Race and health in the United States

Research on race and health in the United States shows many health disparities between the different racial/ethnic groups. Different outcomes in mental and physical health exist between all 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.[1] Certain diseases have a higher prevalence among specific racial groups, and life expectancy also varies across groups. This article is directed towards some of the historical and societal factors that impact the health of various minorities groups in the United States. Race and health in the United States is a topic that has been researched many times, but the causes of disparate outcomes remain something that can be further explored.

Background

Health ratings in US by race.

The U.S. Census definition of race is often applied in biomedical research in the United States. According to the Census Bureau in 2018, race refers to one's self-identification with a certain racial group. The Bureau also specifies that its use of "race" is as a social concept, not a biological or anthropological one.[2] The Census Bureau recognizes five races: Black or African American, White (European American), Asian, Native Hawaiian or other Pacific Islander, and American Indian or Alaska Native. Despite the fact that the United States continues to become more diverse, these Census categories have not changed for almost 20 years.[3] The Census Bureau also recognizes differences in ethnicity among the population, and it defines ethnicity as whether a person is of Hispanic origin or not. For this reason, ethnicity is broken out in two categories in its data, Hispanic or Latino and Not Hispanic or Latino. Hispanics may report as any race.[4]

The 2010 U.S. Census further specifies the number of Americans who identified with each racial and ethnic group; in 2010, 38.9 million identified as African American, 14.6 million as Asian American, 2.9 million as American Indian or Alaskan Native and 50.4 million as Hispanic or Latino.[5]

Because race is a social construct and not a biological trait[citation needed], measures of the relationship between race and medicine are imperfect and inconsistent. The 2000 U.S. Census definition is inconsistently applied across the range of studies that address race as a medical factor, making it more difficult to assess racial categorization in medicine. Additionally, the socially constructed nature of race makes it so that the different health outcomes experienced by different racial groups can be connected to social factors rather than inherent biological ones.

There are significant disparities in health outcomes between the five racial groups recognized by the U.S. Census. These health disparities are in part caused by different levels of income across the five groups recognized by the U.S. Census.[6] There are also notable differences in access to healthcare and the quality of healthcare received by those who identify with different racial categories.

Bias and racism also contribute to disparities in health outcomes. Non-white racial groups may experience bias and racism within the medical system, impacting these groups' access to and quality of care.[7] Additionally, the racism experienced in daily life affects health outcomes. The stress associated with racism can negatively impact a person’s physical and mental health [6] and has been shown to contribute to health problems such as depression, anxiety, insomnia, heart disease, skin rashes, and gastrointestinal problems.[8]