Health, access to Care, and the war on drugs
Structural Racism and Health Inequities in Black Communities
Residential segregation systematically shapes health-care access, utilization, and quality at the
neighborhood, health-care system, provider, and individual levels.The socioeconomic disadvantage
resulting from systematic disinvestment in public and private sectors renders it difficult to attract primary-care
providers and specialists to predominantly black neighbourhoods. Likewise, health-promoting resources
are inadequately invested into these neighborhoods. Health-care infrastructure and services are inequitably
distributed, resulting in predominantly black neighborhoods having lower-quality facilities with fewer clinicians
than those in other neighborhoods. Moreover, most of these clinicians have lower clinical and educational
qualifications than those in other neighborhoods. This inequitable system is likely to disproportionately expose
black residents to racially biased services.
Mass incarceration and public health
The penal institutions that constitute the US criminal justice system—police departments, court systems, correctional agencies, parole and probation departments, and sentencing boards—have established policies and practices that are ostensibly colorblind yet they criminalize communities of colour (eg, through day-to-day practices such as stop and frisk) and disproportionately incarcerate black men, women, and children. Each component of the criminal justice continuum—from arrest to reentry—carries various health consequences, and a growing body of literature has documented severe adverse health outcomes associated with incarceration on the individual, their families, and neighborhoods.