Anti-black Attitudes Are a Threat to Health Equity in the United States.

Abstract

To assess the extent to which persistent racism shapes perspectives on public health policies aimed at improving health equity in the United States. Specifically we evaluate the relationship between implicit and explicit anti-black attitudes and support for the ACA at the beginning of the Trump administration. We use bivariate statistics to examine views toward the ACA, anti-black attitudes, and demographic variables. Using logistic regression, we examine how anti-black attitudes and demographic variables relate to participants stating that the ACA has worsened the quality of health care services in the United States. Data for this study come from the American National Election Studies 2016 Time Series Study, which targets US citizens age 18 and older currently living in the United States (N = 3245). Implicit anti-black attitudes, particularly among whites, are strongly associated with negative feelings toward the ACA. A measure of explicit racial prejudice has the opposite relationship among whites. These results suggest that whites are most critical of the ACA when they hold positive attitudes toward blacks but hold negative stereotypes about blacks' work ethic and reject policies to eliminate racial inequalities. Anti-black racial attitudes are a critical barrier to enacting health policies that stand to improve health equity in the United States. Public health practitioners and policymakers should consider racism as an essential barrier to overcome in the push for greater health equity in the United States.