The United States is a racially diverse country. Race and ethnicity in the United States is a complex topic both because the United States has a racially and ethnically diverse population and because of a history of racism involving slavery and segregation that persists to present day. At the federal level, race and ethnicity have been categorized separately. Race refers to a classification of humans into groups based on physical traits, ancestry, genetics or social relations, while ethnicity refers to a category of people who identify with each other based on similarities such as common ancestry, language, history, society, culture or nation. Race and health refers to how being identified with a specific race influences health.
Race and ethnicity often remain undifferentiated in health research. Differences in health status, health outcomes, life expectancy, and many other indicators of health in different racial and ethnic groups are well documented. Some individuals in certain racial groups receive less care, have less access to resources, and live shorter lives in general. Epidemiological data indicates that racial groups are unequally affected by diseases, in terms or morbidity and mortality. These health differences between racial groups create racial health disparities.
Health disparities are defined as preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations. Health disparities are intrinsically related to the historical and current unequal distribution of social, political, economic and environmental resources (“Health Equity”, 2019). The relation between race and health has been studied from a multidisciplinary perspective, paying attention to how racism influences health disparities and how environmental factors and physiological factors respond to each other and to genetics.
Current evidence supports the notion that these racially centered disparities continue to exist and are a significant social health issue. A current report from the Centers for Disease Control (CDC, 2019) found that 700 women died from preventable complications of pregnancy in the United States, a rate higher than any other developed country, but the rate of death was higher for Black and Native American women. The death rate for Black mothers was over 3 times higher than for white mothers and the rate for Native American mothers was over 2 times higher than for white mothers. A majority of these deaths are largely preventable and some relate to implicit racial bias that is unrelated to social status, income or education.
Minority populations have increased exposure to environmental hazards that include lack of neighborhood resources, structural and community factors as well as residential segregation that result in a cycle of disease and stress (Gee, 2004). Racial segregation is another environmental factor that occurs through the discriminatory action of those organizations and working individuals within the real estate industry, whether in the housing markets or rentals. Even though residential segregation is noted in all minority groups, blacks tend to be segregated regardless of income level when compared to Latinos and Asians. Thus, segregation results in minorities clustering in poor neighborhoods that have limited employment, medical care, and educational resources, which is associated with high rates of criminal behavior (Williams, 2005). In addition, segregation affects the health of individual residents because the environment is not conducive to physical exercise due to unsafe neighborhoods that lack recreational facilities and have nonexistent recreational space.
Racial and ethnic discrimination adds an additional element to the environment that individuals have to interact with daily. Individuals that report discrimination have been shown to have an increased risk of hypertension in addition to other physiological stress-related affects (Mujahid, 2011). The high magnitude of environmental, structural, socioeconomic stressors leads to further compromise on the psychological and physical being, which leads to poor health and disease (Gee, 2004).