Racism, Xenophobia and Discrimination, a public health issue requiring urgent action.
- Shoshana Bloom
- Dec 10, 2022
- 3 min read
Today, The Lancet has launched a special edition examining the link between racism, xenophobia, discrimination, and health [1]. The collection of articles sheds light on the devastating impact that these social determinants can have on individuals and communities. The Lancet highlights that this is more than a moral or ethical concern, but a serious public health issue that requires urgent action.
Racism, xenophobia, and discrimination are all forms of prejudice that involve treating people unfairly based on their race, ethnicity, or national origin. The collection of articles examines the ways in which these forms of discrimination impact health and wellbeing.
Structural racism refers to the ways in which societal institutions and policies contribute to racial inequality. Structural racism is a major contributor to health disparities between racial and ethnic groups. For example, Black and Hispanic people are more likely to live in neighbourhoods with poor air quality, which can lead to respiratory problems. They are also more likely to have reduced access to healthcare, which can lead to worse overall health outcomes.
Xenophobia is the fear or hatred of people from other countries. Xenophobia can lead to the exclusion and marginalisation of certain groups, which can have serious consequences for their health. For example, people who are victims of xenophobia may be less likely to seek medical care, leading to poorer health outcomes. Xenophobia can also lead to social isolation and stress, which can have negative effects on mental health.
The series also examines the role of discrimination in healthcare settings. Black and Hispanic Americans are less likely to receive the same quality of care as their white counterparts, and are more likely to be misdiagnosed or receive inadequate treatment. This is a stark reminder that healthcare is not always a safe and equitable space for some marginalised communities.
One article examines the health effects of structural racism, xenophobia and discrimination, mapping the pathways to health outcomes [2], while another examines these issues from an intersectional perspective [3], showing how multiple factors interact and reminding us that this issue is more complex than single factors such as 'race' or 'identity'.
This research is a stark reminder that these social determinants are associated with negative health outcomes, including increased rates of chronic diseases, mental health disorders, and premature death observed within some communities. These observed disparities in health are not simply a result of individual behaviour or choices, but are deeply rooted in the structures and systems that shape our society. For example, the impact of residential segregation on health outcomes. Black Americans, who are more likely to live in segregated neighbourhoods, are at higher risk of developing chronic diseases such as diabetes and hypertension. This is because these neighbourhoods often lack access to healthy food options, quality healthcare, and other social determinants of health.
One of the key recommendations [4] is for governments and policy makers to address these structural inequalities and take action to address and reduce racism, xenophobia, and discrimination.
While we have the legal framework, within Human Rights Law through which to challenge structural drivers, we need go further with more broader, deeper and transformative approach.
This means investing in policies and programs that promote health equity, such as affordable housing, greater and equitable access to healthcare, and improved job opportunities.
It is also crucial for healthcare professionals to recognise and address the impact of racism, xenophobia, and discrimination on their patients. This means providing culturally competent care, challenging observed bias and prejudice within the healthcare system, and advocating for policies that support health equity.
Finally, a Commission is recommended to bring together global multilateral stakeholders to raise this important issue and advocate for global change.
Overall, this Lancet Series is a powerful reminder of the urgent need to address these social determinants of health, highlighting the ways in which these forms of discrimination can have serious impacts on health and wellbeing. It is important for individuals, health systems and communities to work together in order to promote health and create a more equitable and just society for all.
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