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The Center for Disease Control defines health disparities as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations
.” As the second-largest minority population in the United States, African Americans have been disadvantaged racially, socially, and economically for decades and their health has been drastically affected by this trend through a number of factors.
Factors outside the community
The socioeconomic status of African Americans is a determinant of healthcare access and is an integral part of how race affects health
.
Racism in healthcare is not new.
On average, African Americans have limited access to good quality, conveniently located healthcare facilities. In communities with a high proportion of African Americans, these necessary facilities are placed few and far between and are of poor quality. This has fostered a mindset that is in denial of health issues amongst the community members as there are most times no affordable treatment available, increasing the percentage of chronic illnesses. Research has shown a high correlation between low income and being uninsured, implying that African Americans struggle to afford any insurance.
A racial and economic gap has existed between African Americans and white Americans since 1968 with no significant sign of change. People assume that the amount of money someone makes is based on their job, but for African Americans, their race is tied to their income level and as a result, their health. The average black person has earned about 57 percent of what the average white American makes from 1968 to 2016
. The U.S. economy enforces regulations that keep the majority of the finances in the hands of the richest members of society, excluding most people of the African American race
. Still today, the average white American household earns 6.5 times the amount of an African American household, despite a thriving U.S. economy. Income level is also reflected in the type and placement of housing, allowing for large groups of people within the same race and income level to form their own neighborhoods and attracting those who wish to take advantage of this.
Factors within the community
Health starts with what you eat. Everything you put inside your body is either nourishment or a detriment and for African Americans, the latter is more often true but not by accident. It has been found that unhealthy foods are promoted heavier in African American communities as they are often cheaper and what can be afforded, leading to drastically reduced access to healthy food choices, even in grocery stores. Studies have shown that there is a higher prevalence of fast-food restaurants among and an inverse relationship with low-income neighborhoods, even at the national level
. This means that as the overall income level of the neighborhood goes down, the number of fast-food restaurants increases.
In most cases, the population of African Americans per area was a better indicator of fast-food restaurant density than household
. Essentially, increasing proportions of African Americans in a neighborhood is an indicator of average decreasing income levels and is positively correlated with an increasing number of fast-food restaurants. The conclusion can be made that these fast-food establishments follow elevated African American populations because they are guaranteed business as their prices are more affordable, but the food rarely has any great nutritional value and is highly fattening. What can be seen as somewhat healthy, such as a side salad, is often twice or three times as expensive making it the least likely to be bought by people with limited funds or knowledge of healthier food options.
Effects and implications of these factors
It is no surprise that with all these factors in place to promote unhealthy eating amongst the African American population, a frightening number of health concerns have also raised. The risk factors, morbidity, incidence, and mortality rates for the top ten leading causes of death are disproportionately greater for African Americans than white Americans
. This leads to elevated death rates for heart disease, stroke, cancer, asthma, influenza and pneumonia, diabetes, HIV/AIDS, and homicide, and decreased life expectancy overall for African Americans at an average of 76.1 years compared to 79.8 years for white Americans
. Another obvious effect would be the high obesity rates among adults and children that contribute to a number of additional health risks such as high blood pressure, high cholesterol, heart attacks, and strokes, not to mention decreased performance in completing everyday tasks. The strategic placement of and excess access to unhealthy food without the same ease of access to health facilities to combat the issues that arise shows that the U.S. economy has no intention of closing the racial or socioeconomic gap between white Americans and African Americans soon.
What can be done to alleviate these effects?
This issue with African American health disparities is a matter of environmental justice because it is concerned with the equal distribution of environmental burdens such as health hazards and other inequalities
. It is the responsibility of the U.S. government to provide all citizens with equal access to healthy food choices and healthcare facilities. The implementation of universal, race-neutral policies would be a step in the right direction
. Other means of solving the food situation in African American neighborhoods directly might include improved transportation to facilitate access to healthful foods or mobile markets to increase the supply of fresh produce, and nutritional education
. There is too much of U.S. history built out of racism for all of our problems to be fixed with any one solution, but these propose a good start. Until the racial, ethnic, and socioeconomic disparities between African-Americans and white Americans are dissolved, environmental justice cannot be achieved.
References
Black/African American – The Office of Minority Health. (2019). Retrieved 19 October 2019, from
https://www.minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=61
Health Disparities Experienced by Black or African Americans — United States. (2019). Retrieved 19 October 2019, from
https://www.cdc.gov/mmwr/preview/mmwrhtml/mm5401a1.htm
Hilmers, A., Hilmers, D. C., & Dave, J. (2012). Neighborhood disparities in access to healthy foods and their effects on environmental justice.
American journal of public health
,
102
(9), 1644–1654. doi:10.2105/AJPH.2012.300865
How Economic Inequality Perpetuates U.S. Racial Gaps. (2019). Retrieved 19 October 2019, from
https://scholars.org/brief/how-economic-inequality-perpetuates-us-racial-gaps
Institute of Medicine (US) Committee on Environmental Justice. Toward Environmental Justice: Research, Education, and Health Policy Needs. Washington (DC): National Academies Press (US); 1999. doi: 10.17226/6034
No One Agrees on How to Close the Racial Wealth Gap. (2019). Retrieved 19 October 2019, from
https://www.citylab.com/equity/2019/03/racial-wealth-gap-income-inequality-black-white-households/585325/
The American Journal of Public Health (AJPH) from the American Public Health Association (APHA) publications. (2019). Retrieved 19 October 2019, from
https://ajph.aphapublications.org/doi/full/10.2105/AJPH.93.5.742
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