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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. [1] 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. [2] Societal racism is sometimes referred to as systemic racism as well. [3] Societal racism is a form of societal discrimination. [4]
According to James Joseph Scheurich and Michelle D. Young, racism can be categorized into five types: [5]
Structural racism is harder to detect because it requires data to be examined over time to determine how the set of institutional, historical, cultural, and interpersonal practices maintain racial inequalities over a period of time. However, structural racism is the most prevalent form of racism because of how it pervades every level of society by incorporating the institutional, historical, cultural, and interpersonal practices within a society that perpetuates racial inequalities, therefore evaluating society as a whole. [6]
White supremacy can refer to societal racism or individual, formal racism related to the identity of white people. [7]
The use of the British word “chav” has been described as a form of "social racism". [8]
George M. Fredrickson has written that societal racism is deeply embedded in American culture and that in the 18th century, societal racism had already emerged with the purpose of maintaining a white-dominated society, [9] and that "societal racism does not require an ideology to sustain it so long as it was taken for granted". [10] When looking specifically at structural racism within the United States of America it is the formalization of practices that frequently put whites, or Caucasians, in a position of advantage while at the same time being consistently detrimental to people of color, such as African Americans, Hispanics, Native Americans, Pacific Islanders, Asians, and Middle Easterners. This position of advantage often entails: more opportunities to hold positions of power; privilege, white privilege; and superior treatment by institutions. This results in racial inequalities between whites and other ethnic groups which often manifest as issues of poverty or health disparities between the groups. [6]
The analysis of poverty levels, currently or over a period of time, across different ethnic groups can give an indication of, but do not imply, structural racism. The 2017 poverty guideline for the contiguous United States for a household of 3 is $20,460.00 according to the U.S. Department of Health and Human Services. [11] A household size of three was chosen since the average size in the United States is about three. Using the poverty guideline for a household size of three from the U.S. Department of Health and Human Services as a baseline to compare incomes by household in each ethnic group, one can see the trends and compare the groups. The table below is based on the 2017 U.S. census data and shows the poverty levels of the primary racial groups in the U.S.: [12]
At or below the poverty limit | Between twice the poverty limit to the poverty limit | Households with income over $100,000/year | |
---|---|---|---|
Asian | 12.6% | 15.1% | 41.7% |
White | 13.4% | 20.3% | 32.9% |
Hispanic | 18.1% | 26.2% | 19.8% |
Black | 26.8% | 26.9% | 16.1% |
Compared to households who identify as white those who identify as Black or Hispanic have higher rates of poverty. Households who identify as Asian have lower rates of poverty as many immigrated after receiving job offers earned through their work and education background and Asians born in the United States have a high rate of post-secondary education, contributing to the model minority stereotype that causes distance between Asians and poorer ethnic groups. On the other hand, a significant number of Hispanics in the United States are or are descendent of recent immigrants that sought menial work in the United States and brought little or no wealth with them which would contribute to the income difference seen between Hispanics and others. Black households are twice as likely to be impoverished compared to white households. Hispanic households are about 35% more likely than white households to be at or below the poverty line. Both Hispanic and Black households are 35% more likely than white households to have an income between twice the poverty line and the poverty line. Asian households are 27%, 159%, and 110% more likely than White, Black, or Hispanic households, respectively, to have six figure incomes.
The wealth gap between ethnic groups has existed throughout history. White households hold much greater levels of housing equity, business equity, and financial assets than Black and Hispanic households. [13] Married couples can accumulate wealth quickly through sharing resources. Black households are twice as often single adults compared to white households. [13] Poverty leads to health issues, less higher education, more high school dropouts, more teenage pregnancy, and less opportunities. Therefore, a large part of structural racism has to do with the cycle of poverty which makes it substantially harder for people and their descendants caught in the cycle to accumulate enough wealth to increase their income and capital gains.
The cycle of poverty that structural racism could impose on minorities has adverse effects on their overall health, among other things. Health inequities can manifest as disparities in several aspects of health such as quality of healthcare, incidence and outcome of disease or disorders, life span, infant mortality, health and sexual education, exercise, and drug use. Furthermore, racism itself is thought to have a negative impact on both mental and physical health.
