Katherine P Theall, Samantha Francois, Caryn N Bell, Andrew Anderson, David Chae, Thomas A LaVeist
{"title":"Neighborhood Police Encounters, Health, And Violence In A Southern City.","authors":"Katherine P Theall, Samantha Francois, Caryn N Bell, Andrew Anderson, David Chae, Thomas A LaVeist","doi":"10.1377/hlthaff.2021.01428","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01428","url":null,"abstract":"<p><p>The disproportionate rates of police surveillance and encounters in many communities in the US may be contributing to inequities in health and violence. Frequent policing in communities, which may often also be aggressive policing, has been associated with diminished health and well-being. This study adds to the growing body of research on this issue by examining the relationships between neighborhood police stop-and-frisk encounters and both health outcomes and violence rates in New Orleans, Louisiana, in an ecological, cross-sectional study using local police report, Centers for Disease Control and Prevention, and census data. The average rate of police stop-and-frisk encounters was more than three times higher for Black adults compared with their White counterparts. Even after we accounted for concentrated disadvantage (a high percentage of residents of lower socioeconomic status) and residential racial and income segregation, neighborhoods with higher rates of encounters had significantly higher prevalence rates of smoking, physical inactivity, and poor physical health, and they experienced significantly more violent crime (18.35 more per 1,000) and domestic violence (49.91 more per 1,000) events than neighborhoods with lower levels of police encounters. There is a need for strengthened policy focused on the relationship between frequent policing and health and violence outcomes.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"228-236"},"PeriodicalIF":9.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9037135/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39896682","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Jan M Eberth, Peiyin Hung, Gabriel A Benavidez, Janice C Probst, Whitney E Zahnd, Mary-Katherine McNatt, Ebony Toussaint, Melinda A Merrell, Elizabeth Crouch, Oyeleye J Oyesode, Nicholas Yell
{"title":"The Problem Of The Color Line: Spatial Access To Hospital Services For Minoritized Racial And Ethnic Groups.","authors":"Jan M Eberth, Peiyin Hung, Gabriel A Benavidez, Janice C Probst, Whitney E Zahnd, Mary-Katherine McNatt, Ebony Toussaint, Melinda A Merrell, Elizabeth Crouch, Oyeleye J Oyesode, Nicholas Yell","doi":"10.1377/hlthaff.2021.01409","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01409","url":null,"abstract":"<p><p>Examining how spatial access to health care varies across geography is key to documenting structural inequalities in the United States. In this article and the accompanying StoryMap, our team identified ZIP Code Tabulation Areas (ZCTAs) with the largest share of minoritized racial and ethnic populations and measured distances to the nearest hospital offering emergency services, trauma care, obstetrics, outpatient surgery, intensive care, and cardiac care. In rural areas, ZCTAs with high Black or American Indian/Alaska Native representation were significantly farther from services than ZCTAs with high White representation. The opposite was true for urban ZCTAs, with high White ZCTAs being farther from most services. These patterns likely result from a combination of housing policies that restrict housing opportunities and federal health policies that are based on service provision rather than community need. The findings also illustrate the difficulty of using a single metric-distance-to investigate access to care on a national scale.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"237-246"},"PeriodicalIF":9.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39594098","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Paula A Braveman, Elaine Arkin, Dwayne Proctor, Tina Kauh, Nicole Holm
{"title":"Systemic And Structural Racism: Definitions, Examples, Health Damages, And Approaches To Dismantling.","authors":"Paula A Braveman, Elaine Arkin, Dwayne Proctor, Tina Kauh, Nicole Holm","doi":"10.1377/hlthaff.2021.01394","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01394","url":null,"abstract":"<p><p>Racism is not always conscious, explicit, or readily visible-often it is systemic and structural. Systemic and structural racism are forms of racism that are pervasively and deeply embedded in systems, laws, written or unwritten policies, and entrenched practices and beliefs that produce, condone, and perpetuate widespread unfair treatment and oppression of people of color, with adverse health consequences. Examples include residential segregation, unfair lending practices and other barriers to home ownership and accumulating wealth, schools' dependence on local property taxes, environmental injustice, biased policing and sentencing of men and boys of color, and voter suppression policies. This article defines <i>systemic</i> and <i>structural racism</i>, using examples; explains how they damage health through many causal pathways; and suggests approaches to dismantling them. Because systemic and structural racism permeate all sectors and areas, addressing them will require mutually reinforcing actions in multiple sectors and places; acknowledging their existence is a crucial first step.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"171-178"},"PeriodicalIF":9.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39896766","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Racism Runs Through It: Examining The Sexual And Reproductive Health Experience Of Black Women In The South.","authors":"Terri-Ann Monique Thompson, Yves-Yvette Young, Tanya M Bass, Stephanie Baker, Oriaku Njoku, Jessica Norwood, Monica Simpson","doi":"10.1377/hlthaff.2021.01422","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01422","url":null,"abstract":"<p><p>Few studies have illustrated how racism influences Black women's use of reproductive health care services. This article presents findings of a collaborative study conducted by a research team and a reproductive justice organization to understand Black women's concerns with sexual and reproductive health services. The qualitative research was conducted with Black women living in Georgia and North Carolina, using a community-based participatory research approach. Themes were developed from participant accounts that highlight how racism, both structural and individual, influenced their reproductive health care access, utilization, and experience. Structural racism affected participants' finances and led some to forgo care or face barriers to obtaining care. Individual racism resulted in some women electing to receive care only from same-race medical providers. These findings suggest a need for policies and practices that address structural barriers to reproductive health care access and improve the reproductive health experience of Black women.