Addressing Racism as a Public Health Threat: Part 3 - Social Determinants of Health

In the third part of our series addressing the impact of racism on healthcare outcomes, we highlight the harms represented in social determinants of health. Social determinants of health encompass the conditions in which people are born, grow, live, work, and age, all of which profoundly influence health outcomes and disparities. These determinants include factors such as socioeconomic status, education, employment, housing, and access to healthcare, which are shaped by broader social, economic, and political structures. Racism, as a pervasive and systemic form of discrimination, not only influences access to these social determinants but also directly impacts health outcomes for marginalized communities. Indeed, racism itself can be considered a social determinant of health, as it perpetuates structural inequities and disparities that shape health trajectories. By understanding how racism manifests within social determinants of health, we can better address the root causes of health inequities and work towards achieving health equity for all individuals, regardless of race or background.

Historical and ongoing discrimination in housing, education, employment, and criminal justice contribute to disparities in socioeconomic status, access to healthcare, and exposure to environmental hazards. Socioeconomic factors, such as income inequality and unemployment, negatively impact health outcomes among Black Americans, as economic instability and poverty increase vulnerability to health risks, including higher rates of chronic diseases and HIV/AIDS within Black communities. Within the context of access to healthcare, racism creates barriers that result in limited access to affordable healthcare coverage, transportation, and culturally competent care, which contributes to delays in HIV testing, late diagnosis, and suboptimal treatment outcomes. Moreover, mistrust of the healthcare system due to historical injustices, such as the Tuskegee Syphilis Study, further impedes engagement in HIV care and perpetuates stigma and shame surrounding the virus. Additionally, racial disparities in housing quality, neighborhood environments, and access to nutritious food contribute to negative health outcomes. Environmental racism, including the disproportionate siting of hazardous waste sites, pollution, and lack of access to green spaces in Black neighborhoods increase exposures to toxins and pollutants that compromise immune function and increase susceptibility to HIV infection.

At Arkansas RAPPS, we are committed to addressing the intersection of racism, social determinants of health, and HIV/AIDS disparities within Black communities. By advocating for equitable policies, culturally competent healthcare, and community-driven interventions, we can strive to dismantle systemic barriers, promote health equity, and improve the well-being of all individuals. Together, we can create a future where every individual has the opportunity to thrive in a healthy and equitable society.