According to a paper that analyzed published research on PubMed from the years 2005–2007 on the connection between discrimination and health, there is an inverse relationship between the two; furthermore, the pattern is becoming more apparent across a greater variety of issues and data. [14] This study shows that this long known pattern has not disappeared. According to the 1985 Report of the Secretary's Task Force on Black and Minority Health by the U.S. Department of Health and Human Services in general Americans were getting healthier and had increased longevity but there is a persisting inequality between Blacks and other minority groups in the rate of death and illness contrasting to the overall population; furthermore, the report notes that this inequality has been around for more than a generation at this point or since better, more factual federal records have been kept. [15]
This is definitive proof that the federal government noticed these racial inequalities in health long before the 2005-2007 study of research data that revealed a pattern. Based on the studies they reviewed it became apparent that regardless of socioeconomic status, racial inequalities in health were present between minority groups for several health issues such as diabetes, hypertension, heart disease, and obesity. [14] This shows that health inequities can be alleviated by increasing socioeconomic status but they still persist at all levels. Research findings often lack racial or ethnic variables. A 2023 scoping review of the literature found that in studies involving multiracial or multiethnic populations, race or ethnicity variables lacked thoughtful conceptualization and informative analysis concerning their role as indicators of exposure to racialized social disadvantage. Racialized social disadvantage encompasses systemic and structural barriers, discrimination, and social exclusion experienced by individuals and communities based on their race or ethnicity, resulting in disparities in access to resources, opportunities, and health outcomes. [16] [17]
In addition, there is data that supports the fact that as health care has advanced worldwide overall there are more increases in health inequalities between races. One such study that supports this is "The Progress Toward the Healthy People 2010 Goals and Objectives" which is a review, done by members of the National Center for Health Statistics of the Centers for Disease Control and Prevention and the Center of Excellence on Health Disparities, Morehouse School of Medicine, that explores progress towards improving the overall health quality and longevity of Americans and the health disparities between ethnic groups. To accomplish this they used a system of 31 measures to analyze the progress and disparities; which consisted of 10 leading health indicators (LHI), created by the Department of Health and Human Services, with a few objectives each for twenty two total and the remaining measures were formulated by the group who did the review. [18] The ten leading health indicators are: Physical activity, overweight and obesity, tobacco use, substance abuse, responsible sexual behavior, mental health, injury and violence, environmental quality, immunization, and access to healthcare; the group who did the review supplemented the leading health indicators with 7 more objectives and 2 more measures, infant mortality and life expectancy to give 31 in total. [18] They used these measures to track the disparities between Asians, Hispanic or Latino, Black Non-Hispanics, white non-Hispanic, American Indian or Alaskan Natives, and Native Hawaiians or Pacific Islanders; Data is not available for every ethnic group for all 31 measures. Using the available data for the objectives they have more than one time period on they found 6 objectives showed a decrease in disparity between ethnic groups and the national average while they found 18 disparity increases across 11 objectives. [18]
This confirms that even as healthcare is advancing and new scientific discoveries are being made overall the disparities between ethnic groups are increasing. This is a trend that was noticed in the 1985 report and has continued through the time worsening its effects and contributing to greater health inequalities. It is possible for structural racism to hinder the health and longevity of minorities.
Structure and agency are opposites. Agency is the idea that a person's life outcomes are due entirely, or significantly influenced by their own individual efforts. Social structure is the idea that life outcomes are due entirely, or significantly influenced by the individual's race, class, gender, social status, inherited wealth, legal situation, and many other factors that are outside the individual's control.
A society, even a "colorblind" society, can be structured in a way that perpetuates racism and racial inequality even if its individual members do not hold bigoted views about members of other racial groups. Society can still effectively exclude racially disadvantaged people from decision-making or make choices that have a disparate impact on them. [19] For example, a policy to give more money to rural schools and less to urban schools is facially neutral: on the face of it, the policy says nothing about race. However, if the rural and urban populations have significantly different racial proportions, then this policy would have a society-wide racial effect.
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.
