As part of the U of M’s public health institute class on framing health disparities, we are
using this blog post to inform our collective effort to send the “right”
message.
Every time I read the communications research (see previous blog post) on this
subject, I’m always left thinking about the recommendation that the “right”
message means NOT talking explicitly about racism or even emphasizing racial
differences when talking about disparities.
I get it. I believe their analysis. As an ex-advertising
exec I should be all over it.
But I just can’t buy it. Not naming it renders it invisible,
insignificant and enables the systemic status quo. I get that ultimately it
works toward the same social justice goal, but I think there are other
implications of prioritizing this frame: particularly for us folks that work in
or with systems. I’ve observed and participated in too many health disparities
discussions, workshops, conferences, etc where racism is never named or
discussed. Doesn’t that make us complicit in perpetuating it?
“We need to illuminate racism in order to eliminate racism.
By consciously addressing racial equity, we can stop unconsciously replicating racism”
~Terry Keheler, Applied Research Center
We can do both. I don’t have a communications report to
support my assertion, but I continue to believe that by talking about/telling
stories about how systems and structures impact health outcomes – and showing
how structural racism contributes to those systems, structures and policies –
we are sending the “right” message.
Easier said than done. We’ve got tons of data and talking
points about our health problems and our efforts to impact individual behavior.
Where’s the data, research, stories, insights, talking
points that can support the “right’ message?
Why, it’s right below – in the comments section!
Courtesy of the University of Minnesota’s PubH 7200, Section
114 class.
Check out our write-ups of the evidence we found to support
our message.
I explored the relationship between place, race and health through the growing field of community mapping in a June 2009 PolicyLink report by Sarah Treuhaft (http://www.policylink.org/site/apps/nlnet/content2.aspx?c=lkIXLbMNJrE&b=5136581&ct=10756937).
ReplyDelete_Community Mapping for Health Equity Advocacy_ examined geographic information system (GIS) mapping as a tool for policy advocacy within communities. Through case studies, Treuhaft discussed how mapping reveals health disparities, such as air quality and access to healthy foods and parks, and proves place matters for our health and wellbeing, especially in low-income communities and communities of color.
Chicago-based consultant Mari Gallagher’s 2006 case study was spotlighted in _Analyzing Food Deserts and Health in Chicago_. Mapping was used to investigate healthy food access based on three geographic elements – census tracts, ZIP codes, and City-defined community areas – and three elements related to health policy and equity of access within neighborhoods: healthy food retailers; racial composition; and diet-related health. The result was a compelling portrayal of Chicago’s “uneven retail landscape,” characterized by barriers within low-income and minority neighborhoods. Study findings confirmed that those living in food deserts are more likely to suffer poor diet-related health outcomes due to limited access to grocers and higher concentrations of low-nutrition foods through convenience stores and fast-food venues.
Gallagher’s reflection on the power of maps was well-aligned with our discussion about framing health inequities. “Mapmakers must use the best methods available for ensuring that the picture they present is the most honest and most truthful one…; maps are most powerful when they are clear and compelling...(for) a broader audience,” according to Gallagher. This reminds us that we are each responsible to convey facts and figures about the negative effects of race- and place-based disparities on health and wellbeing using messages and tools that influence policy and program changes for the benefit of all members of our communities.
Contact: kahnx084@umn.edu
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ReplyDeleteRace, Socioeconomic Status, and Health
ReplyDeleteThe Added Effects of Racism and Discrimination
David R. Williams
http://141.213.232.243/bitstream/handle/2027.42/71908/j.1749-6632.1999.tb08114.x.pdf;jsessionid=02CF1D0B800D1ACAB45D29BF7568A528?sequence=1
This paper acknowledges the role of SES and race on health status and how racism and discrimination contribute to harmful health outcomes.
The conditions in which minorities live in the US are not due to pure coincidence. There seems to be a repeated pattern of minorities clustered in certain geographic areas and lacking of access to basic needs like education, health and jobs. Segregation seems to be a key mechanism by which racial inequality has been created and reinforced (Williams). Residential segregation has led to racial differences in the quality of elementary and high school education, job access, healthcare, etc. This is supported by social and institutional structures that determine where these residential segregation are strategically located. The continuing gaps in disparities and the stigma suffered by minorities is worrisome, unless we see radical changes in social structures and specific policies addressing these issues are rigorously implemented, racial disparities will continue to persist as they have for so long in past.
