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2 Racism and Health Inequities
Pages 5-16

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From page 5...
... Gee provided an overview of the role of racism in the production of racial and ethnic health inequities and discussed intersectionality as a lens for examining the impact of racism over the life course. RACE IN THE UNITED STATES As argued by Healthy People 2020, reducing racial health inequities will require attending to the "historical and contemporary injustices" that underlie race relations (National Partnership for Action to End Health Disparities, 2011; also see Braveman and Gruskin, 2003)
From page 6...
... When people talk about discrimination, it is important to recognize the role not only of day-to-day individual experiences, but also the structures that perpetuate such inequality. Today, the United States may no longer have de jure segregation of things like water fountains or systems, but if people think about what has happened with lead in the drinking water in Flint, Michigan, or national discussions about closing United States borders to immigrants, it might be said that those days of overt blatant racism are not the distant past, but a contemporary reality (see Figure 2-2)
From page 7...
... RACISM AND HEALTH INEQUITIES 7 FIGURE 2-1  Image of Chinese Exclusion Act of 1882. SOURCE: Courtesy of Royal British Columbia Museum and Archives.
From page 8...
... Importantly, this multilevel understanding of race and racism paral lels a broader understanding of the multilevel production of well-being. Urie Bronfenbrenner and many others have talked about how the health and well-being of individual persons are not simply about their personal behaviors but, also, importantly, a function of who their peers are, what is going on with their families, where they live, where they work, where
From page 9...
... Discrimination and Health Many meta-analyses and reviews have been published in recent years that have consistently shown that people's experiences with discrimination are associated with a variety of morbidity outcomes, not only in the United States but across the world (Paradies et al., 2015; Pascoe and Smart Richman, 2009; Schmitt et al., 2014; Williams and Mohammed, 2009)
From page 10...
... SOURCE: Gee and Ro, 2009. Race/Ethnicity Residential Segregation Residential Location Community level Neighborhood Community Structural Environmental vulnerability Resources Stressors Factors Hazards and Pollutants Community Exposure stress Individual Stressors Individual Coping Internal dose Appraisal Process Individual level Individual stress Biologically vulnerability effective dose Health effect (disparities)
From page 11...
... 1 year 23 22 21 20 19 No Discrimination Discrimination FIGURE 2-5  Interaction between racial discrimination and years in the United States, according to the National Latino and Asian American Study (n = 2,095)
From page 12...
... After a child is born, the child's experiences are largely shaped by family, but as the child ages, the child moves into new life stages shaped by education, work, and retirement. The blue bar in the figure represents undesirable times in one's life caused by such things as unemployment, incarceration, and illness.
From page 13...
... R03062, 2-6, editable Gee said that the recent events highlighted by the Black Lives Matter movement and many other events such as the tragic death of Tamir Rice and other young people have encouraged him to rethink what the earlier framework published some years ago may look like in 2016 (see Figure 2-8)
From page 14...
... Life course trajectory potentially shaped by racism Early Illness, Pre child- EducaƟon Unemploy, Work ReƟrement natal hood etc. Inequity in Life Expectancy FIGURE 2-7  Conceptual model of how racism may shape time over the life course.
From page 15...
... The study of racism and the interlocking systems of oppression across generations and individuals' life courses need to be studied directly, Gee said, in order to achieve health equity and social justice. What this suggests, ultimately, is that policies that are designed to improve civil rights not only buttress the foundations of a just and civil society but lead to a healthier one as well.


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