9 Conversation Tips on Race & Health Equity
Seeing friends or extended family by video? You can have a huge impact by talking to them about issues that are important to you. Take the opportunity to discuss health care access for communities of color.
Here are 9 tips for leading the conversation. Remember: Talking with your friends and family about the issues you care about can have a real influence that extends even beyond your circle.
Tip #1: Open the dialogue in a way that’s welcoming.
Share how the last couple of years have affected your views on health and health insurance. Say something like, “I’ve been [concerned/angry] about COVID-19’s disproportionate impact on [Black and Brown communities/our community].”
ASK: “Could we talk about how racist our country’s health care system is? I have some ideas about what can be done, and I’d love to hear your take.”
Tip #2: Get everyone on the same page by defining common terms.
Racism in America is the outgrowth of white supremacist policies and ideas that assume white people are superior to other racial groups.
Racist policies are written and unwritten laws and customs that cause racial inequity, putting racial groups on unequal footing.
Public health is built on the principle of protecting and improving the health of people and their communities.
A public health crisis happens when something threatens the lives and health of an entire community or multiple groups of people.
ASK: Have you [seen/experienced] racism in health care?
Tip #3: Define some terms about race that are less common.
Anti-Blackness refers to a worldwide ideology that devalues being Black.
Anti-Black policies and institutions in white supremacist systems dehumanize and marginalize Black people around the world.
Anti-Black racism covertly disregards and overtly attacks anti-racist policies, Black people, and Black institutions.
Structural racism is a system in which policies, practices, and other norms perpetuate racial inequity. It’s the root cause for the health inequities we see today.
Racial inequity in America blocks Black and Brown people from living freely and safely — while putting white people in power, giving them more resources, and chipping away at their humanity.
Racist health care policies cause health inequities for racial groups, fortifying long-standing barriers and creating new barriers to health care access for Black and Brown communities.
Tip #4: Define some terms about health and fairness that are less common.
Equality gives everyone the same exact things, but ignores differences. Equal access to COVID-19 testing means everyone could theoretically get a test. But for many people, testing is too expensive and far away, or only open at times where they are unable to take off work or get childcare.
Equity gives everyone what they need, tailored to their individual situation. Equitable access to COVID-19 testing would be affordable, nearby, and have flexible hours for everyone.
Health Inequities vs. Health Equity
Health inequities are systemic, avoidable, and unjust differences in the health of a group of people compared to other groups.
Health disparities are any kind of differences in health outcomes for a group compared to other groups. Disparities don’t refer to social or structural causes like inequities do.
Health equity happens when everyone has a fair and just opportunity to be as healthy as possible. This requires removing obstacles to health such as: poverty, discrimination, powerlessness, limited education, unstable housing, unsafe environments, and lack of health insurance.
Tip #5: Provide examples of racial and health inequities.
Racism is embedded in the structure of the U.S. health care system. The people in charge of that system — including politicians and insurers — have carried out discriminatory practices throughout its history.
Institutionalized discrimination in the U.S. health care system has thrown up roadblocks to insurance, testing, treatment, and care for communities of color. That includes the system’s reliance on employer-sponsored insurance. Because of historic economic barriers, Black and Brown people are less likely to be working in jobs that offer this benefit.
Racial bias among medical researchers and health care providers — such as the erroneous belief that Black people feel less physical pain — have withheld needed care and pain management from Black patients.
Being Black in America takes a toll on the health of Black people.
Racism, microaggressions, and discrimination cause chronic stress.
Researchers have shown that racism stresses and prematurely ages human cells.
All that stress causes physical and psychological harm over time.
The result: increased rates of illness and death among Black people.
Tip #6: Share how health care inequities have led to dramatic disparities in health conditions for Black and Brown communities.
Racial and health inequities help explain why — regardless of income or education — Black and Brown patients have disproportionately fared worse compared to their white counterparts across many health outcomes.
Racism’s chronic stress is linked to higher risk of depression, diabetes, and high blood pressure.
Black people disproportionately experience police-inflicted harassment, violence, injuries, and murder. Living in fear of state-sanctioned brutality causes a host of underlying health problems.
Because of racist policies like redlining, Black and Brown people are more likely to live near toxic sites and amid high pollution, as well as in neighborhoods that lack healthy food options and places to exercise. These environments are linked to higher rates of asthma, respiratory illnesses, and cardiovascular disease.
Long-standing, systemic health and social inequities in the United States and discrimination in doctors’ offices and hospitals all have resulted in a high maternal mortality rate among Black women — three times the rate for white women.
Structural racism, public health failures and economic inequalities — including that the location of Black and Brown workers’ jobs are more likely to put them at risk of catching COVID-19 — have all translated to exponentially higher COVID-19 infection and death rates in Black, Indigenous, and Latino communities.
Tip #7: Discuss why racism is a public health crisis.
The American Medical Association, the American Public Health Association, several states, and other U.S. institutions declared that racism is a public health crisis and called for urgent action from policymakers and institutions.
Discrimination creates barriers to health, both inside and outside the doctor’s office. Your health depends on whether you can access health care, employment, good wages, food security, clean air and water, and stable housing — all of which are hurt by racism.
SCROLL UP: Refer to the definition of “public health crisis” and share how you feel about it.
ASK: “How do you feel about racism being declared a public health crisis?”
Tip #8: Share what federal policies you support to address racial inequity.
For example, you may want them to support policies that:
Aim to eliminate the inequities and biases woven into the fabric of this nation’s institutions, particularly the racial inequities in maternal health.
Provide additional COVID-19 relief that helps Black, Indigenous, and Latino communities — which have been disproportionately ravaged due to ongoing systemic racism and oppressive policies.
Defund the police. Instead of investing in police forces that brutalize Black people, prioritize a public-health approach that strengthens Black communities, promotes community support, and connects people to services.
Support Black organizations and leaders who are at the forefront of the fight to fix the public health crisis that racism presents and the systems that exploit people of color.
Tip #9: Express gratitude for everyone in the conversation.
Thank your friends and family for connecting with you on this issue, and let them know that you’re open to speaking with them again.
Show them some warmth — and give them the time and space to sit with the discussion.
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