Across the United States, communities of color experience dramatically worse health outcomes and lack of access to equitable, quality healthcare. Dr. Rochelle Walensky came to the Center for Disease Control as their new director with this in mind. 

“I came from a place of taking care of patients with HIV and infectious diseases and those who work in public health have known forever that the diseases afflicting the poor, and afflicting those with access to health care, and afflicting racial and ethnic minorities are different than the diseases afflicting white Americans, or more privileged Americans,” Walensky explains.

While addressing all of these social determinants of health that lead to racial health inequities require much more than interventions from a public health capacity and perspective, prioritizing racial inequity in healthcare is crucial in the national effort to prevent and stop the cycles of healthcare disparities. 

In particular, the toll from the Covid pandemic disproportionately impacts communities of color in the United States. Beyond the surface level tolls of 2 to 3 times higher rates of hospitalization from Covid for Black and Latinx Americans, one study found that the pandemic will result in a reduction of life expectancy for these communities 3–4 times as large as the reduction for White Americans. The level of devastation and trauma these communities endure as a result of health inequity during the pandemic alone necessitates intervention, as trauma does not strike individuals and communities at one place in time; it creates a cycle.

Racism itself and institutional oppression through reinforcing social structures, such as the criminal justice system, harm communities of color at all stages of their lives and deeply shape their health outcomes and interactions with the healthcare system. Experiences of racism, while varied among groups, are significantly correlated to adverse mental and physical health outcomes.

Mass incarceration is also a deeply entrenched issue that harms the health of communities of color. At the lowest level of offenses, such as technical violations of probations or status offenses, Black and Native American youth (at or below 17) are 3 times more likely to be confined to juvenile facilities than White youth. In California, Black youth are 8.4 times more likely to be incarcerated than White youth, compared to 4 times more likely nationally. 

Moreover, detained youth, especially youth of color, are not treated much differently than adults. In California, prosecutors send Hispanic youth to adult court at 3.4 times the rate of White youth and Native American youth are almost 2 times more likely compared to White youth to receive an adult prison sentence. Ninety-two percent of youth in juvenile facilities are in locked facilities. Two-thirds of youth are held for more than one month, and a quarter are held for more than 6 months, effectively depriving them of consistent access to family, support circles, education, healthcare, recreational, and personal development prospects. These two statistics alone make up 90% of incarcerated youth. Mass incarceration, and mass incarceration of youth in particular, continues even as research has shown that incarceration exacerbates physical and psychiatric problems.

Given this, Dr. Walensky announced her agency’s new robust initiative to address racial disparities in healthcare, Racism and Health. This initiative’s goal is to bring race equity to the top of the CDC’s agenda. To Dr. Walensky, prioritizing race equity is crucial to the agency’s implementation of interventions. “It has to be baked into the cake; it’s got to be part of what everybody is doing,” she stresses.

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Read more about Dr. Rochelle Walensky’s work in transforming the CDC here: https://time.com/5953200/exclusive-cdc-director-rochelle-walensky-racism-health-initiative/