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Chapter 3 - Health Equity as a Perennial Pursuit

Published online by Cambridge University Press:  12 June 2025

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Summary

Despite contemporary vitriol to the contrary, race continues to be a variable that influences interactions among people throughout the United States. Interactions between people of certain races (e.g., Blacks and Whites) are especially likely to be affected. Because of systemic socioeconomic and historical influences, the quality of interracial interactions is often compromised. One can observe some of the most pronounced attenuation in the quality of interactions between African Americans and Whites, and this occurs across all sectors, including healthcare, law enforcement, education and schools, real estate, shops, restaurants, and more.

Ironically, most scientists who study human beings in all of their complexity—from their genomic basis to their cultural traditions—recognize that race as a variable says little about meaningful variations within and across human beings. Indeed, “race” is primarily a visual classifier rather than an indicator of a distinct subspecies of the human population. Instead, its importance lies in its roots as a means for justifying the enslavement and later subjugation of a class of people. Thus, the highly profitable triangular slave trade of Africans and the ensuing system of slavery that enabled the economic growth of the newly established United States required a separation of “races” and inferiorizing of Africans.

Our nation's current reality is tethered to its past, which was built, cultivated, and allowed to flourish on the basis of a racist structure enabled by racist beliefs. For a large part of the time in which the United States has existed, it has either explicitly called for racial separation or implicitly sanctioned racist treatment of its constituents. Of the 245 years of its existence, the United States has only legislated against racist treatment to varying degrees within the last 70 years. Racism is a “multilevel system of oppression based on the social categories of race whereby the superordinate group (traditionally Whites in the United States) subordinates members of other racial groups using overt and covert methods.”

Racism exists at individual, institutional, and cultural levels. Individual racism is interpersonal discrimination; for instance, perpetration of hate crimes against people of color or refusal to rent to an interracial couple. Institutional racism resides in the policies and practices of governments, courts, businesses, schools, etc., to subordinate people of color and benefit white communities.

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Chapter
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Navigating the Inequitable U.S. Healthcare System
In Search of Critical Care
, pp. 37 - 52
Publisher: Anthem Press
Print publication year: 2024

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