Improving the health of African Americans in the USA: an overdue opportunity for social justice.

Allan S Noonan,Fernando A Wagner,Hector Eduardo Velasco-Mondragon

doi:10.1186/s40985-016-0025-4

Abstract

Using a modified social ecological model, we conducted a review of the literature and nationwide statistics on African American health. We discuss the main social determinants of health and main health disparities, risk factors, the leading causes of morbidity and mortality, and access to health services for blacks in the USA. The mechanisms through which social determinants, including racism, exert their deleterious effects on black health are discussed at the macro and individual levels. Incarceration and mental health care issues are highlighted as priorities to be addressed. African Americans remain the least healthy ethnic group in the USA, a somber legacy of years of racial and social injustice and a formidable challenge to equitable health care for all. Systemic causes of suboptimal black health require equally systemic solutions; positive trends in black health indicators seem to be driven by social development programs, economic investment in education, participation of African Americans in policy, and decision-making and expansion of access to health care.

Highlights

In 1928, Louis Israel Dublin wrote “An improvement in Negro health, to the point where it would compare favorably with that of the white race, would at one stroke wipe out many disabilities from which the race suffers, improve its economic status and stimulate its native abilities as would no other single improvement
Many of the responsibilities that have traditionally been those of public health are incorporated into the “Community Health Plan” of the hospital and expansion of Medicaid. This change in the basic protocol of healthcare delivery in the USA offers a significant opportunity for African Americans and other under-represented and minority groups to insert themselves into the health care infrastructure [81]
After 250 years of social segregation and discrimination, current health data confirm that African Americans are the least healthy ethnic group in the USA

Summary

Introduction

In 1928, Louis Israel Dublin wrote “An improvement in Negro health, to the point where it would compare favorably with that of the white race, would at one stroke wipe out many disabilities from which the race suffers, improve its economic status and stimulate its native abilities as would no other single improvement. While we cannot break down these data to analyze possible racial and ethnic differences, it is important to consider that stigma has been major factor in blacks not receiving mental health care and may further complicate the effect of other healthcare barriers [63,64,65,66]. The data depict a rather complex picture in which blacks generally have similar if not lower incidence rates of mental disorders and substance involvement than whites, but at the same time suffer higher prevalence of serious mental health and legal problems, with devastating effects.

Results

Conclusion