The man who wrote the book about poorer health outcomes for persons of color will be in St. Louis on Monday, January 15 as the MLK celebration keynote speaker at Washington University School of Medicine.
Brian D. Smedley, Ph.D., is cofounder and executive director of the National Collaborative for Health Equity in Washington, D.C. The project connects research, policy analysis, and communications with on-the- ground activism to advance health equity and, he said, “undo the health consequences of racism.” He is the author of “Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare” (2002).
“In a clear and convincing manner, this book laid out evidence that racial and ethnic minorities receive a lower quality of healthcare than non-minorities, even when controlling for factors such as insurance status and incomes,” said Will Ross, M.D., associate dean for Diversity and professor of Renal Medicine at Washington University School of Medicine, whose office sponsors the annual MLK lecture.
“The publication was a clarion call for action to identify and reduce systemic barriers to healthcare for racial and ethnic minorities.”
So far, Smedley said, not so good.
“We are not making significant progress, because we still see evidence of systematic equities, in health care systems as well as outside of health care systems,” Smedley said. “The very kinds of structures and systems that helped to create poorer health for many communities of color, unfortunately, persist.”
That is where the National Collaborative for Health Equity is focusing its current work.
“We know that health care accounts for about 10 percent of population health,” he said. “When we look overall at the health status of populations – statistics like longevity, like disease burden – we know that health care in itself doesn’t create those inequities.”
He said we must recognize the systematic challenges that are barriers to opportunities for good health for communities of color.
“Communities of color are too often overrun with environmental health threats,” Smedley said. “Too often we see communities of color are in so-called ‘food deserts’ – lacking access to nutritious, inexpensive or affordable foods. And, in contrast, they are overrun with vendors selling unhealthy products, like fast food and carryout, and disproportionate alcohol and tobacco advertising and sales.”
He said communities of color also face an inequitable criminal justice system that is disproportionately warehousing men of color, which has broad negative consequences for entire communities, not just young men and their families.
Community disinvestment and lack of economic vitality are other systemic issues that negatively affect heath, as well as education.
“Kids of color find themselves segregated in high-poverty schools that lack the resources to help prepare them for higher education and beyond,” Smedley said. “Some people might think that does not have much to do about health, but researchers have long known there is an important relationship between educational attainment and health.”
Conditions in neglected, marginalized neighborhoods play a role in fomenting the violence that plagues so many communities.
“Violence has been created, in no small part, by government policies that have concentrated poverty into certain neighborhoods – and in particularly in communities of color,” Smedley said. “Violence is not something that is natural or innate or should be expected. It comes about as a result of a lack of opportunity and as a result of youth being disconnected from school or jobs. When youth don’t see meaningful opportunities in their communities, we can expect violence as a way of acting out and trying to create opportunity where there is none.”
Using facts and data about the St. Louis area, Smedley said he wants to draw a line between the kind of inequity that we see in health care systems to broader social, economic problems and policies.
“The fact that government has been complicit with the private sector, historically, in creating highly segregated neighborhoods, is at the root of many of the problems that we see,” Smedley said. “We can see these are some of the problems at the root of why many communities of color have a higher burden of disease and disability and shortened life spans.”
He said communities did not get there by accident, and it will take community advocates working with government officials to make changes.
“We need activists and advocates on the ground to understand these issues,” Smedley said, “and to pressure local governments to find regional solutions around housing, around transportation, around education, criminal justice.”
“Bending the Arc: Harnessing Research and Engagement for Health Equity” with Brian D. Smedley as keynote speaker will take place 4 p.m. Monday, January 15 at the Eric P. Newman Center, 320 S. Euclid. To R.S.V.P. and for more information, call (314) 362-6854, email ginabiondo@wustl.edu, or visit mlk18.splashthat.com. There is validated parking at the North Euclid Parking Garage.
