By Glenn Ellis
There is no disagreement that African Americans have worse health outcomes across the board. Researchers, scientists, sociologists, and doctor all agree.
Data and statistics reflect the dismal reality that if you are African American, you will be more likely to die at birth, die giving birth, grow up sicker, be diagnosed of a life-threatening illness later, and die sooner.
What is less known, and agreed upon, is the fact that the determining factors for all of these outcomes, is not because one is African American, but because of what are known as social determinants of health.
It’s true, research had concluded that medical care is only responsible for 10 to 20 percent of a person’s health: regardless of what color they are. The remaining 80 to 90 percent is attributed to these social determinants of health (SDOH).
Doctors see this every day in their patient population. A recent survey by The Physician Foundation revealed that 90%of the doctors in this country say that most of their patients have a social condition that poses a serious threat to their health. Only 1 percent of the doctors surveyed felt that none of their patients were affected by SDOH.
So, what exactly are social determinants of health?
According to the World Health Organization (WHO), these are the “conditions in which people are born, grow, live, work, and age”. In other words, the conditions of health are alarming in communities with poor SDOH such as unstable housing, low income, unsafe neighborhoods, and/or substandard education.
One only has to look at every city (urban and rural) to see how this plays out in most of our lives.
In the United States, it is SDOH, not race that accounts for the dismal health outcomes for African Americans. In fact, the inequities in outcome are clear all the way down to the level of neighborhoods in the same city.
Several years ago, The Robert Wood Johnson Foundation initiated a first of its kind initiative to look at life expectancy by neighborhood in respective cities around the country.
We can see it even today doctors have been found to believe that there is something about being African American that results in not providing adequate pain medications due to the belief that we have a higher tolerance for pain, because of our skin color. The same phenomena were observed even in children at Emergency room with appendicitis; African American children were denied pain medication for the same reason.
Most alarming to me are the implications as we move further into genomic medicine.
If we are not careful, we can see research from this endeavor to further engrain the notion that there are racial differences that justify our higher rates of high blood pressure; diabetes; and other diseases and conditions.
Currently, policy, legislation, and funding are directed towards supporting the theory that African Americans are more susceptible to poorer health outcomes, while SDOH are being largely ignored.
Dr. Richard Cooper of Loyola University has done research on high blood pressure that has made an indisputable case for the dismissal of the fallacy of African Americans being “predisposed” to poor health outcomes.
In his research, Dr. Cooper studied high blood pressure in Nigerians, Jamaicans, and in African Americans. His conclusions: only African Americans had the highest rates of high blood pressure. To further make the case, he found that Germans and Russians has rates that were significantly higher than African Americans!
Seems like its more about being African American in this country, than it is about just being African American.
It begs the question: Is it race or is it racism?