How Does Racism Impact Health?

MINNEAPOLIS (WCCO) -- Even before NorthPoint Health & Wellness Center began testing for COVID-19 in mid-April, CEO Stella Whitney-West knew the impact of the virus would be personal.

More than 90% of the patients at NorthPoint are from communities of color.

"We do know so many people who are impacted are our family members or our friends, our neighbors," Whitney-West said.

The COVID-19 positivity rate statewide is around 7%. At NorthPoint, it averages 26%. Whitney-West says part of the reason behind the higher positivity rate is that people of color are more likely to be front-line workers who are exposed to COVID. They might also live in places where it can be harder to socially distance.

"I think it's important for people to understand the root cause of disparity," she said. "The underlying root cause is racism."

Last week, Hennepin County declared racism a public health crisis. One of the resolutions in the declaration directs Hennepin County to advocate for policies to improve health outcomes for Black, Indigenous and communities of color.

According the Centers for Disease Control, the life expectancy for white Americans is 79 years old. For Black Americans, it's 75 years old.

"These aren't new issues, I think they've been highlighted in an important way," said University of Minnesota professor and health equity researcher Dr. Rachel Hardeman.

Her main area of research centers around why Black mothers are three to four times more likely to die during and in the year after childbirth.

Hardeman said when talking about health inequities, it's important to understand the "weathering" hypothesis, which was coined by a University of Michigan researcher in the 1990s. Arline Geronimus suggests long-term and cumulative exposure to social and economic disadvantage and racism can lead to declines in health.

That stress and trauma can lead to "physiologically breaking down of the body making it more susceptible to injury and disease and chronic conditions we know are going to shorten someone's life," according to Hardeman.

Hardeman said another big issue is racism and discrimination in the broader health care system and at the individual level.

"We see this implicit bias show up in a clinical encounter and I think they're both incredibly important to understand," Hardeman said.

She points to her research which found several black women sharing their experiences of not bring heard by their providers, not trusting their providers or having tests run without their consent.

"We have to think about why that's happening," Hardeman said. "There's a distrust, a mistrust between a lot of communities of color and the black community in particular and healthcare system."

She's currently working on anti-racist training programs for medical providers as well as making sure more students of color have access to medical school.

And shortly after the COVID-19 pandemic came to the U.S., data showed African-Americans were more likely to die from COVID-19 than White people. Explanations for this included a discussion of "underlying conditions" like hypertension, diabetes, and obesity.

Those conditions are more likely to be found among African-Americans and Hardeman said it's important to try to understand why.

"We talk about where you work, live, play that matters for health," she said. "What we're still trying to grapple with is why those matter for health."

It could have to do with access to education, where are person is able to get a job and opportunities to earn more than minimum wage. There might also be environmental factors that come into play like pollution or living near a SuperFund site.

"Often times, people want to blame the individual as to why they're not healthy," Whitney-West said. "They need to understand it's complex."

She says that's part of the reason why NorthPoint offers not just physical health resources, but mental health, housing, social services and a food shelf.

"It involves a number of social and economic factors," Whitney-West said. "It's a long-term fix."

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