Contact: lenar047@umn.edu
Chelsea Schneider, Part 1: Making the Case
ReplyDeletePlace not Race, may better explain America's health disparities
http://www.theatlanticcities.com/neighborhoods/2011/10/health-disparities/268/%20
I read the article Place not Race written by Emily Badger. This article addressed the issue that health disparities need to be analyzed more by where the person lives instead of their race. An important argument that came up frequently is people should stop talking about race and health disparities, but instead start discussing health care availability, experience/quality of life, and availability to unhealthy items such as liquor stores and fast food establishments.
In wealthy communities there are often beautiful parks, well kept sidewalks, community activities, and limited access to fast food restaurants. They often have better access to fresh fruits and vegetables as well as the ability to pay for health care. Unfortunately, an un-wealthy individual lives in a poorer community with limited access to health care, poor living conditions that may cause illness, and limited access to fresh food.
It is shocking to me that this topic isn't discussed more because it seems like something over time that could be fixed. I think the more important question is do people want to help fix it? Do others care enough about minorities? Sometimes I think no. People have always been segregated and there is always going to be a hierarchy. If people started to shift their mind set to believing health disparities are location based instead of based on gender or race, more positive changes could be made.
Contact:schn0802@umn.edu
THE GROWING RURAL-URBAN DISPARITY IN INDIA- SOME ISSUES
ReplyDeletehttp://www.ijoart.org/docs/The-Growing-Rural-Urban-Disparity-in-India-Some-Issues.pdf
This article talks about the health disparities that exist between the rural and urban India . It is a comparative study and uses many indicators to see where the health disparities predominate. Through the research, the authors have pointed out to the fact that overall, rural India is in a despair condition as compared to the urban areas owing to a number of factors. Although India is a developing economy and is being predicted as the emerging superpower, it still needs to dwelve on its rural development because major chunk of India is made of rural population.
The article elaborately explains the low level of literacy in the rural areas as well as the low net attendance of children In the schools. It also puts the sad state of affairs related to health in these areas. It takes into account the anemic mothers and also talk about the avaialiability of nasic amenities like electricity and water.
These disparities have a lot to do with the place of residence. The rural areas in India usually are not as developed as their urban counterparts. With the advent of globalization and urbanization, the urban areas progressed quickly and became industrial hubs leading the government to concentrate all the development around these “hot-spots”. A lot of migration took place as people started coming to the urban areas in search of a better life.
This led to the development of urban slums and instead of finding better living conditions, these “urban poor” found themselves in even worse conditions. As a result of which, agriculture, which is the main backbone of Indian economy suffered deeply. Thus, this article also highlights the fact how the health disparities occur as a result of place of dwelling of the people.
http://www.sciencedaily.com/releases/2011/10/111006113613.htm
ReplyDeleteWhen we health frame disparities we usually focus on racial, ethnic, class and the caste differences. We do not consider the confounding factors like socioeconomic status of the individual. There is segregation of places along racial lines. A particular group of people live together in an area. Due to this access to various opportunities and resources varies. As a result, we always end up with blaming racism, caste system as the factors responsible for health disparities. Our national data shows only one aspect of health disparities as it does not take into account the differences in place and opportunities. In this study they have taken a setting in which there are at least 35 percent of African Americans and 35 percent of white Americans that are exposed to same socioeconomic and environmental conditions. They conducted structured interviews with residents and measured blood pressure. They compared the study data with the data from National Health surveys. They found that the racial differences in social environment are responsible for one third difference in hypertension as shown in national data. No racial disparities in obesity were found when they African American and white American are exposed to similar living conditions. There is a need to focus on confounding factors that can lead to health disparities. Proper framing of health disparities is very important otherwise such wrong interpretations can have serious implications for policy making.
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ReplyDeleteInequality in the Built Environment Underlies Key Health Disparities in Physical Activity and Obesity
ReplyDeletehttp://pediatrics.aappublications.org/content/117/2/417.short
I read this article which links environmental factors to the Physical activity and other obesity related behaviours. Often the onus to stay healthy is placed on the individual. The author underlines how there had been no national studies on the relationship between disparities in access to recreational facilities and overweight patterns in US adolescents. The researcher utilized national databases and satellite data to map the Physical activity facilities( such as parks, YMCA,youth organizations and Public facilites) and linked it to each respondent using Geographical information system. The author tested the relationship of the facilities with the Socio-economic status of the block and subsequently tested the relationship of the facilities with the overweight and physical activity.
It was found that the blocks with greater proportion of highly educated population were more likely to have a wide variety of physical activity facilities. Also the relative odds of having atleast 1 facility decreased with the increase in minority population.
With the US battling the obesity epidemic,it is imperative that the policymakers work towards a more equitable society so that every individual has an equal opportunity to make the right choices that would enable him/her to lead a healthy life.
Has there ever been any racism in health care?
ReplyDelete