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Jane Lazarre was pacing the hospital waiting room. Her son Khary, 18, had just had knee surgery, but the nurses weren't letting her in to see him.

"They told us he would be out of anesthesia in a few minutes," she remembers. "The minutes became an hour, the hour became two hours."

She and her husband called the surgeon in a panic. He said that Khary had come out of anesthesia violently - thrashing and flailing about. He told Lazarre that with most young people Khary's age, there wouldn't have been a problem. The doctors and nurses would have gently held him down.

"But with our son, since he was so 'large and powerful,' they were worried he might injure the medical staff," Lazarre says. "So they had to keep sending him back under the anesthesia."

Khary was 6 feet tall. But he was slim.

"He wasn't the giant they were describing him as," Lazarre says.

Lazarre is white. Her husband is black. Lazarre says there's no doubt in her mind that the medical team's fear of Khary was because of race.

"I understood, certainly not for the first time, that my son - and my sons both - were viewed as being dangerous, being potentially frightening to people who were white," she says.

She's also sure the surgeon didn't see it that way.

"Like most white people, I don't think he was conscious of it at all," Lazarre says.

She and her husband insisted on seeing Khary. They saw right away that he wasn't angry or violent.

"He was scared," Lazarre says. She and her husband leaned over and whispered in Khary's ear: "'It's going to be OK, you can calm down.' And he began coming out of the anesthesia more normally."

Lazarre first wrote about this experience in her book Beyond the Whiteness of Whiteness: Memoir of a White Mother of Black Sons. Though it's been years since Khary's surgery, Lazarre says there's still so much that hasn't changed.
Racial Disparity In Medical Treatment Persists
Even as the health of Americans has improved, the disparities in treatment and outcomes between white patients and black and Latino patients are almost as big as they were 50 years ago.

A growing body of research suggests that doctors' unconscious behavior plays a role in these statistics, and the Institute of Medicine of the National Academy of Sciences has called for more studies looking at discrimination and prejudice in health care.

For example, several studies show that African-American patients are often prescribed less pain medication than white patients with the same complaints. Black patients with chest pain are referred for advanced cardiac care less often than white patients with identical symptoms.

Doctors, nurses and other health workers don't mean to treat people differently, says Howard Ross, founder of management consulting firm Cook Ross, who has worked with many groups on diversity issues. But all these professionals harbor stereotypes that they're not aware they have, he says. Everybody does.

"This is normal human behavior," Ross says. "We can no more stop having bias than we can stop breathing."

Unconscious bias often surfaces when we're multitasking or when we're stressed, research shows. It comes up in tense situations where we don't have time to think - which can happen frequently in a hospital.

"You're dealing with people who are frightened, they're reactive," Ross says. "If you're doing triage in the emergency room, for example, you don't have time to sit back and contemplate, 'Why am I thinking about this?' You have to instantaneously react."

Doctors are trained to think fast, and to be confident in their decisions. "There's almost a trained arrogance," Ross says.

But some medical schools are now training budding physicians and other health professionals to be a bit more reflective - more alert to their own prejudice.

Places like the University of Texas Medical School at Houston, the University of Massachusetts, and the University of California, San Francisco now include formal lessons on unconscious bias as part of the curriculum.
New Approach Teaches Students To Recognize Bias - And Slow Down
At UCSF, all first year medical school students take a workshop led by Dr. Rene Salazar, who coaches other members of the medical team, too.

"A lot of folks come to San Francisco thinking, 'Oh it's such an open-minded place, there are no biases here,' " he tells a class of newly arrived pharmacy residents. "That's not true. You're going to see this in every hospital. It's going to be an issue."

What Salazar wants these students to talk about isn't other people's biases, but their own. And not just the biases they know they have. But the ones they don't know - or don't believe - they have.

"Like it or not, all of us hold unconscious beliefs about various social and identity groups," he says. "Many times we think about bias and unconscious bias - they are incompatible with our conscious values, right?"

Before the class, students were asked to take an implicit association test, a series of timed computer tests that measure unconscious attitudes around race, gender, age, weight and other categories. Salazar asks who wants to share their results.

The students study their fingernails.

Salazar clears his throat.

