A global pandemic and a social justice movement centered on police brutality will certainly be historic events characterizing the year 2020, but the convergence of these two crises has heightened visibility of a problem that has long plagued people of color: the social determinants of health.
These factors directly affect the health risks and outcomes of individuals, and are fueled by structural racism. As an academic health center with a mission to support the health and well-being of all Oregonians, I believe OHSU has a duty and responsibility to address the underlying causes of adverse health outcomes, and that includes racism.
As the COVID-19 pandemic unforgivingly swept through the globe, it was touted early on as the ‘great equalizer,’ meaning that the impact on everyone would be similar. That belief, however, could not be further from the truth, as evidenced by data that continues to show Black, Indigenous and People of Color (BIPOC) are disproportionately impacted by COVID-19.
For example, data from New York City in May shows that Black and Hispanic people are two times more likely as white people to have COVID-19. In Louisiana, 33% of the population is Black, but make up 57% of the COVID-19-related deaths. Chicago has a Black population of about 30%, but represent 52% of the confirmed COVID-19 cases and 72% of the deaths. This aligns with the trends in cities across the country, and Oregon is no different. In Multnomah County, Black, Indigenous and other people of color represent 40% of COVID-19 cases, while making up only 30% of the total population.
Limited or lack of access to health care, healthy foods and affordable housing are examples of social determinants of health. All have profoundly negative health consequences and lead to higher rates of chronic illness for marginalized populations. Furthermore, health care access and positive health outcomes are directly related to an individual’s employment and income status.
While grappling with a once-in-a-century global pandemic, the world witnessed the death of George Floyd at the hands of law enforcement, sparking outrage and a demand for change. We cannot ignore the impact of police violence on mental health even though death and injury are the most obvious and direct consequences of police brutality. For example, Black Americans are incarcerated at more than 5 times the rate of white Americans and are 2.5 times more likely to be killed by police than white men. While police violence in Latinx communities is believed to be underreported, the death rate of Latinx men by police is second to Black men, as they are 1.3 to 1.4 times more likely to be killed by police than white people.
When people of color continue to experience, witness and read about these events over and over and don’t see substantial changes to prevent them from happening, it can and does create trauma, stress and other harmful psychological and physical health effects.Evidence shows that mistrust of police and mistrust of medical care are highly correlated among people of color, and reinforces skepticism for hospitals and clinics. When this happens, people are less likely to seek the care they need, including vaccinations, which only increases the disproportionate health outcomes and health disparities. We must ask why this is and what can be done about it. And, that is where OHSU can play an important role.
We are a community of healers who have dedicated our lives to improving the human condition of others. This must include addressing the physical and mental anguish people of color and other marginalized communities are suffering from because of bias, discrimination, and racism.
OHSU has committed to doing what is needed to become an anti-racist institution, and has already begun implementing changes across the university. We have much more to do but are resolute in our objectives. We will continue to stand up against structural racism in support of health equity, but recognize that no one action, individual or entity will solve the problem entirely. It will require support from our entire community to have the desired impact. I ask that you join us in this effort of dismantling structural racism and prioritizing health equity.
