How to Fix Racial Inequities in the U.S. Health System

Three experts discuss why health care needs a paradigm shift — and how to get there

Dana G Smith
Elemental
Published in
9 min readJul 13, 2020

--

A health care worker gives a Covid test to a patient in the Covid-19 Unit at United Memorial Medical Center in Houston, Texas, July 2, 2020. Photo: Mark Felix/AFP/Getty Images

Covid-19 has illuminated the stark racial inequities that exist in the United States’ health care system. The risk of dying from the novel coronavirus is up to nine and eight times higher for young Black and Latinx Americans, respectively, compared to white Americans. Experts say this disparity is in large part explained by the fact that people of color are more likely to work in jobs deemed essential during the pandemic, often with minimal protections against the virus. Other factors at play are limited access to health care and higher rates of pre-existing conditions due to chronic stress and systemic racism, placing them at an increased risk for severe infection and death from the virus.

In June, three physicians and public health experts — Aletha Maybank, MD, MPH, chief health equity officer for the American Medical Association; Jonathan Metzl, MD, PhD, professor of sociology and psychiatry at Vanderbilt University; and Fernando De Maio, PhD, professor of sociology at DePaul University — penned a piece for the Journal of the American Medical Association about the inequities that exist in health care and how to resolve the injustices with an anti-racism lens. Elemental recently followed up with them to discuss how the country got here and how to begin fixing the problem.

The interview has been lightly edited for length and clarity.

Elemental: I realize this is an entire field of history, and numerous books have been written on the subject, but, briefly, how did we get here? How did we get to these dramatic racial inequities that we’re seeing in the health care system?

Aletha Maybank: Because it’s a pandemic and the inequities exist in so many different places and so many different cities are affected at one time, it now has been made visible to people who haven’t been paying attention. But those who are in health equity have known this for generations. W.E.B. Du Bois wrote his book The Philadelphia Negro and pointed out that there are inequities that existed between ex-slaves and whites in the city of Philadelphia. But because of white supremacy, his work was made invisible over many, many…

--

--

Dana G Smith
Elemental

Health and science writer • PhD in 🧠 • Words in Scientific American, STAT, The Atlantic, The Guardian • Award-winning Covid-19 coverage for Elemental