By Sandra C. Melvin
JA Guest Writer
Dr. Martin Luther King Jr. stated, “Of all the forms of inequality, injustice in health is the most shocking and the most inhumane.” Addressing disparities in health and health care is important not only from an equity standpoint but also for improving the nation’s overall health and economic prosperity. People of color and other underserved groups experience higher rates of illness and death across a wide range of health conditions, limiting the overall health of the nation.
The lack of equitable health care access, delivery, and coverage, combined with racialized poverty, segregation, environmental degradation, and discrimination, harm people of color and drive poorer health outcomes, which are exacerbated in prison settings. Furthermore, the systems that perpetuate inequity in health care delivery and health outcomes have also largely relegated mental health and substance use treatment to the criminal legal system, destabilizing communities and further fueling mass incarceration.
People of color are disproportionately punished for using drugs instead of being referred to treatment. Although Black and white people use drugs at similar rates, this trend is also seen in the rates at which Black mothers are reported to child protective services at the time of delivery, due to substance use, compared to their white counterparts.
Health equity is the presence of opportunity for each person to be as healthy as possible regardless of their identity or circumstances.
Several factors within and beyond the health care system drive disparities in health and health care. Though health care is essential to health, studies show that health outcomes are driven by multiple factors, including underlying genetics, health behaviors, social and environmental factors, and access to health care. While there is currently no consensus in the research on the magnitude of the relative contributions of each of these factors to health, studies suggest that health behaviors and social and economic factors, often referred to as social determinants of health, are the primary drivers of health outcomes and that social and economic factors shape individuals’ health behaviors. Moreover, racism negatively affects mental and physical health both directly and by creating inequities across the social determinants of health.
Everyone has a right to good health and well-being. Individual health does not exist in a vacuum. It is tied to the community conditions in which we are born, grow, live, work, and age. For people of color, geography, income, and race are longstanding predictors of health outcomes. These health outcomes are influenced by fragmented public and private health systems and a lack of access to resources across the lifespan.
The Institute for the Advancement of Minority Health works with other community partners and stakeholders to achieve health equity by building systems that eliminate discriminatory barriers to health, disrupt harmful stereotypes, promote health equity, support people who may be experiencing difficult circumstances, and advocate for policies to address systemic barriers that result in health disparities in minority, underserved, and under resourced communities.
As we think of the Martin Luther King Jr. holiday, let us take a moment to reflect on what his work stood for and why we fight today to remove the barriers to access to health care that prevent people of color from improving their health outcomes and enjoying the quality of life that is the right to all people born in this country. Health is a civil right and everyone is entitled to the highest standard of care regardless of race, gender, sexual orientation, political affiliation, or socioeconomic status.
Sandra C. Melvin, DrPH, MPH is Chief Executive Officer, Institute for the Advancement of Minority Health.
