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A panel of public health experts discussed the social and political determinants of health in a Tuesday webinar co-sponsored by the offices of diversity and inclusion at Harvard Medical School, School of Dental Medicine, and School of Public Health.
The panelists tackled the origins of health inequities, from the history of discrimination in the United States to the role of voter suppression in public health policy.
Medical School Dean for Diversity and Community Partnership Joan Y. Reede and School of Public Health Professor David R. Williams moderated the event, which featured Daniel E. Dawes, the director of the Satcher Health Leadership Institute at the Morehouse School of Medicine. Three other panelists accompanied them: doctoral candidate Anna K. Hing from the University of California, Los Angeles’s School of Public Health, HSPH Professor Jose F. Figueroa, and Tuskegee University’s National Center for Bioethics in Research and Healthcare Director Rueben C. Warren.
Dawes opened the event by speaking about health disparities communities of color face which he said have been present “throughout our nation’s history.”
Higher rates of air pollution, lack of access to healthy foods, and increased stress are just some of the “social determinants” that have led to poor health among people of color, Dawes said.
But underlying these social determinants, Dawes added, are longstanding “political determinants” — upstream policy decisions that have perpetuated health inequity.
Dawes tied these political determinants to the country's long history of discrimination toward people of color. He described how politicians first used slavery and overt racism to justify creating laws that have perpetuated health disparities, later turning to less conspicuous racial discrimination methods after abolition.
“Racism does not sleep in this country,” Dawes said.
Following Dawes’s presentation, the full panel discussed the current state of American health policy, specifically considering how the value-based care system harms low income communities of color, as well as the healthcare workers who treat them.
“Every single value-based care program that has come out has, in its core DNA, some form of structural racism and discrimination,” Figueroa said. “These programs often reward and bonus providers who take care of the wealthiest and white populations.”
King focused on the health impacts of voter suppression, explaining that young adults who vote have “higher future incomes and better mental health.” She also emphasized the stigma placed on ineligible voters and discrimination towards voters of color. She said Americans need to “truly understand voter suppression as a form of structural racism meant to uphold white supremacy.”
Additionally, the panelists emphasized the connection between public health and social justice issues. Health disparities and health inequities are “different pieces of the same puzzle,” according to Warren, who also called attention to the importance of including oral health as a key part of health policy discussions.
In a Q&A session at the end of the webinar, speakers addressed questions about what actions clinicians and civilians alike can take to combat structural violence and health inequities.
King urged people to make sure the voices of people of color are “included, listened to, and respected” to prevent further marginalization of these groups in the policy-making process.
The panelists ultimately encouraged audience members to respond to the topics discussed throughout the webinar through civic engagement.
“My take-home message to you — hear me clearly — go vote. Please go vote,” Warren said.
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