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"195-202"},"PeriodicalIF":9.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39896769","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"The Intellectual Roots Of Current Knowledge On Racism And Health: Relevance To Policy And The National Equity Discourse.","authors":"Ruth Enid Zambrana, David R Williams","doi":"10.1377/hlthaff.2021.01439","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01439","url":null,"abstract":"<p><p>Research related to racism and health has evolved in recent decades, with a growing appreciation of the centrality of the social determinants of health, life-course approaches and structural racism, and other upstream factors as drivers of health inequities. Examining how race, class, and structural racism relate to each other and combine over the life course to affect health can facilitate a clearer understanding of the determinants of health. Yet there is ongoing discomfort in many public health and medical circles about research on racism, including opposition to the use of racial terminology. Similarly, most major national reports on racial and ethnic inequities in health have given limited attention to the role of racism. We conclude that there is a need to acknowledge the central role of racism in the national discourse on racial inequities in health, and paradigmatic shifts are needed to inform equity-driven policy and practice innovations that would tackle the roots of the problem of racism and dismantle health inequities.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"163-170"},"PeriodicalIF":9.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39896683","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Melanie D Sabado-Liwag, Erin Manalo-Pedro, Roy Taggueg, Adrian M Bacong, Alexander Adia, Donna Demanarig, Jake Ryann Sumibcay, Claire Valderama-Wallace, Carlos Irwin A Oronce, Rick Bonus, Ninez A Ponce
{"title":"Addressing The Interlocking Impact Of Colonialism And Racism On Filipinx/a/o American Health Inequities.","authors":"Melanie D Sabado-Liwag, Erin Manalo-Pedro, Roy Taggueg, Adrian M Bacong, Alexander Adia, Donna Demanarig, Jake Ryann Sumibcay, Claire Valderama-Wallace, Carlos Irwin A Oronce, Rick Bonus, Ninez A Ponce","doi":"10.1377/hlthaff.2021.01418","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01418","url":null,"abstract":"<p><p>Within the monolithic racial category of \"Asian American,\" health determinants are often hidden within each subgroup's complex histories of indigeneity, colonialism, migration, culture, and socio-political systems. Although racism is typically framed to underscore the ways in which various institutions (for example, employment and education) disproportionately disadvantage Black/Latinx communities over White people, what does structural racism look like among Filipinx/a/o Americans (FilAms), the third-largest Asian American group in the US? We argue that racism defines who is visible. We discuss pathways through which colonialism and racism preserve inequities for FilAms, a large and overlooked Asian American subgroup. We bring to light historical and modern practices inhibiting progress toward dismantling systemic racial barriers that impinge on FilAm health. We encourage multilevel strategies that focus on and invest in FilAms, such as robust accounting of demographic data in heterogeneous populations, explicitly naming neocolonial forces that devalue and neglect FilAms, and structurally supporting community approaches to promote better self- and community care.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"289-295"},"PeriodicalIF":9.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39594096","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Christopher J King, Bryan O Buckley, Riya Maheshwari, Derek M Griffith
{"title":"Race, Place, And Structural Racism: A Review Of Health And History In Washington, D.C.","authors":"Christopher J King, Bryan O Buckley, Riya Maheshwari, Derek M Griffith","doi":"10.1377/hlthaff.2021.01805","DOIUrl":"https://doi.org/10.1377/hlthaff.2021.01805","url":null,"abstract":"<p><p>Recent events have amplified the debilitating effects of systemic racism on the health of the United States. In an effort to improve population health and dismantle more than 400 years of racial injustice, retrospective examinations of policies, practices, and events that have sustained and continue to undergird racial hierarchy are necessary. In this historical review we feature Washington, D.C.-a city with a legacy of Black plurality. We begin with an overview of contemporary place-based health and socioeconomic disparities. To express the etiology of the trends and uncover opportunities to undo the damage, we reflect on the national landscape as well as on policies and events that socially, economically, and politically disenfranchised Black residents, yielding stark differences in health outcomes among Washington, D.C., populations. In the spirit of atonement in policy and practice, we hope that this approach will inspire policy makers and practitioners in communities across the nation to conduct similar examinations.</p>","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"273-280"},"PeriodicalIF":9.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39594097","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"Racism And Health.","authors":"Alan R Weil","doi":"10.1377/hlthaff.2022.00033","DOIUrl":"https://doi.org/10.1377/hlthaff.2022.00033","url":null,"abstract":"","PeriodicalId":300542,"journal":{"name":"Health affairs (Project Hope)","volume":" ","pages":"157"},"PeriodicalIF":9.7,"publicationDate":"2022-02-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"39594095","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}