Race plays a significant role in health outcomes according to the document. When addressing racial equity and health, it is important to examine the structural and systemic roots of social and economic disparities. The document discusses how unconscious and institutional racism negatively impact health through policies that concentrate environmental hazards and disparities in education, incarceration rates, and access to opportunities in certain racial groups. The solution involves training on racial equity, using data to identify racial inequities, and assessing programs through a health equity lens.

1. Race Equity & Health

2. • Race plays a significant role, explicitly or implicitly, in
health outcomes.
• A transformative dialogue on race can shine light on the
structural dynamics of social and economic
disparities, which are at the root of health disparities.
• When we start with race, we start from root of social
disparity – hence we are building equity for all when we
work on racial equity.
2
Why Focus on Race?

3. 2020 Scorecard on Health System Performance. Commonwealth Fund
Black people are more likely to die earlier than their White
counterparts from treatable conditions, 2016-2017

4. 4
COVID-19 Hospitalization and Death Disparities

5. Terminology & Concepts

6. Health is a state of complete physical,
mental and social well-being and not
merely the absence of disease or
infirmity.
Health begins where we live, learn, work, worship
and play – Robert Wood Johnson Foundation
What is Health?

7. “Health equity means that everyone has a fair and just
opportunity to be as healthy as possible. This requires
removing obstacles to health such as poverty,
discrimination, and their consequences, including
powerlessness and lack of access to good jobs with fair
pay, quality education and housing, safe environments,
and health care.”
Robert Wood Johnson, ‘What is Health Equity and
What Difference does a Definition Make?’ 2017
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8. Racial Equity is the condition where one’s race identity
has no influence on how one fares in society.
Awake, Woke to Work: Building a Race Equity Culture, Equity in the Center, accessed June 11, 2020
Racial Equity is defined as just and fair inclusion into a
society in which all people can participate, prosper, and
reach their full potential.
“The Equity Manifesto,” PolicyLink, 2015, accessed April 10, 2017, http://www.policylink.org/about/
equity-manifesto
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9. Racial Inequity is the result of structural racism that is
embedded in our historical, political, cultural, social, and
economic systems and institutions. It works cumulatively
and produces vastly adverse outcomes for people of
color in areas such as health, wealth, career, education,
infrastructure, and civic participation.
Center for the Study of Race and Ethnicity in America, “How Structural Racism Works” (lecture series,
Brown University, 2015), accessed March 30, 2017, https://www.brown.edu/academics/race-
ethnicity/howstructural-racism-works
9

10. 10

11. Illustration by Na Kim; photograph
from EyeEm / Getty. The Fight to
Redefine Racism. The New Yorker.
Unconscious biases are social stereotypes
about certain groups of people that
individuals form outside their own
conscious awareness.
Everyone holds unconscious beliefs about
various social and identity groups, and
these biases stem from one's tendency to
organize social worlds by categorizing.
Implicit Bias
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12. • Institutional practices create different outcomes for different racial
groups:
– City sanitation policies that concentrate environmental hazards disproportionately in
communities where Black, Indigenous, and People of Color live.
– Quality and funding of school systems in neighborhoods where BIPOC communities
live.
– Treatment versus criminalization of drug use.
– Disproportionately high incarceration rates among black versus white individuals.
Institutional Racism

13. We all live in systems
and structures and
systems and structures
live in us
The structures are not
neutral
They enhance or impair
life outcomes
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Processes, Systems, and Structures Influence Health

14. Structural Racism
Complex system of
organizations,
institutions, processes,
and policies that create
and perpetuate
social/economic/political
arrangements that are
harmful to people of
color and to our society
as a whole
Redlining
Lower value homes
Unable to get a home loan
Lower tax base
Less funding for schools
High school graduation
rates
Incarceration rates
Poverty
Adverse childhood
experiences
Poor Health Outcomes
Access to higher education
Less transfer of wealth
between generations
Lower income jobs
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15. Why does this matter?

16. https://www.barhii.org/barhii-framework
Public Health’s Role Continues to Evolve

17. • Five decades of research indicate that your
environment has a profound impact on your access
to opportunity and likelihood of success
• High poverty areas with poor employment,
underperforming schools, distressed housing and
public health/safety risks depress life outcomes
– A system of disadvantage
– Many manifestations
• cities, rural areas, suburbs
• Several historical housing policies have contributed
to black people being far more likely to live in
opportunity-deprived neighborhoods and
communities
Place, Race, and Opportunity Structures:
Neighborhoods & Access to Opportunity

18. So where do we go from here?
What’s the solution?

19. 1. Incorporate training on racial equity and
racial justice
2. Use data to identify racial disparities and
inform actions
3. Assess programs and policies using a health
equity framework
Opportunities

20. • NACDD Foundations of Health Equity
• APHA Racial Equity Webinar Series
Trainings

21. Reading
Resources:
https://www.thegoodtrade.com/fe
atures/books-on-race
21-Day
Racial
Equity Habit
Building
Challenge ©
Personal Strategies

23.  Assessing if the policy or procedure is written and implemented in a way that is
inclusive and allows for diversity.
 Determine if and where there are opportunities/decision points to ensure the policy
or procedure is inclusive and promotes diversity.
 Identify action steps to modify the policy or procedure and to implement new steps to
ensure diversity and inclusion.
 Vetting the plan/policy with an Equity Crosscheck
The Moving to Institutional Equity Tool

24. • Pay disciplined attention to race and ethnicity while analyzing problems, looking
for solutions and defining success
• Analyze data and information about race and ethnicity
• Understand Health and Social inequities and why they exist
• Look at problems and their root causes from a structural standpoint
• Name race explicitly when talking about problems and solutions
• Shed light on racial dynamics that shape social, economic and political structures.
Using a Health & Racial Equity Lens

25. Racism
and
Public
health
Racism is a public health crisis. Racism structures opportunity and
assigns value based on how a person looks. The result are conditions
that unfairly advantage some and unfairly disadvantage others. Racism
hurts the health of our nation by preventing some people the
opportunity to attain the things needed for the highest level of health.
American Public Health Association, (https://www.apha.org/topics-and-
issues/health-equity/racism-and-health. 2021).
We all live in systems and structures. And systems and structures live in us.
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26. “To fulfill our Mission, the National Association of Chronic Disease
Directors commits to implementing and supporting public health practice
that promotes equity and eradicates the fact that race, income, where a
person lives, and other social factors determine a person’s access to
care and opportunities to live a long healthy life. Health equity embodies
the values, policies, and practices that work to eliminate health
inequities and inequitable access to quality health care for people who
have historically faced health inequities based on race/ethnicity, age,
ability, sexual orientation, gender identity, poverty, geography,
citizenship status, or religion”.