Racism and health link must be acknowledged: expert

Monday, February 10, 2014 - 2:50pm

By Everton McLean

Health care providers need to acknowledge they are human and therefore prone to unconsciously believing stereotypes if they are to overcome discrimination and its negative effects on health, says a Harvard University expert in race and health.

David R. Williams is a professor of public health at the Harvard School of Public Health, as well as professor of African and African American studies and of sociology.

His research has shown direct links between a person’s race and health. In particular, he said, race can influence how health care practitioners provide care to individuals, whether the health workers realize it or not. Meanwhile, underlying social discrimination also deteriorates health in targeted groups, due to the stress of daily interactions and their negative impact on chronic diseases.

“Beyond the close relationship between race and education and income (and health), there is an added effect of racism that also affects health,” Williams said, between meetings in Halifax, where he was presenting a free public lecture Feb. 10.

Williams said that even in countries such as Canada that legislate universal access to health care, racial inequalities persist in the quality and intensity of care.

“Much of this we think is unconscious and unintentional – there is no intent on behalf of the providers,” said Williams.

However, he said, health care providers are members of the broader community and carry with them the racial friction inherent to that community.

“It’s a very human phenomenon. We all process things by putting them in social categories,” he said. “When you encounter someone from a social group that you hold negative stereotypes about, you will treat that person differently, you will discriminate, without any awareness on your part and without and intent on your part.”

This occurs even among people who are committed to non-discriminatory views. Evidence from multiple studies across the world suggests the same kinds of systemic discrimination, Williams said.

For example, in the wake of Sept. 11 in the United States, studies showed a peak in discrimination against people of Middle-Eastern descent. Those experiences adversely affected the targeted people’s mental health.

This discrimination affected physical health as well. One study evaluated the birth outcomes among California women of Middle-Eastern descent six months after Sept. 11.

There was a clear increased risk of low birth weight and pre-term birth when compared to middle-eastern women who’d given birth in the six months before Sept. 11, and when compared to all other women who’d given birth in the six months after the event.

“It’s a dramatic finding that suggests discrimination not only affects the mental health of these women, but it actually affects the babies they are carrying,” Williams said. “It actually has biological consequences for the health of targeted groups.”

Given the scientific research Williams points to, the next question for both health care providers and the public, he said, is what to do about this racial inequality?

Admitting that everyone is prone to believing stereotypes is an important first step, he said.

The next step is to encounter every person as an individual first, and actively try not to resort to using the stereotype. This process of “individuation” allows a health care provider to see past the inherent racial categories they have preformed.

“We are all human, and there are powerful human processes (at work),” he said. “An individual that says ‘That would not be me, I would never do that,’ is someone who is perfectly set up to (discriminate).”