Describe Examples From Camara Phyllis and Other Sources in the Text ("Race, Ethnicity, and Health" Author Thomas A. Laveiston) How Racism Imposes an Additional Health Burden on People of Color
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Inequities in the social determinants of health, such as poverty and healthcare access, affecting these groups are interrelated and influence a wide range of health and quality-of-life outcomes and risks. To achieve health equity, barriers must be removed so that everyone has a fair opportunity to be as healthy as possible.
Southern Jamaica Plain Health Center convened teen workshops to gain insights about the struggles they face, while Cone Health tapped cancer survivors’ expertise to identify ways the health system didn’t serve them. This work may lead to customized interventions rather than standardized protocols. Efforts to reduce racial disparities must go beyond cultural competency or workforce diversity initiatives. At HealthPartners, “key equity measures are built into our scorecards, our health equity sponsor group meets regularly, and equity is a standing topic at every board of directors’ quality committee meeting. That has helped keep us on track,” say Brian Lloyd, who oversees HealthPartners’ equity initiatives. The health system has trained more than 170 “equitable care champions,” employees who go through training on implicit bias and cultural humility and then take responsibility for explaining the rationale for equity initiatives to colleagues. The health system also takes advantage of opportunities to facilitate open discussions about racial bias, as it did in July 2016 after Philando Castile, a local African American man, was shot by a police officer during a traffic stop. In the end, advocates say, it’s important to realize that while racism is a large and multifaceted problem, there are concrete steps health care providers can and should take. “Because we are talking about structural racism — something that is such a broad and deep force in our society — it is tempting to say we are a small organization, what are we going to do about this? We don’t have the power to control national policy or address all these big forces,” says Tom Kieffer, executive director of Southern Jamaica Plain Health Clinic. “For us, it was important just to recognize that we can start small and be explicit about what we are trying to address.”
Recent sociological research illustrates how gene environment interactions can potentially shed light on the mechanisms linking the social environment to disease. For example, analysis of data for adolescents in the Add Health Study found that genetic traits interacted with family processes (e.g., daily family meals), school processes (e.g., repeating a grade) and friendship network variables (e.g., friend delinquency) to predict delinquency and violence among male adolescents (Guo and Roettger 2008).In contemporary society, racial groups differ on a broad range of social, behavioral, nutritional, psychological, residential, occupational and other variables. And given that biology is not static but is adaptive to the environmental conditions in which the human organism exists, there are likely to be interactions between the social environment with both innate and acquired biological factors. Thus, although variation in gene frequency is unlikely to play a major role in accounting for racial disparities, differences in gene expression linked to the occupancy of different environmental contexts could play a critical role.
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Guo Guang, Roettger Michael E. The Integration of Genetic Propensities into Social-Control Models of Delinquency and Violence among Male Youths. American Sociological Review. 2008;73:543–568.
Hayward Mark D., Miles Toni P., Crimmins Eileen M., Yang Yu. The significance of socioeconomic status in explaining the racial gap in chronic health conditions. American Sociological Review. 2000:910–930.
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