"Well, I can share with you my story," he says.

When he took the test for the first time, it showed that he had a preference for whites - or a bias against African-Americans. Research shows that 75 percent of people who take the race test show an automatic preference for whites.

"I was struck," he tells the students. "Particularly being in the health professions and wanting to serve diverse communities, to learn that I had these biases - it was a bit disheartening."

So he began to explore where these biases came from.

"I grew up in south Texas - 99 percent Mexican-American. Mostly Latino. In my high school, we had one black student," he tells the pharmacy residents. "And so, up until age 18, you can imagine, a lot of my ideas - a lot of my attitudes, a lot of my beliefs - about folks who were black came from what? The media."

A student named Amanda raises her hand. She asks that we not use her last name because she's afraid that what she learned about herself could harm her career.

Amanda explains to the class that her parents made their way to the U.S. from Iran, and settled in Marin County, north of San Francisco. She took the version of the test that measures bias against Muslims, and another on light and dark skin tone.

"I kind of went in thinking that these are two areas that I would probably not have a bias, and that's kind of why I chose them," she says.

But the results were not what she expected.

"It was like, actually, 'You're biased and you don't like brown people and you don't like Muslims,' " she says. "Which is interesting for me - because that's, kind of, the two things that I am."
Traditional Diversity Training Didn't Work - And Sometimes Backfired
The UCSF curriculum is based on a training program designed by Howard Ross, the diversity consultant. He says he developed the new "unconscious bias" approach to sensitizing people to their own predjudices after realizing that the traditional diversity training he was doing in the '80s and '90s wasn't working.

"People who seemed to have transformative responses to those [earlier] trainings, to have that kind of 'aha' moment - particularly people in the dominant group, [of] whites, men, heterosexuals - often, if you talk to them a month or two later, they actually felt quite wounded by the experience," Ross says. In some cases, he adds, participants seemed to become more defensive and hardened in their biases after those early trainings, not less prejudiced.

A 2007 study described in the Harvard Business Review examined diversity training programs at more than 800 companies over 30 years, and the results underscore Ross's point. Overall, such programs seemed to do nothing to change people's prejudices or improve diversity. Instead, in some cases, they reinforced bias.

"What happens is, ultimately, we feel bad about ourselves, or bad about the person that made us feel that way," Ross says.

So rather than making people feel bad or awkward, Ross and Salazar say that, more than anything, they want people to accept that having biases is part of being human.

"You know we all have them," Salazar tells his class in San Francisco. "It's important to pause for a second and normalize this. And be OK with this."

Salazar emphasizes that unconscious bias can't be eliminated, but it can be managed.

"So how do we address our bias? What do we do?"

One student says, "Slow down."

"Yeah," Salazar responds. "A trick that I use is that I pause before I walk in, take 10 seconds even, 15 seconds, just to try to clear your mind and go in with that clean slate."

It's too early to know if these new types of trainings that explore unconscious bias are actually having any effect on what goes on in the exam room. Participants fill out evaluation forms after the class, and these anecdotal self-reports are often positive. But, so far, there have been no formal studies to measure if anything in patient care has actually changed.

"What happens when that door closes? What happens in the interaction when I can't see the patient and the doctor talking?" Salazar says. "That's a little hard to capture."

Still, UCSF is betting the technique will help. Salazar and other leaders believe the younger generation of health care providers could help shift medicine - by learning early how to keep their own biases in check.

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Can Health Care Be Cured Of Racial Bias?

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Jane Lazarre was pacing the hospital waiting room. Her son Khary, 18, had just had knee surgery, but the nurses weren't letting her in to see him. "They told us he would be out of anesthesia in a few minutes," she remembers. "The minutes became an hour, the hour became two hours."

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National Health Reform and Racial and Ethnic Disparities in Health Care

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Racial Economic Inequality and Health Care Disparities

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Racial Health Disparities The Bias of Media Coverage

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Critical Race Studies and Social Work Practice Racial Inequality in Healthcare PSA

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Joint Center for Political and Economic Studies

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Racial and Ethnic Disparities in the Quality of Health Care for Medicaid Recipients. MSW 595: Critical Race Studies and Social Work Practice Racial Inequality in Healthcare PSA, a modest action plan to bring awareness of racial and ethnic disparities in healthcare and the Medicaid program.

