Booker T. Washington was born into slavery, but he went on to be an educator, reformer, adviser to presidents — and he was an influential spokesman for African Americans. In April 1915, recognizing that health is the key to progress and equity in all other things, he proposed National Negro Health Week. He called on multiple key stakeholders within the African American community to unite in a national health movement.
In 2002, this call was supported with a concurrent resolution from Congress that stated that “A National Minority Health and Health Disparities Month should be established to promote educational efforts on the health problems currently facing minorities and other health disparity populations.” The resolution went on to state that this month encourages “all health organizations and Americans to conduct appropriate programs and activities to promote healthfulness in minority and other health disparity communities.”
National Minority Health and Health Disparities Month has now become National Minority Health Month, and it’s observed in April — a time to focus on and advance health equity for all historically and intentionally excluded or disinvested communities across the country.
What are health inequities? What is health equity?
Health inequities are health differences that are avoidable, unnecessary, unfair and unjust. On the other hand, health equity means that everyone can be as healthy as possible, and there are no avoidable, unfair or remediable health differences among groups of people — whichever way these groups are described — such as by race, gender, economics, geography or otherwise.
Unfortunately, racial and ethnic minority populations in the U.S. are significantly affected by health inequities, and people in these populations are much more likely to die from certain diseases, compared to the general population. The disproportionate effects the COVID-19 pandemic has had on racial and ethnic minority populations in the U.S. has provided a glimpse into these inequities, which are deeply rooted.
What is the cause of the health inequities?
Systemwide bias and institutionalized racism continue to contribute to inequities across the U.S. and have devastating effects on society, particularly what are called the social determinants of health.
Social determinants of health are the circumstances where people live, learn, work and play. They are the biggest drivers for the health of communities and individuals, and are closely linked to health inequities. For instance, people who are poor and who live in areas where poverty is more common tend to have poorer health outcomes than people who live in areas with more material means and less poverty.
Many of the foundations of these social determinants of health are deeply rooted in the history of racism that must be confronted to make any progress. Many leading health organizations, including Mayo Clinic, now recognize the role of systemwide bias and institutionalized racism, and have pledged to address it, investing time, money and talent in these efforts.
What is your role in the efforts to achieve health equity?
To address health inequities, an equity lens must be applied to everything. Having an equity lens means that in every step of caring for patients, a pause must be taken to intentionally consider whether what will be done will improve or worsen health inequities. This includes every step of the health journey of patients and communities, from access to quality health care, continuous assessment of outcomes of health to identify ongoing inequities and development of interventions that address these inequities.
Bias, whether conscious or unconscious, also is one of the contributors to health inequities affecting minority groups. One way to contribute is to frankly consider what your biases are?
It is also crucial to address more upstream issues that contribute to ongoing health inequities. These issues include improving access to healthy food, safe opportunities for physical activity, education opportunities, focus on career pipelines, and fairness in employment and wages for all racial and ethnic minority population communities across the country.
For 2022, the Department of Health and Human Services’ Office of Minority Health has selected “Give Your Community a Boost” as the theme, given the disproportionate effects the COVID-19 pandemic has had on racial and ethnic minority populations in the country. Whatever your role, promoting COVID-19 vaccination, including boosters, within your family, social networks and communities is a tangible thing that can be done.
Jane Njeru, M.B., Ch.B., is a physician in Primary Care in Rochester and Kasson’s Division of Community Internal Medicine, Geriatrics and Palliative Care. She completed medical school at the University of Nairobi in Kenya and her residency in internal medicine at Mayo Clinic in Rochester. Her interests include developing interventions to reduce health disparities, with special focus on patients with limited English proficiency, immigrants and refugees.
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