Public health leaders have long recognized the significant racial disparities in diseases like asthma. For example, African Americans have higher asthma prevalence, asthma emergency department visit and hospitalization rates, and asthma mortality than whites. In recent decades, the conversation broadened to include racial inequities – that is, the understanding that inequitable access to clean air and healthy housing, for instance, create asthma’s racial disparities.
We are pleased to see the public health field take yet another step to acknowledge racism as the root cause of these dynamics. It is racism that historically and currently creates: barriers to wealth accumulation; educational inequities; inequities in the justice system. As public health leader Nancy Krieger explains, “[R]acism operates as the underlying determinant of the determinants.”
Perhaps spurred by the historic protests for racial justice throughout 2020, the leadership of the Black Lives Matter movement, and the increasing conversations about how to be antiracist, numerous public health and medical journals published articles and statements about racism this month. To name just a few, the New England Journal of Medicine published Race and Genetic Ancestry in Medicine — A Time for Reckoning with Racism; the Annals of Family Medicine published Dear White People; and, the Journal of the American Board of Family Medicine published Systemic Racism and Health Disparities: A Statement From Editors of Family Medicine Journals. In the journal Pediatrics, researchers and advocates from Oakland and San Francisco authored, Racism as a Root Cause Approach: A New Framework. They present the Racism as a Root Cause (RRC) approach as a new framework for developing strategies, policies, and mechanisms to address the root causes of health disparities. As they state, “Addressing racism as a root cause is critical to advancing population health.”
As we enter 2021 with both hope and determination, we commit to exploring how the Racism as a Root Cause framework can be integrated into our work on asthma, and encourage our partners to explore these articles and ideas for your work, as well.
Warm regards,
RAMP staff