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Medical care

The practices of traditional Western medicine are favored by most European Americans in the U.S. Western medicine is characterized by rigorous safety protocols with treatments and medications that must pass a strict review before they can be used for patient care. Health care providers use methods developed according to medical and scientific traditions. Treatments may include medication, surgery, chemotherapy, radiation, and physical therapy. Western medicine differs from Eastern medicine in its approach to treatment. Western medicine’s greatest strength is in trauma care and therapies for acute problems. Increasing attention is being paid to preventive medicine to address growing rates of chronic diseases, preventable cancers, and the epidemic increase in obesity and diseases related to obesity, such as heart disease, hypertension, stroke, and type 2 diabetes.

The holistic approach of Eastern medicine is increasingly being incorporated into traditional medical treatment. Illnesses and conditions are uniquely treated according to the way a particular patient experiences a disease. For example, patients with fibromyalgia may use meditation or massage therapy to reduce stress and improve muscle function. Eastern medicine’s greatest strength is in the area of treating the whole person—mind, body, and spirit—not just the disease.

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Definition Of Health | Andrew Weil, M.D.

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What is Cultural Competency in Healthcare?

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Caucasians treated with better quality care as compared to minorities.
Why?

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Study: Black Kids Less Likely To Receive Pain Medication Than White Kids In ER

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Researchers have found that race appears to be a factor in the distribution of pain medications in the emergency room. Researchers have found that race appears to be a factor in the distribution of pain medications in the emergency room.

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Creating health equity is a guiding priority and core value of APHA. By health equity, we mean everyone has the opportunity to attain their highest level of health.

What is Health Equity?

APHA Health Equity Fact Sheets, Briefs, Reports and Infographics

COVID-19 Vaccination: An Equitable Response urges equity as a priority to curb the pandemic's devastation on communities of color.

This fact sheet calls on reaching those at highest risk and most vulnerable and using data to determine those categories. Examples of how to build trust with communities include using frequent, transparent communication and by forging partnerships with community health workers and other trusted messengers.

Share the fact sheet in English (PDF) and Spanish (PDF)

COVID-19's Impact on Housing Instability offers a visual overview of how the pandemic has put millions more at risk of eviction.

Share our infographic to spread the word on how the problem has disproportionately impacted some communities and how public health can help.

COVID-19's Impact on Health of the Unsheltered underscores how people experiencing unsheltered homelessness, especially those from marginalized communities, are at higher risk of COVID-19 illness and death.

The infographic also gives recommendations on ways we in public health can help both now and over the long term.

Creating the Healthiest Nation: Opportunity Youth (PDF) takes a look at the higher disease and premature death risks of disconnected youth - also referred to as opportunity youth in recognition of the benefits made possible by a return to school or work and the tremendous potential they hold.

The fact sheet highlights the toll of the COVID-19 pandemic on this population and offers solutions we can take at the local, state and federal levels to address youth disconnection.

Creating the Healthiest Nation: Children's Environmental Health (PDF) explains how exposure to environmental pollutants during childhood can have lifelong negative health impacts, including developmental delays and higher risks of cancer and asthma.

The fact sheet gives recommendations on combatting the existing disparities that worsen such health impacts for children of color and those who live in underserved communities. Those recommendations include enforcing routine testing and inspection of homes for such environmental hazards as radon, lead and mold.

Creating the Healthiest Nation: Health & Housing Equity (PDF) examines how structural racism and discriminatory policies led to housing and health inequality in America for low-income communities and people of color.

To equip public health professionals with the tools to address these inequities in their communities, the report outlines numerous ways to advance equitable change in housing equity through policy and advocacy, cross-sector partnerships and community engagement and education.

Creating the Healthiest Nation: Water and Health Equity (PDF) discusses the root problems to access and affordable water in the United States today. The fact sheet also highlights several types of water contamination that deeply impact the health of the consumer, the connection between water and agriculture and climate change, how water quality will affect some more than others, as well as recommendations on what can be done to improve our status.

