By John Salak –
In what’s been labeled a ground-breaking study, a multi-institutional team of health equity researchers is reporting that structural racism is “deeply interrelated” to poor health outcomes.
The team’s analysis announced “how neighborhood prevalence of chronic kidney disease (CKD), diabetes and hypertension are strongly associated with an increased burden of structural racism indicators.”
The research involved an observational cross-sectional study in Durham County, North Carolina, using public data sources and deidentified electronic health records to explore how a comprehensive collection of data points associates the presence of structural racism and the neighborhood prevalence of these three chronic health conditions.
“It was important to look at these three conditions because they are interconnected and highly associated with heart disease, as well as quality and length of life. Importantly, Black people share a disproportionate burden of these three illnesses,” reported senior author Dr. Dinushika Mohottige, an assistant professor at the Icahn School of Medicine at Mount Sinai.
The study identified structural racism as how societies foster discrimination through a series of systems that are reinforcing, such as housing, education and unemployment.
“These systems cascade into discriminatory belief values, and the distribution of resources,” added researcher Dr. L. Ebony Boulware, Dean of Wake Forest University School of Medicine. “Dr. Mohottige and I agreed it was important to tap the unusual data assets available in Durham to learn how we can improve the health of communities and individuals by identifying the factors that may affect their health the most. Our goal was to use the data to help us identify possible interventions.”
Data measuring health outcomes for such issues as kidney disease and diabetes helped the team understand how the conditions where people live affect their well-being.
“This is especially true for groups that, because of their race or ethnicity, historically experience worse health outcomes when compared to others,” Boulware explained.
The researchers studied data of aggregate estimates of the prevalence of chronic conditions for each of 150 residential neighborhoods in Durham using the Durham Neighborhood Compass, a unique data asset created by public health officials.
“This study fills an important evidence gap and helps us identify factors that might be targeted to address community health inequities,” Mohottige reported.
Other key findings included:
- Residential neighborhoods with the highest prevalence of CKD, diabetes and hypertension, tended to be in neighborhoods with the lowest proportions of White residents and vice versa.
- The same neighborhoods tended to be in areas with the lowest income and higher area deprivation. They also had the lowest rates of college education.
- Most discrete indicators of structural racism (examples include reported violent crime, eviction rates, election participation, income and poverty) were associated with greater neighborhood prevalence of the three diseases.
“Very limited evidence exists to tie together these structural racism constructs with the aggregate health of individuals in a given neighborhood using electronic health data and rigorous assessments of chronic conditions,” Mohottige noted.
