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Historical, sociological, and ecological analyses reveal that the health of a people is broadly determined by the strength, resilience, and vitality of their culture. The destructive effects of oppression and exploitation on health linger and are difficult to transcend when systemic attacks on the institutional stability of a people persist. Normative cultural destabilization produces added and abnormal challenges to the health status of African Americans. The pursuit of health becomes both a goal and a tool of liberation. Better health builds and releases mental, physical, and spiritual energy that can be directed toward achieving empowerment and development. The process of self-consciously pursuing better health attacks the fundamental mechanisms of cultural exploitation and oppression by serving to dismantle colonial-like relationships of dependency.
In the United States, some populations suffer from far greater disparities in health than others. Those disparities are caused not only by fundamental differences in health status across segments of the population, but also because of inequities in factors that impact health status, so-called determinants of health. Only part of an individual's health status depends on his or her behavior and choice; community-wide problems like poverty, unemployment, poor education, inadequate housing, poor public transportation, interpersonal violence, and decaying neighborhoods also contribute to health inequities, as well as the historic and ongoing interplay of structures, policies, and norms that shape lives. When these factors are not optimal in a community, it does not mean they are intractable: such inequities can be mitigated by social policies that can shape health in powerful ways. Communities in Action: Pathways to Health Equity seeks to delineate the causes of and the solutions to health inequities in the United States. This report focuses on what communities can do to promote health equity, what actions are needed by the many and varied stakeholders that are part of communities or support them, as well as the root causes and structural barriers that need to be overcome.
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What is it like to be a black person in America today? The voices of middle class African Americans captured in this book will surprise those who think the era of racial discrimination is past. The Many Costs of Racism is a vivid account of the mental, physical health, and economic effects of everyday racism for Black Americans—and of racism's high costs for all Americans. Drawing on well documented studies, it vividly portrays the damage done to individuals, families, and communities by stress from workplace discrimination. It shows the strong connection between discrimination and health problems, describing these as “costs” above and beyond the economic trials of discrimination. The book is an ideal text, accessible to students in sociology, law, psychology, and medicine.
At times mirroring and at times shockingly disparate to the rise of traditional white American medicine, the history of African-American health care is a story of traditional healers; root doctors; granny midwives; underappreciated and overworked African-American physicians; scrupulous and unscrupulous white doctors and scientists; governmental support and neglect; epidemics; and poverty. Virtually every part of this story revolves around race. More than 50 years after the publication of An American Dilemma, Gunnar Myrdal's 1944 classic about race relations in the USA, An American Health Dilemma presents a comprehensive and groundbreaking history and social analysis of race, race relations and the African-American medical and public health experience. Beginning with the origins of western medicine and science in Egypt, Greece and Rome the authors explore the relationship between race, medicine, and health care from the precursors of American science and medicine through the days of the slave trade with the harrowing middle passage and equally deadly breaking-in period through the Civil War and the gains of reconstruction and the reversals caused by Jim Crow laws. It offers an extensive examination of the history of intellectual and scientific racism that evolved to give sanction to the mistreatment, medical abuse, and neglect of African Americans and other non-white people. Also included are biographical portraits of black medical pioneers like James McCune Smith, the first African American to earn a degree from a European university, and anecdotal vignettes,like the tragic story of "the Hottentot Venus", which illustrate larger themes. An American Health Dilemma promises to become an irreplaceable and essential look at African-American and medical history and will provide an invaluable baseline for future exploration of race and racism in the American health system.
This book shows how living in a highly racialized society affects health through multiple social contexts, including neighborhoods, personal and family relationships, and the medical system. Black-white disparities in health, illness, and mortality have been widely documented, but most research has focused on single factors that produce and perpetuate those disparities, such as individual health behaviors and access to medical care. This is the first book to offer a comprehensive perspective on health and sickness among African Americans, starting with an examination of how race has been historically constructed in the US and in the medical system and the resilience of racial ideologies and practices. Racial disparities in health reflect racial inequalities in living conditions, incarceration rates, family systems, and opportunities. These racial disparities often cut across social class boundaries and have gender-specific consequences. Bringing together data from existing quantitative and qualitative research with new archival and interview data, this book advances research in the fields of families, race-ethnicity, and medical sociology.
According to Randall, Blacks suffer from the generational effect of a slave health deficit that was not relieved during the reconstruction period (1865-1870), the Jim Crow Era (1870-1965), the Affirmative Action Era (1965-1980), or the Racial Entrenchment Era (1980 to present). Repairing the health of Blacks will require a multi-facet long term legal and financial commitment.
This is the first book to offer a comprehensive perspective on health and sickness among African Americans. It shows how living in a highly racialized society affects health through multiple social contexts, including neighborhoods, personal and family relationships, and the medical system.
PULITZER PRIZE FINALIST • "A stunning exposé of why Black people in our society 'live sicker and die quicker'—an eye-opening game changer."—Oprah Daily From an award-winning writer at the New York Times Magazine and a contributor to the 1619 Project comes a landmark book that tells the full story of racial health disparities in America, revealing the toll racism takes on individuals and the health of our nation. In 2018, Linda Villarosa's New York Times Magazine article on maternal and infant mortality among black mothers and babies in America caused an awakening. Hundreds of studies had previously established a link between racial discrimination and the health of Black Americans, with little progress toward solutions. But Villarosa's article exposing that a Black woman with a college education is as likely to die or nearly die in childbirth as a white woman with an eighth grade education made racial disparities in health care impossible to ignore. Now, in Under the Skin, Linda Villarosa lays bare the forces in the American health-care system and in American society that cause Black people to “live sicker and die quicker” compared to their white counterparts. Today's medical texts and instruments still carry fallacious slavery-era assumptions that Black bodies are fundamentally different from white bodies. Study after study of medical settings show worse treatment and outcomes for Black patients. Black people live in dirtier, more polluted communities due to environmental racism and neglect from all levels of government. And, most powerfully, Villarosa describes the new understanding that coping with the daily scourge of racism ages Black people prematurely. Anchored by unforgettable human stories and offering incontrovertible proof, Under the Skin is dramatic, tragic, and necessary reading.
This book addresses the unique sociocultural and historical systems of oppression that have alienated African-American and other racial minority patients within the mental healthcare system. This text aims to build a novel didactic curriculum addressing racism, justice, and community mental health as these issues intersect clinical practice. Unlike any other resource, this guide moves beyond an exploration of the problem of racism and its detrimental effects, to a practical, solution-oriented discussion of how to understand and approach the mental health consequences with a lens and sensitivity for contemporary justice issues. After establishing the historical context of racism within organized medicine and psychiatry, the text boldly examines contemporary issues, including clinical biases in diagnosis and treatment, addiction and incarceration, and perspectives on providing psychotherapy to racial minorities. The text concludes with chapters covering training and medical education within this sphere, approaches to supporting patients coping with racism and discrimination, and strategies for changing institutional practices in mental healthcare. Written by thought leaders in the field, Racism and Psychiatry is the only current tool for psychiatrists, psychologists, administrators, educators, medical students, social workers, and all clinicians working to treat patients dealing with issues of racism at the point of mental healthcare.