Creating the Healthiest Nation: Advancing Health Equity (PDF) explains why health inequities hurt public health. The fact sheet outlines key principles for advancing health equity and takes a look at the role of such social determinants of health as housing, education, income and neighborhood conditions.

Creating the Healthiest Nation: Environmental Justice for All (PDF) defines such important terms as 'fair treatment' and 'environmental racism' and gives recommendations for advancing environmental justice. Among the key findings highlighted in the fact sheet: race is the strongest indicator for the placement of toxic facilities in the United States.

Creating the Healthiest Nation: Health and Educational Equity (PDF) gives a snapshot of which students are most at risk for not graduating from high school. The fact sheet tells us how to advance health and educational equity through such efforts as offering group therapy, giving students access to washers and dryers and making sure school staff have ongoing opportunities for culturally informed professional development.

More about health equity

Inequities are created when barriers prevent individuals and communities from accessing these conditions and reaching their full potential. Inequities differ from health disparities, which are differences in health status between people related to social or demographic factors such as race, gender, income or geographic region. Health disparities are one way we can measure our progress toward achieving health equity.

How do we achieve health equity? We value all people equally. We optimize the conditions in which people are born, grow, live, work, learn and age. We work with other sectors to address the factors that influence health, including employment, housing, education, health care, public safety and food access. 1 We name racism as a force in determining how these social determinants are distributed.

As APHA Executive Director Georges Benjamin, MD, writes in this U.S. News & World Report piece, "Health equity is a goal we can achieve, and it's within our power to do so. We have the tools and the knowledge to make health equity happen, but it's up to all of us to use them."

From The Nation's Health
Special Section: Addressing health equity through state, regional partnerships Climate change, health equity 'inextricably linked' Complete streets promoting health equity in communities: Supporting transportation for all users Health departments placing stronger emphasis on equity
More APHA Resources

All Health is Connected: Can Leveraging Women's Health Care Help Narrow Gaps in Black Men's Health? (APHA issue brief)
Climate Change, Health and Equity: A Guide for Local Health Departments
Health equity now: A state of play on public health and equity (from APHA's Public Health Newswire)

Fumes across the fence-line (from APHA's Public Health Newswire)
APHA's Georges Benjamin on "Closing the Gap on Health Disparities"
Better Health Through Equity: Case Studies in Reframing Public Health Work (PDF) highlights state and local efforts from health agencies and one Tribal Nation across Colorado, Oregon, Texas, Virginia and Wisconsin to address the root causes of health inequities.

Read APHA Executive Director Georges Benjamin's thoughts on health equity ("It is simply impossible to talk about the roles that racism and discrimination play in the health of our communities without taking a hard look inward...")

Partner Resources:

Learn More:

1 What are Health Disparities and Health Equity? We Need to Be Clear

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Creating health equity is a guiding priority and core value of APHA. By health equity, we mean everyone has the opportunity to attain their highest level of health. COVID-19 Vaccination: An Equitable Response urges equity as a priority to curb the pandemic's devastation on communities of color.

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List of the risks of Caucasians, including illnesses, disorders, ailments, maladies, and diseases associated with Caucasian race. What are the dangers unique to being Caucasian? This list includes genetic disorders and chronic conditions linked to Caucasians by the medical and science communities through research. List items include Bladder cancer, Chronic fatigue syndrome and more. The illnesses and medical conditions are listed in alphabetical order, and you can sort them by column. While many of the diseases related to being Caucasian have only been suggested through correlation, a few diseases are caused by being Caucasian and do not exist without this risk factor. Among other potential problems, being Caucasian can lead to harmful conditions. (9 Items)

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List of the risks of Caucasians, including illnesses, disorders, ailments, maladies, and diseases associated with Caucasian race. What are the dangers unique to being Caucasian? This list includes genetic disorders and chronic conditions linked to Caucasians by the medical and science communi...

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"There is substantial evidence that patients’ sex, age, diagnosis, marital status, sexual orientation, type of illness,29,30,78,89–105 and, more recently, race/ethnicity58,71,106–108 can influence providers’ beliefs and expectations."

