In this prompt topic area we have been exploring how racial discrimination, in all its many forms, has a negative impact on both physical and mental health thus creating and perpetuating substantial health inequalities. Interesting to note, studies have determined that the volume of discrimination experienced matters more than the type of experience. Repeated exposure to racial discrimination is associated with high or very high psychological distress. This chronic stress can wreak havoc on an individual in several ways.

To be clear, disparities in health and health care not only affect the groups facing disparities, but also limit overall improvements in quality or care and health for the broader population and result in increased costs. As the population becomes more diverse, with people of color projected to account for over half of the population by 2045, it is increasingly important to address health disparities.

This article looks at the segregation patterns related to health care in Boston, determining that these disparities remain stubbornly entrenched. Color Line Persists, in Sickness as in Health

We must address this! Why America’s Black Mothers and Babies Are in a Life-or-Death Crisis This article suggests the answer to the disparity in death rates has everything to do with the lived experience of being a black woman in America:

 The reasons for the black-white divide in both infant and maternal mortality have been debated by researchers and doctors for more than two decades. But recently there has been growing acceptance of what has largely been, for the medical establishment, a shocking idea: For black women in America, an inescapable atmosphere of societal and systemic racism can create a kind of toxic physiological stress, resulting in conditions — including hypertension and pre-eclampsia — that lead directly to higher rates of infant and maternal death. And that societal racism is further expressed in a pervasive, longstanding racial bias in health care — including the dismissal of legitimate concerns and symptoms — that can help explain poor birth outcomes even in the case of black women with the most advantages.

Actual institutional and structural racism has a big bearing on our patients’ lives, and it’s our responsibility to talk about that more than just saying that it’s a problem…

Here is another example of a mental health issue and the lived experience of being a black woman. Rethinking Work-Life Balance for Women of Color  

According to a recent CDC report the death rate for African Americans declined 25 percent from 1999 to 2015. But disparities still persist between blacks and whites. Although blacks as a group are living longer, their life expectancy is still 4 years less than that of whites. While there is progress reducing leading causes of death, African Americans are still more likely to die at a younger age.

Mental Health: Let’s Talk About Culture, Race and Ethnicity

Predictably, there is a long history of discrimination in the access to and quality of mental health care. A report completed by the surgeon general determined that racial and ethnic minorities have less access to mental health services than do whites. They are also less likely to receive care when they need it. When they do receive care, the report said, it is more likely to be poor in quality. Not White, Not Rich, and Seeking Therapy

Stop. Think. Respect. Racial Discrimination and Mental Health

8 Reasons Racial and Ethnic Minorities Receive Less Mental Health Treatment

Historical Trauma in Native Americans. This article provides fundamental definitions and examples of historical and cultural trauma.

Black Mental Health Is Different from White Mental Health  "When you talk about mental illness in the black community, I think you have to begin with the experience of trauma and how trauma continues to abound in their experiences in their daily lives."

Do We All Have PTSD?: Mental health in the age of racial terror

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