Being endemic in the US, racism is pervasive in health care. It explains everything from the fact that the black to white infant mortality ratio has never dipped below to 2:1, to more generally, disproportionate un- and under-insured rates, compromised access, non-referrals, accelerated aging and and excess deaths. More pernicious than interpersonal racism, structural or systemic racism, where the failure to provide equal benefit to racial and ethnic minorities, is embedded in health care along with education, employment, environmental, housing, transporation and numerous other federal policies. As I've noted recently, this explains why COVID-19-related deaths among African American and Hispanics are far greater than among non-Hispanic whites. (Before George Floyd was killed, he suffered a COVID-19 infection.) Listeners will recall structural racism was an theme in my January 9th interview with Prof. Andrea Freeman regarding her recent book, Skimmed: Breastfeeding, Race and Injustice.
During this 30-minute conversation, Prof. Yearby begins by defining the difference between structural and institutional racism. She provides examples of structural racism, for example, home health workers (moreover women of color) are not protected under, for example, the 1938 Fair Labor and Standards Act, she discusses the link between hospital closures and race and the ongoing effect structural racism is having on minority communities during the current pandemic, i.e., how it compares to the H1N1 pandemic. She concludes by discussing solutions to address or mitigate structural racism in health care and how proposed federal legislation to limit employer liability for COVID-19 infections could be justified.
Ms. Ruqaiijah Yearby is a Professor, Member of the Center for Health Law Studies at Saint Louis University School of Law and also the Co-founder and Executive Director of Saint Louis University’s Institute for Healing Justice and Equity. She is also a Co-Principal Investigator of the Robert Wood Johnson Foundation grant entitled, “Are Cities and Counties Ready to Use Racial Equity Tools to Influence Policy?” She, too, serves as a Research Consultant and Board Member for the RWJF grant “Investigating Conceptions of Health Equity and Barriers to Making Health a Shared Value.” Her work has been cited in The Oxford Handbook of Public Health Ethics (2019), Dolgin & Shephard, Bioethics and the Law (4th ed 2019), Mark Hall, et al, Health Care Law and Ethics (9th ed 2018), Implicit Racial Bias Across the Law (Cambridge Univ. Press 2012), The Oxford Handbook of Bioethics (2007). Professor Yearby earned her BS in Biology from the University of Michigan, an MPH from Johns Hopkins School of Public Health, and her JD from Georgetown University Law Center.
Professor Yearby's publications are available at: https://papers.ssrn.com/sol3/cf_dev/AbsByAuth.cfm?per_id=549981.
Per my noting of critical race theory (CRT), or its mention in a July 2nd Health Affairs blog, see: https://www.healthaffairs.org/do/10.1377/hblog20200630.184036/full/.
Concerning the federal government's response to date to the COVID-19 pandemic, listeners would be remiss if they did not read Part I of Robert Brenner's "Escalating Plunder," in the May-June issue of the New Left Review, at: https://newleftreview.org/issues/II123/articles/robert-brenner-escalating-plunder.