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American Public Health Association (APHA) publications

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The American Journal of Public Health (AJPH) from the American Public Health Association (APHA) publications

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The American Journal of Public Health (AJPH) from the American Public Health Association (APHA)

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Deaths among white U.S. men and women aged 45-54 rose significantly between 1999 and 2013, according to a new analysis. This change reversed decades of progress in mortality and was unique to non-Hispanic whites in the United States. In parallel, morbidity rates increased as well. The study found self-reported declines in health, mental health, and abilities to conduct activities of daily living, accompanied by increases in reports of chronic pain, inability to work, and deterioration of liver function among this group.

Anne Case, Ph.D., and Angus Deaton, Ph.D., of Princeton University, detail these findings in a study published online on November 2, 2015 in the Proceedings of the National Academy of Sciences. The analysis was funded by the National Institute on Aging (NIA), part of the National Institutes of Health.

The three causes of death that accounted for the change in mortality among non-Hispanic whites were suicide, drug and alcohol poisoning, and chronic liver diseases and cirrhosis. The researchers used data from the Centers for Disease Control and Prevention, the U.S. Census Bureau, individual death records, and other sources for their analysis.

From 1978-1998, the mortality rate for middle-aged white Americans fell by an average of two percent per year. This matched the average rate of decline in France, Germany, Canada, Australia, Sweden, and the United Kingdom, as well as the average over all European Union countries. Other rich countries continued to decline at about two percent per year after 1998. The mortality rate for middle-aged people in the United States began to increase by half a percent a year, starting in 1999.

The authors note that the increase in midlife mortality is only partly understood. Increased availability of opioid prescription drugs, chronic pain (for which opioids are often prescribed), and the economic crisis which began in 2008 may all have contributed to an increase in overdoses, suicide, and increased liver disease associated with alcohol abuse. In their discussion, the researchers also noted that the reversal in health trends indicates that today's middle-aged adults will be entering their senior years and Medicare eligibility in worse health than today's adults age 65 and older.

Journal Reference:

Anne Case, Angus Deaton. Rising morbidity and mortality in midlife among white non-Hispanic Americans in the 21st century. Proceedings of the National Academy of Sciences, 2015; 201518393 DOI: 10.1073/pnas.1518393112

Cite This Page:

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chronic illness; teen health; diseases and conditions; health policy; mental health; racial issues; addiction; child psychology

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Death rates, health problems, rise among middle-aged white Americans: Suicide, drug and alcohol poisoning, liver diseases are top causes of death

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Deaths among white U.S. men and women aged 45-54 rose significantly between 1999 and 2013, according to a new analysis. This change reversed decades of progress in mortality and was unique to non-Hispanic whites in the United States. In parallel, morbidity rates increased as well.

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Understanding the relationship between how population groups experience "place" and the impact of "place" on health is fundamental to the social determinants of health-including both social and physical determinants.

Examples of social determinants include:

Availability of resources to meet daily needs (e.g., safe housing and local food markets)

Access to educational, economic, and job opportunities

Access to health care services

Quality of education and job training

Availability of community-based resources in support of community living and opportunities for recreational and leisure-time activities

Transportation options

Public safety

Social support

Social norms and attitudes (e.g., discrimination, racism, and distrust of government)

Exposure to crime, violence, and social disorder (e.g., presence of trash and lack of cooperation in a community)

Socioeconomic conditions (e.g., concentrated poverty and the stressful conditions that accompany it)

Residential segregation

Language/Literacy

Access to mass media and emerging technologies (e.g., cell phones, the Internet, and social media)

Culture

Examples of physical determinants include:

Natural environment, such as green space (e.g., trees and grass) or weather (e.g., climate change)

Built environment, such as buildings, sidewalks, bike lanes, and roads

Worksites, schools, and recreational settings

Housing and community design

Exposure to toxic substances and other physical hazards

Physical barriers, especially for people with disabilities

Aesthetic elements (e.g., good lighting, trees, and benches)

By working to establish policies that positively influence social and economic conditions and those that support changes in individual behavior, we can improve health for large numbers of people in ways that can be sustained over time. Improving the conditions in which we live, learn, work, and play and the quality of our relationships will create a healthier population, society, and workforce.

