What Happened In My Own Practice
In my medical practice, which serves a highly diverse population, I witnessed an incident in the reception area that underscored the impact of structural and systemic racism on health.
A woman, puzzled by another patient's illness, bluntly inquired, "How in the world did you end up with that disease?"
The man, visibly taken aback, struggled for words before murmuring, "God knows."
His discomfort was palpable, reflecting a deeper stigma often associated with illness.
As I navigated this delicate interaction, addressing the privacy breach and facilitating a more empathetic dialogue, the woman began to grasp the broader societal forces at play. I encouraged her to think about why her own community doesn’t have people with this disease. What makes her community or neighborhood so special?
When the Light Dawned
I saw it hit her—the sudden understanding of how health and healthcare disparities are so greatly impacted by the underlying structural inequalities that exist in our communities.
The woman turned to the other patient and apologized to him.
This encounter poignantly reminded me of the complex interplay between individual health experiences and the systemic conditions that define them.
It sets the stage for a deeper exploration into the roots and ramifications of structural and systemic racism in our society.
What is Structural or Systemic Racism?
Structural and systemic racism are forms of racism that are embedded in the policies, institutions, and processes of a society, leading to disparities in wealth, education, employment, justice, and healthcare.
Unlike individual acts of racism, structural and systemic racism are built into the very framework of society, affecting people's opportunities and quality of life, often without overt racial hostility or intent. This systemic inequality can lead to poor health outcomes for affected communities, particularly for people of color.
Who Suffers from Structural or Systemic Racism?
Did you know that structural or systemic racism can affect everyone's health? It's a significant issue that transcends racial boundaries, impacting both white and black individuals. However, it is important to recognize that black people often bear a disproportionate burden of this impact.
Observations from the Field
In my daily practice, the repercussions of structural and systemic racism are evident. This form of racism not only exacerbates health disparities but also contributes to the onset of various illnesses among my patients.
The recent pandemic highlighted how interconnected our health is and how vulnerabilities in certain communities can pose risks to us all!
Reflecting on Personal Experience
As a healthcare professional, I've witnessed firsthand the detrimental effects of these systemic issues on individual health. It's a reminder that the fight against structural and systemic racism is not just a social or political issue but a crucial public health concern.
Confronting This Kind of Racism—And Asking “Why?”
As I have confronted the existing inequalities, I’ve been prompted to ask why they occur. I never anticipated that my medical practice would involve addressing social inequalities as part of diagnosing and understanding the health conditions I see daily!
One health condition I confront daily is obesity.
Did you know that obesity rates vary significantly across different communities? Have you ever stopped to wonder why? Think about it—if a community has no recreational parks or facilities and no safe spaces for physical activities, people cannot exercise as easily as those who can go out for a walk or a run. The impact will be weight gain and other various health conditions.
Similarly, dietary choices are often limited by what is available and affordable in one's neighborhood. Many of my patients express frustration over the lack of healthy food options, pointing out that they live in food deserts without access to stores that carry quality food.
We must keep asking "why?" to understand the deeper causes of health disparities. When we do, we can identify the systemic issues at play and work towards addressing them.
I’m Speaking Up
It’s important to speak out about the fact that healthcare disparities exist and that structural and systemic racism still plagues our society. We don’t just see it in healthcare. We also see it in:
- Housing
- Education
- Employment opportunities in communities
- Equal earnings
- Equal opportunities for wealth-building
- Equal access to credit
- The justice system
Those disciplines are outside my realm, so I encourage you to speak up! Do you know people who work and move in these sectors? Help them start asking “why.” Prod them to probe, take some action, and make a difference.
Commitment to Change: My Journey as a Physician
As a committed healthcare provider, I aim to ensure that my community can access quality healthcare services. With each patient interaction, I delve into the "why" behind their health conditions. This approach helps me develop strategies to disrupt generational patterns of poor health, navigate systemic barriers, and tirelessly advocate for every patient under my care.
Since embarking on my medical career, I have been actively addressing healthcare disparities on an individual level. In doing so, I am gradually dismantling the walls of structural racism, one patient at a time. This process of chipping away at entrenched disparities not only addresses immediate health issues but also empowers my patients.
The collective effort of questioning, understanding, and acting against these disparities is crucial. James Baldwin’s warning from over thirty years ago rings true today: We are out of time to address the systemic racism that pervades our society. It’s time for us to take up our metaphorical hammers and work together to break down these barriers.
Thank you for joining me on this vital journey towards health equity and social justice.
Dr. Sidney Coupet, The People’s Doctor
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