Redlining is a discriminatory practice in which financial services are withheld from neighborhoods that have significant numbers of racial and ethnic minorities. Redlining has been most prominent in the United States, and has mostly been directed against African-Americans. The most common examples involve denial of credit and insurance, denial of healthcare, and the development of food deserts in minority neighborhoods.
Institutional racism, also known as systemic racism, is a form of institutional discrimination based on race or ethnic group and can include policies and practices that exist throughout a whole society or organization that result in and support a continued unfair advantage to some people and unfair or harmful treatment of others. It manifests as discrimination in areas such as criminal justice, employment, housing, healthcare, education and political representation.
Covert racism is a form of racial discrimination that is disguised and subtle, rather than public or obvious. Concealed in the fabric of society, covert racism discriminates against individuals through often evasive or seemingly passive methods. Covert, racially biased decisions are often hidden or rationalized with an explanation that society is more willing to accept. These racial biases cause a variety of problems that serve to empower the suppressors while diminishing the rights and powers of the oppressed. Covert racism often works subliminally, and much of the discrimination is done subconsciously.
The African-American middle class consists of African-Americans who have middle-class status within the American class structure. It is a societal level within the African-American community that primarily began to develop in the early 1960s, when the ongoing Civil Rights Movement led to the outlawing of de jure racial segregation. The African American middle class exists throughout the United States, particularly in the Northeast and in the South, with the largest contiguous majority black middle-class neighborhoods being in the Washington, DC suburbs in Maryland. The African American middle class is also prevalent in the Atlanta, Charlotte, Houston, Memphis, Dallas, Los Angeles, New Orleans, New York, San Antonio, and Chicago areas.
Race and health refers to how being identified with a specific race influences health. Race is a complex concept that has changed across chronological eras and depends on both self-identification and social recognition. In the study of race and health, scientists organize people in racial categories depending on different factors such as: phenotype, ancestry, social identity, genetic makeup and lived experience. Race and ethnicity often remain undifferentiated in health research.
Research shows many health disparities among different racial and ethnic groups in the United States. Different outcomes in mental and physical health exist between all U.S. Census-recognized racial groups, but these differences stem from different historical and current factors, including genetics, socioeconomic factors, and racism. Research has demonstrated that numerous health care professionals show implicit bias in the way that they treat patients. Certain diseases have a higher prevalence among specific racial groups, and life expectancy also varies across groups.
Social privilege is an advantage or entitlement that benefits individuals belonging to certain groups, often to the detriment of others. Privileged groups can be advantaged based on social class, wealth, education, caste, age, height, skin color, physical fitness, nationality, geographic location, cultural differences, ethnic or racial category, gender, gender identity, neurodiversity, physical disability, sexual orientation, religion, and other differentiating factors. Individuals can be privileged in one area, such as education, and not privileged in another area, such as health. The amount of privilege any individual has may change over time, such as when a person becomes disabled, or when a child becomes a young adult.
In the United States, despite the efforts of equality proponents, income inequality persists among races and ethnicities. Asian Americans have the highest median income, followed by White Americans, Hispanic Americans, African Americans, and Native Americans. A variety of explanations for these differences have been proposed—such as differing access to education, two parent home family structure, high school dropout rates and experience of discrimination and deep-seated and systemic anti-Black racism—and the topic is highly controversial.
In the United States, racial inequality refers to the social inequality and advantages and disparities that affect different races. These can also be seen as a result of historic oppression, inequality of inheritance, or racism and prejudice, especially against minority groups.
Structural inequality has been identified as the bias that is built into the structure of organizations, institutions, governments, or social networks. Structural inequality occurs when the fabric of organizations, institutions, governments or social networks contains an embedded bias which provides advantages for some members and marginalizes or produces disadvantages for other members. This can involve property rights, status, or unequal access to health care, housing, education and other physical or financial resources or opportunities. Structural inequality is believed to be an embedded part of the culture of the United States due to the history of slavery and the subsequent suppression of equal civil rights of minority races. Structural inequality has been encouraged and maintained in the society of the United States through structured institutions such as the public school system with the goal of maintaining the existing structure of wealth, employment opportunities, and social standing of the races by keeping minority students from high academic achievement in high school and college as well as in the workforce of the country. In the attempt to equalize allocation of state funding, policymakers evaluate the elements of disparity to determine an equalization of funding throughout school districts.p.(14)
Structural inequality occurs when the fabric of organizations, institutions, governments or social networks contains an embedded cultural, linguistic, economic, religious/belief, physical or identity based bias which provides advantages for some members and marginalizes or produces disadvantages for other members. This can involve, personal agency, freedom of expression, property rights, freedom of association, religious freedom, social status, or unequal access to health care, housing, education, physical, cultural, social, religious or political belief, financial resources or other social opportunities. Structural inequality is believed to be an embedded part of all known cultural groups. The global history of slavery, serfdom, indentured servitude and other forms of coerced cultural or government mandated labour or economic exploitation that marginalizes individuals and the subsequent suppression of human rights are key factors defining structural inequality.
