The COVID-19 pandemic clearly illustrates the intersection of structural racism, social risk factors, and health. Data from the Centers for Disease Control and Prevention on COVID-19 infection and mortality rates show high incidences in specific geographic regions. Further investigation within Louisiana revealed that rates of hospitalisation and death in Black patients were twice as high as would be expected on the basis of demographic representation. It has been hypothesised that increased exposure to COVID-19 among Black Americans is attributable to greater representation in service occupations and a greater likelihood of living in inner cities with high population density.
With a concerted effort that encompasses multiple sectors, Egede and Walker suggest we can change the fabric of structural racism and social risk that leads to disparities in health. In this New England Journal of Medicine article, they propose that to be effective, change must occur within federal, state, county, and city governments; within private and nonprofit businesses and in the health care, food, housing, education, and justice arenas; and at the individual level. If everyone took a stand to stop racism and found a way to participate in sustainable change in one of the six suggested areas below, the result could be transformational.
Recommended action items for mitigating structural racism:
- Change policies that keep structural racism in place.
- Break down silos and create cross-sector partnerships.
- Institute policies to increase economic empowerment.
- Fund community programs that enhance neighborhood stability.
- Be consistent in efforts by health systems to build trust in vulnerable communities.
- Test and deploy targeted interventions that address social risk factors.