Health equity arises from access to the social determinants of health, specifically from wealth, power and prestige. Individuals who have consistently been deprived of these three determinants are significantly disadvantaged from health inequities, and face worse health outcomes than those who are able to access certain resources. It is not equity to simply provide every individual with the same resources; that would be equality. In order to achieve health equity, resources must be allocated based on an individual need-based principle.
In the United States, the relationship between race and crime has been a topic of public controversy and scholarly debate for more than a century. Crime rates vary significantly between racial groups; however, academic research indicates that the over-representation of some racial minorities in the criminal justice system can in part be explained by socioeconomic factors, such as poverty, exposure to poor neighborhoods, poor access to public and early education, and exposure to harmful chemicals and pollution. Racial housing segregation has also been linked to racial disparities in crime rates, as black Americans have historically and to the present been prevented from moving into prosperous low-crime areas through actions of the government and private actors. Various explanations within criminology have been proposed for racial disparities in crime rates, including conflict theory, strain theory, general strain theory, social disorganization theory, macrostructural opportunity theory, social control theory, and subcultural theory.
Institutional discrimination is discriminatory treatment of an individual or group of individuals by institutions, through unequal consideration of members of subordinate groups. Societal discrimination is discrimination by society. These unfair and indirect methods of discrimination are often embedded in an institution's policies, procedures, laws, and objectives. The discrimination can be on grounds of gender, caste, race, ethnicity, religion, disability, or socio-economic status. State religions are a form of societal discrimination.
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, Baltimore MetropolitanCharlotte, Houston,Memphis MetropolitanDallas, Los Angeles, New Orleans,Philadelphia MetropolitanNew York, San Antonio Detroit Metropolitan 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.
Social inequality occurs when resources within a society are distributed unevenly, often as a result of inequitable allocation practices that create distinct unequal patterns based on socially defined categories of people. Differences in accessing social goods within society are influenced by factors like power, religion, kinship, prestige, race, ethnicity, gender, age, sexual orientation, intelligence and class. Social inequality usually implies the lack of equality of outcome, but may alternatively be conceptualized as a lack of equality in access to opportunity.
Residential segregation is the physical separation of two or more groups into different neighborhoods—a form of segregation that "sorts population groups into various neighborhood contexts and shapes the living environment at the neighborhood level". While it has traditionally been associated with racial segregation, it generally refers to the separation of populations based on some criteria.
In the United States, housing segregation is the practice of denying African Americans and other minority groups equal access to housing through the process of misinformation, denial of realty and financing services, and racial steering. Housing policy in the United States has influenced housing segregation trends throughout history. Key legislation include the National Housing Act of 1934, the G.I. Bill, and the Fair Housing Act. Factors such as socioeconomic status, spatial assimilation, and immigration contribute to perpetuating housing segregation. The effects of housing segregation include relocation, unequal living standards, and poverty. However, there have been initiatives to combat housing segregation, such as the Section 8 housing program.
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.
Housing inequality is a disparity in the quality of housing in a society which is a form of economic inequality. The right to housing is recognized by many national constitutions, and the lack of adequate housing can have adverse consequences for an individual or a family. The term may apply regionally, temporally or culturally. Housing inequality is directly related to racial, social, income and wealth inequality. It is often the result of market forces, discrimination and segregation.
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.
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.
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.
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.
The COVID-19 pandemic has had an unequal impact on different racial and ethnic groups in the United States, resulting in new disparities of health outcomes as well as exacerbating existing health and economic disparities.
White Americans, as the largest racial group in the United States, have historically had better health outcomes than oppressed racial groups in America. However, in recent years, the scholarly discourse has switched from recognition of the immense positive health outcomes of white Americans towards understanding the growing persistence of negative outcomes unique to this racial group. Scholars have discussed the effects of racial prejudice and its negative effect on health outcomes to not only those being oppressed but also those being given privileges. In addition to the effects of living in a racialized society, white Americans have the highest rate of suicide and lifetime psychiatric disorders of any other ethnicity or racial category. In conjunction with these psychiatric issues, the population presents higher rates of alcohol usage alongside lower levels of psychological flourishing. Given this information, the health status of white Americans has gained increasing importance due to the differences in health outcomes between white Americans and white people from other parts of the world.