health and Health Disparities

Structural Racism/Discrimination Workshop Participants
Structural Racism/Discrimination Workshop Participants. Front row: Dr. Abigail Sewell, Dr. Alana LeBrón, Dr. Thomas LaVeist, Ms. Linda Greene, Dr. Spero M. Manson. Second row: Drs. David Chae, Derrick Tabor, Roland J. Thorpe Jr., Vickie Mays, J. Neil Henderson, María L. Gómez, J. Emilio Carrillo, Kwame McKenzie. Back row: Drs. Mark Hatzenbuehler, Gilbert Gee, Mark Fossett, Kelli Komro, Sandro Galea, Eliseo J. Pérez-Stable.

On May 22 and 23, 2017, NIMHD and the U.S. Department of Health and Human Services Office of Minority Health convened a workshop on identifying structural racism/discrimination (SR/D) and addressing it in minority health and health disparities research. Participants included staff from NIH and other agencies, grantees, and members of the National Advisory Council on Minority Health and Health Disparities.

The topic of SR/D has only recently gained attention, although the connection between social inequality and health disparities has been recorded for many years. Structural racism (SR) is about the interconnection of five elements that reinforce racism: institutional racism, racial climate, segregation, racialized rules, and time. Institutional racism refers to the discriminatory policies or practices of an institution. Racial climate, which changes over time, embodies the shared views about racial groups and hierarchies. Multilevel segregation exists in housing and education and has been associated with adverse health outcomes. Racialized rules come from historical attitudes on race that have influenced research and thus led to outdated and scientifically unsound data.1 Time is another way to measure the effect of racism on a person’s life and on minority populations. With less time spent in education, shorter life expectancies, and more social and financial hardships, members of racial minorities are more likely to live shorter lives with more strife. 2

Plenary speaker Gilbert Gee, Ph.D., from UCLA Fielding School of Public Health, opened the workshop by speaking on the theme of time as an important factor of SR/D. Dr. Gee also discussed the interconnectedness of societal institutions in reinforcing SR/D. His remarks proceeded with speakers—including Sandro Galea, M.D., Dr.P.H., from Boston University School of Public Health—who argued that racism is so common in society that it must be targeted by limiting exposure in all populations. J. Emilio Carrillo, M.D., M.P.H., from Massachusetts General Hospital, spoke about focusing on neighborhoods through community-based participatory research as another way to address the problem.

The workshop included three panel sessions. The first panel identified factors of SR/D that affect minority health and health disparities. One recommendation was to examine how SR/D leads to stress and causes adverse health outcomes. Identifying causal pathways would help direct further studies.

The second session focused on ways to measure SR/D. The resulting recommendations were to encourage research on SR/D and improve the data sources for measuring it. Improving data linkages and creating new data products will require public and private partnerships.

The third session discussed how policy and practice-based research can improve minority health and reduce health disparities. In order to translate research findings into policy and practice, the research sector must connect with the private and policy sectors. Importantly, the research must include the community and address concerns that are significant to stakeholders. These recommendations may guide future workshops on SR/D.

Eliseo J. Pérez-Stable, M.D., director of NIMHD, concluded the workshop with a reminder to researchers to take advantage of the opportunities to collaborate with institutions, such as city government, enterprises, community organizations, foundations, and academic health centers. Such collaborations are within easy reach of the research community and are one means for implementing their research findings.

References

  1. Gee, G. C. & Ford, C. L. (2011, April). Structural racism and health inequities: old issues, new directions. Du Bois Review: Social Science Research on Race, 8(1), 115–132. doi: 10.1017/S1742058X11000130.
  2. Gee, G. C., Walsemann, K. M., & Brondolo, E. (2012, May). A life course perspective on how racism may be related to health inequities. American Journal of Public Health, 102(5), 967–974. doi: 10.2105/AJPH.2012.300666.

Posted July 17, 2018