Charles Vernon Hamilton was an American political scientist, civil rights leader, and the W. S. Sayre Professor of Government and Political Science at Columbia University.
The social determinants of health in poverty describe the factors that affect impoverished populations' health and health inequality. Inequalities in health stem from the conditions of people's lives, including living conditions, work environment, age, and other social factors, and how these affect people's ability to respond to illness. These conditions are also shaped by political, social, and economic structures. The majority of people around the globe do not meet their potential best health because of a "toxic combination of bad policies, economics, and politics". Daily living conditions work together with these structural drivers to result in the social determinants of health.
Societal racism is a type of racism based on a set of institutional, historical, cultural and interpersonal practices within a society that places one or more social or ethnic groups in a better position to succeed and disadvantages other groups so that disparities develop between the groups. Societal racism has also been called structural racism, because, according to Carl E. James, society is structured in a way that excludes substantial numbers of people from minority backgrounds from taking part in social institutions. Societal racism is sometimes referred to as systemic racism as well. Societal racism is a form of societal discrimination.
Structural discrimination occurs in a society "when an entire network of rules and practices disadvantages less empowered groups while serving at the same time to advantage the dominant group".
Structural discrimination is a form of institutional discrimination against individuals of a given protected characteristic, such as race, gender, caste, which has the effect of restricting their opportunities. It may be either intentional or unintentional, and it may involve either public or private institutional policies. Such discrimination occurs when these policies have disproportionately negative effects on the opportunities of certain social groups.
Arline Geronimus wrote about the weathering hypothesis the early 1990s to account for health disparities of newborn babies and birth mothers due to decades and generations of racism and social, economic, and political oppression. It is well documented that people of color and other marginalized communities have worse health outcomes than white people. This is due to multiple stressors including prejudice, social alienation, institutional bias, political oppression, economic exclusion, and racial discrimination. The weathering hypothesis proposes that the cumulative burden of these stressors as individuals age is "weathering", and the increased weathering experienced by minority groups compared to others can account for differences in health outcomes. In recent years, social scientists investigated the biological plausibility of the weathering hypothesis in studies evaluating the physiological effects of social, environmental and political stressors among marginalized communities. The weathering hypothesis is more widely accepted as a framework for explaining health disparities on the basis of differential exposure to racially based stressors. Researchers have also identified patterns connecting weathering to biological phenomena associated with stress and aging, such as allostatic load, epigenetics, telomere shortening, and accelerated brain aging.
Institutionalized discrimination refers to the unjust and discriminatory mistreatment of an individual or group of individuals by society and its institutions as a whole, through unequal selection or bias, intentional or unintentional; as opposed to individuals making a conscious choice to discriminate. It stems from systemic stereotypical beliefs that are held by the vast majority living in a society where stereotypes and discrimination are the norm . Such discrimination is typically codified into the operating procedures, policies, laws, or objectives of such institutions. Members of minority groups such as populations of African descent in the U.S. are at a much higher risk of encountering these types of sociostructural disadvantage. Among the severe and long-lasting detrimental effects of institutionalized discrimination on affected populations are increased suicide rates, suppressed attainment of wealth and decreased access to health care.
The COVID-19 pandemic has revealed race-based health care disparities in many countries, including the United States, United Kingdom, Norway, Sweden, Canada, and Singapore. These disparities are believed to originate from structural racism in these countries which pre-dates the pandemic; a commentary in The BMJ noted that "ethnoracialised differences in health outcomes have become the new normal across the world" as a result of ethnic and racial disparities in COVID-19 healthcare, determined by social factors. Data from the United States and elsewhere shows that minorities, especially black people, have been infected and killed at a disproportionate rate to white people.
Medical racism in the United States encompasses discriminatory and targeted medical practices, as well as misrepresentations in medical education, usually driven by biases based on characteristics of patients' race and ethnicity. In American history, it has impacted various racial and ethnic groups and affected their health outcomes, especially vulnerable subgroups such as women, children and the poor. As an ongoing phenomenon since at least the 18th century, examples of medical racism include various unethical studies, forced procedures, and differential treatments administered by health care providers, researchers, and government entities. Whether medical racism is always caused by explicitly prejudiced beliefs about patients based on race or by unconscious bias is not widely agreed upon.