Healthy People 2020 Approach to Social Determinants of Health

A "place-based" organizing framework, reflecting five (5) key areas of social determinants of health (SDOH), was developed by Healthy People 2020.

These five key areas (determinants) include:

Economic Stability

Education

Social and Community Context

Health and Health Care

Neighborhood and Built Environment

Each of these five determinant areas reflects a number of key issues that make up the underlying factors in the arena of SDOH.

Health and Health Care

Access to Health Care

Access to Primary Care

Health Literacy

This organizing framework has been used to establish an initial set of objectives for the topic area as well as to identify existing Healthy People objectives (i.e., in other topic areas) that are complementary and highly relevant to social determinants. It is anticipated that additional objectives will continue to be developed throughout the decade.

In addition, the organizing framework has been used to identify an initial set of evidence-based resources and other examples of how a social determinants approach is or may be implemented at a state and local level.

Emerging Strategies To Address Social Determinants of Health

A number of tools and strategies are emerging to address the social determinants of health, including:

Use of Health Impact Assessments to review needed, proposed, and existing social policies for their likely impact on health6

Application of a "health in all policies" strategy, which introduces improved health for all and the closing of health gaps as goals to be shared across all areas of government4, 7

References

1Secretary's Advisory Committee on Health Promotion and Disease Prevention Objectives for 2020. Healthy People 2020: An Opportunity to Address the Societal Determinants of Health in the United States. July 26, 2010. Available from: http://www.healthypeople.gov/2010/hp2020/advisory/SocietalDeterminantsHealth.htm

2World Health Organization, Commission on Social Determinants of Health. Closing the Gap in a Generation: Health equity through action on the social determinants of health. Available from: http://www.who.int/social_determinants/en

3National Partnership for Action: HHS Action Plan to Reduce Racial and Ethnic Health Disparities, 2011; and The National Stakeholder Strategy for Achieving Health Equity, 2011. Available from: http://minorityhealth.hhs.gov/npa

4The National Prevention and Health Promotion Strategy. The National Prevention Strategy: America's Plan for Better Health and Wellness, June 2011. Available from: https://www.surgeongeneral.gov/priorities/prevention/strategy/index.html

5The Institute of Medicine. Disparities in Health Care: Methods for Studying the Effects of Race, Ethnicity, and SES on Access, Use, and Quality of Health Care, 2002.

6Health Impact Assessment: A Tool to Help Policy Makers Understand Health Beyond Health Care. Annual Review of Public Health 2007;28:393-412. Retrieved October 26, 2010. Available from: http://www.annualreviews.org/doi/abs/10.1146/annurev.publhealth.28.083006.131942

7European Observatory on Health Systems and Policies. Health in All Policies: Prospects and potentials, 2006. Accessed on June 16, 2011. Available from: http://www.euro.who.int/__data/assets/pdf_file/0003/109146/E89260.pdf [PDF - 1.23 MB]

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Understanding the relationship between how population groups experience "place" and the impact of "place" on health is fundamental to the social determinants of health-including both social and physical determinants.

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APHA supports National Day of Racial Healing Racism is an ongoing public health crisis that needs our attention now APHA calls out police violence as a public health crisis Declarations of racism as a public health issue
WHAT IS RACISM?
"Racism is a system of structuring opportunity and assigning value based on the social interpretation of how one looks (which is what we call "race"), that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities, and saps the strength of the whole society through the waste of human resources."
-- APHA Past-President Camara Phyllis Jones, MD, MPH, PhD
Racism structures opportunity and assigns value based on how a person looks. The result: conditions that unfairly advantage some and unfairly disadvantage others. Racism hurts the health of our nation by preventing some people the opportunity to attain their highest level of health.

Racism may be intentional or unintentional. It operates at various levels in society. Racism is a driving force of the social determinants of health (like housing, education and employment) and is a barrier to health equity.

To achieve health equity and create the Healthiest Nation in One Generation, we must address injustices caused by racism. We must support actions at all levels to ensure equal opportunity for all.

How do we do that? Through racial healing (#RxRacialHealing). That means using a healing and heart-centered approach to get rid of the false belief that any people are superior to others based on their skin color.

