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Hidden Social Factors: How Underlie the Roots of Racial Health Disparities?
The relationship between race and health is a complex and multifaceted issue, involving how identifying with a particular race affects health outcomes. This concept not only relies on self-identity but is also influenced by social identification. For studies of race and health, scientists organize people into racial categories based on factors such as phenotype, ancestry, social identity, and more. Research shows that racial and ethnic groups have significant differences in health status, health outcomes, and life span on many health indicators. The roots of these differences are often tied to social disadvantages, such as implicit stereotypes and differences in socioeconomic status. .
Health disparities are defined as “preventable differences in disease, injury, violence, or opportunities for optimal health experienced by disadvantaged groups in society.” These disparities are closely related to the unequal distribution of social, political, economic and environmental resources.
Health disparities are particularly problematic in the United States. According to the U.S. Health Resources and Services Administration, health disparities are “differences in the presence of disease, health outcomes, or access to care among certain groups.” For example, African Americans face two to three times the mortality rate from pregnancy-related complications than white people. Clearly, these differences are not universal, and some minority groups (e.g., recent Hispanic immigrants to the United States) may even have better health outcomes than whites upon arrival in the United States. However, this situation changes as you live longer in the United States.
In the United States, more than 133 million people (or approximately 45% of the population) have one or more chronic disease, with rates of chronic disease particularly among racial/ethnic minority groups between the ages of 60 and 70. 1.5 to 2.0 times that of white people.
The root causes of these health disparities are not just genetic factors but also barriers created by structural racism and socioeconomic inequality. African Americans face a higher risk of death from COVID-19 than white people, according to a study, highlighting the strong connection between social circumstances and health. For African Americans, systemic racial discrimination negatively affects their mental health and increases their risk of death from substance use disorders.
Structural racism is an important driver of these disparities and spans multiple interconnected systems including housing, health care, education, and more. Black communities, for example, face greater health risks due to housing discrimination and restrictions on quality medical resources. The combination of these factors, combined with racial bias in medical care, contributes to worsening health outcomes and higher mortality rates among African Americans.
Emergency medicine, as a field that studies these health disparities, shows the clear impact of these inequalities, particularly in the treatment of communicable diseases, non-communicable diseases, and trauma cases.
Over the past few decades, the rate of chronic disease among U.S. children has quadrupled, with minorities disproportionately more likely to face these conditions. At the same time, the development of health services and research for these groups still lags behind. Although some health institutions have begun to pay attention to this, there is still a long way to go in formulating effective health policies that target the needs of these specific groups.
Especially in the current healthcare environment, healthcare providers need to understand race, social determinants of health, and their impact on health outcomes. The problem of racial inequality is not only based on genetic differences, but also caused by social and environmental factors. However, the traditional medical model often ignores this, leaving minorities with longer wait times and unequal pain management in the process of accessing care.
These phenomena not only demonstrate the pervasive impact of institutional bias but also underscore the need to address these inequalities. Research shows that public health policy needs to focus more on social determinants to address the root causes of health disparities. Even if genetic influences appear to vary for some diseases, environmental, cultural and socioeconomic factors still have a profound impact on disease progression.
Further research revealed that there is no unified standard for the definition of health. It has been suggested that the use of “race” to express population risk may lead to underdiagnosis of low-risk groups. But it also means that understanding health disparities must go beyond superficial racial definitions and delve deeper into the social structures that underlie them.
In the future, we need to reflect on how to weaken the impact of racial and socioeconomic inequality in health care and improve health equity in society as a whole. How long will it take for the social problems hidden behind the data to receive real attention and change?
