unit 2 - racism and discrimination

Question 1

understanding associations

Answer 1

• Racially and ethnically stigmatized people experience higher than
  average rates of illness, impairment, and death
• See in earlier onset of illness, more severe disease, and poorer
  quality of care compared with their majority peers
• Understanding the complex ways in which race, ethnicity, and SES
  combine to influence health outcomes is a critical task in addressing
  the disparities

Question 2

from a historical perspective

Answer 2

• The categorization of social groups into races has reflected
  oppression, exploitation, and social inequality
• Racial categories have changed with every national census since
  1790
• Race reflects confounding biological factors
• Ancestral history
• Geographic origins
• Environmental exposures (physical, social, chemical, across life course,
  biological adaptation)

Question 3

socioeconomic status

Answer 3

• Comprises a range of factors encompassing economic
  resources, power, and prestige that can influence health
• At different times in the life course (infancy, adolescence)
• At different levels (individual, household, and neighborhood)
• Via different pathways (education, workplace)

Question 4

of note:

Answer 4

• Asian individuals have a high SES
  profile
• Levels of college graduation
  are
  almost twice as high for
  Whites
  compared with those of
  Black Americans and Hispanic people
  For every dollar of income
  that Whites earn:
  Black people: 59 cents
  Hispanic people: 70 cents

Question 5

life expectancy

Answer 5

Four-year difference in life expectancy between
Non-Hispanic Whites and non-Hispanic Blacks or
African Americans

Question 6

race still matters for health

Answer 6

even after SES is considered
- exposure to adversity
- racism
- non-equivalence of SES indicators
- elevated risk to psychosocial stressors

Question 7

implications for research and policy

Answer 7

• Future research needs to examine how the levels, timing, and
  accumulation of experiences of racial bias over the life course,
  combine toxic stressors, to influence the onset and course of illness
• Renewed research attention given to identify makers that are better
  than race to identify potential contribution of genetic factors
• Renewed research focus on identifying the interventions at multiple
  societal levels

Question 8

racism - getting to the root of the problem

Answer 8

• A system of structuring opportunity and assigning value based
  on the social interpretation of how we look (“race”)
• Unfairly disadvantages some individuals and communities
• Unfairly advantages other individuals and communities

Question 9

framework: understanding three levels of racism

Answer 9

• Institutionalized racism
• Personally mediated racism
• Internalized racism
  How does racism operate to
  influence health?
  How do we intervene on
  racism?

Question 10

institutionalized racism

Answer 10

differential access to the goods, services and opportunities of
society by race
* Inherited disadvantage, institutionalized in norms, customs and laws
* It can be through acts of commission or acts of omission, and often
manifested as inaction in the face of need
* Examples
* Education, housing, job opportunities, health care access, income
inequality

Question 11

personally-mediated racism

Answer 11

differential assumptions about the abilities, motives, and intents of
others by race (prejudice) and differential actions based on those
assumptions (discrimination)
* People are generally most aware of this form of racism (“everyday racism”)
* Can be intentional or unintentional
* Can have direct and indirect impact on health
* Examples?

Question 12

manifestations of personally-mediated racism

Answer 12

• Lack of respect (poor or no service)
• Suspicion (everyday avoidance, shopkeepers’ vigilance, purse
  clutching)
• Devaluation (surprise at competence)
• Scapegoating
• Dehumanization (police brutality, hate crimes)

Question 13

internalized racism

Answer 13

acceptance by members of the stigmatized races of negative
messages about their own abilities and intrinsic worth
* Manifested as helplessness, hopelessness, self-devaluation, “accepting
the limitations of the box into which we have been put”
* Examples:
* “I can’t be a lawyer” “I won’t amount to anything because I’m Black”
* Can lead to destructive health behaviors

Question 14

a gardeners tale (ted talk)

Answer 14

• How is institutionalized racism illustrated?
• Where is personally mediated racism occurring?
• Where is the internalized racism?
• How do we make things right in the garden?
• Who is the gardener?

Question 15

CERD

Answer 15

• United Nations International Convention on the Elimination of all
  Forms of Racial Discrimination (CERD)
• Purpose: elimination of racism, racial discrimination, and other forms
  of intolerance
• Requires countries to review governmental, national, and local
  policies, and to amend or repeal laws and regulations that have the
  effect of creating or perpetuating racial discrimination* Adopted on December 21, 1965; enforced January 4, 1969
• CERD was ratified in 1994, with the U.S. signing and legally
  agreeing to be bound by its requirements (25 Titles)
• As of July 2007, 173 countries had agreed to be bound by the
  terms of the CERD