MORE ON RACISM AND HEALTH

Racial Equity fact sheet (PDF)

Letter from APHA to the House of Representatives in support of H.R. 1280, the George Floyd Justice in Policing Act of 2021 (PDF)

Letter to President-elect Joe Biden urging swift repeal of ban on trainings that address racial and sex stereotyping (PDF)

Communities recognizing racism as a public health crisis ( The Nation's Health)

APHA webinar series: Advancing Racial Equity

APHA webinar series: The Impact of Racism on the Health and Well-Being of the Nation

From APHA Press: Racism: Science and Tools for the Public Health Professional

Racial Equity sessions at the APHA 2020 Annual Meeting & Expo (PDF)

Webinar: A Tale of Two Pandemics: How COVID-19 and Racism Intersect With Intimate Partner Violence

APHA policy statement: Addressing Police Violence as a Public Health Issue

Racism is undeniably a public health issue (APHA's Georges Benjamin in Popular Science)

" We need to change things so that we value all people equally."(Benjamin on PBS News Hour)

Ending police violence requires public-health based approach ( The Nation's Health)

Rooting out systemic racism in America: A Q&A with Keon Gilbert ( The Nation's Health)

Letter to Congress in support of H.R. 7120, The George Floyd Justice in Policing Act of 2020 (PDF)

Dozens of Cities Dub Racism a Public Health Crisis (Bloomberg CityLab)

Aggressive Policing and the Mental Health of Young Urban Men ( American Journal of Public Health)

Racism can shape decisions to practice in underserved communities ( The Nation's Health)

Testifying before the Helsinki Commission, Gail Christopher details innovative approach toward eliminating racism and facilitating healing in the United States

Programs work from within to prevent black maternal deaths: Workers targeting root cause - Racism ( The Nation's Health)

Achieving environmental justice in the 21st century: The way forward (APHA/National Environmental Health Partnership Council webinar)

Historic lynching tied to mortality today ( The Nation's Health)

Why ending police violence is a public health issue: A Q & A with APHA's Georges Benjamin ( The Nation's Health)

APHA's Georges Benjamin on Severe weather disasters, health & structural racism: a critical intersection

From CNN: Charlottesville, hate crimes are public health issue, experts say

AJPH editorial: " Black Lives Matter: A Commentary on Racism and Public Health"

RESOURCES AND TOOLS

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APHA supports National Day of Racial Healing Racism is an ongoing public health crisis that needs our attention now APHA calls out police violence as a public health crisis Declarations of racism as a public health issue "Racism is a system of structuring opportunity and assigning value based on the social interpretation of how one looks (which is what we call "race"), that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities, and saps the strength of the whole society through the waste of human resources."

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Death rate among middle-aged white Americans on the rise

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National Review reporter Jillian Melchior and NewOak Capital President James Frischling on a new study reporting a rise in the death rate for middle-aged white Americans. Watch Charles Payne talk about Health Care and Healthy Lifestyle on Making Money With Cpayne.

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My maiden name is Purdy
My mother's maiden name is Inglis
My married name is Woodfork

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One quarter to one half of new arrivals to Virginia and the Carolinas died within one year due to diseases like dysentery, typhoid, and malaria. Others succumbed to the strain of hard labor in a new climate and a strange place—an adjustment process the English described as “seasoning.” Only 7 percent of indentures claimed the land that they had been promised.
Read more: http://www.smithsonianmag.com/history/17th-century-english-who-settled-southern-us-had-very-little-be-thankful-180953466/#4xqg0T3xTAgmiVIk.99
Give the gift of Smithsonian magazine for only $12! http://bit.ly/1cGUiGv
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The Trotula texts are considered the "most popular assembly of materials on women's medicine from the late twelfth through the fifteenth centuries."[17] The nearly 200 extant manuscripts (Latin and vernacular) of the Trotula represent only a small portion of the original number that circulated around Europe from the late 12th century to the end of the 15th century....
...The first known translation was into Hebrew, made somewhere in southern France in the late 12th century.[22] The next translations, in the 13th century, were into Anglo-Norman and Old French.[23]

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My cousin had this made for my grandfather.