ObesityWeek

ObesityWeek

Source:

Ard JD. Addressing disparities meaningfully. Presented at: ObesityWeek Interactive; Nov. 2, 2020 (virtual meeting).

Disclosures: Ard reports he serves on the corporate advisory board of Novo Nordisk and Amgen and receives consultant fees from Nestle Healthcare Nutrition and Boehringer Ingelheim.
November 03, 2020
2 min read
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Current health disparities for Black people follow from history of structural racism in US

Source:

Ard JD. Addressing disparities meaningfully. Presented at: ObesityWeek Interactive; Nov. 2, 2020 (virtual meeting).

Disclosures: Ard reports he serves on the corporate advisory board of Novo Nordisk and Amgen and receives consultant fees from Nestle Healthcare Nutrition and Boehringer Ingelheim.
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A long history of structural racism in the United States continues to lead to health disparities today for Black people and other historically underrepresented groups, including disproportionate deaths from COVID-19, according to a speaker.

“From the birth of this nation to present day, Blacks and other disadvantaged groups have endured health outcomes that are generally worse than advantaged whites,” Jamy D. Ard, MD, professor of epidemiology and prevention and co-director of the Weight Management Center at the Wake Forest School of Medicine, said during a presentation at ObesityWeek Interactive. “History shows that the disparities and health outcomes we observe are not by happenstance, but the result of intentional decisions designed to limit access to health care.”

Ard is a professor of epidemiology and prevention and co-director of the Weight Management Center at the Wake Forest School of Medicine.

Health care disparities for Black people date back to slavery. Ard noted that Black people who were enslaved experienced poor nutrition and disease-ridden conditions that stemmed from slaveholders strategies to protect their investment at a minimal cost. There was also prejudice from white physicians who described false diseases that were “peculiar” to Black people, such as Drapetomania, a disease that was said to cause enslaved people to run away.

Health disparities in Black communities continued after the Civil War, when legislators failed to help contain disease outbreaks, resulting in high mortality rates among Black people. Ard said the ruling class’s primary concern at the time was that a healthy Black population would upend the social order.

“Disease was weaponized to limit the ability of the freed slaves to pursue the basic tenants of what America promised for everyone else: life, liberty and the pursuit of happiness,” Ard said.

In the 20th century, discrimination continued, especially in the South, as segregation took hold in many parts of life, including in health care. The Hill-Burton Act of 1946 codified separate but equal health care and denied Black people access to quality medical services and technology. Racially segregated health care was later outlawed by the U.S. Supreme Court ruling Simkins v. Moses H. Cone Memorial Hospital, in 1963.

Disparities are also rooted in the growth of employer-based health insurance after World War II. While this type of insurance became the norm for many Americans, Ard said, insurance companies discriminated against Black people and many Black people worked in jobs that did not offer health insurance benefits.

“Blacks were largely kept out of the health insurance market, through no fault of their own,” Ard said. “Without health insurance coverage, health care is a remedy of last resort, leading to poor health outcomes, driven by increased prevalence of preventable diseases.”

The COVID-19 pandemic has exposed these health care disparities, Ard said. According to www.covid-tracking.com, 21% of all COVID-19 deaths in which race is known have been in Black people, who are dying at 2.3 times the rate of white people.

“COVID is showing a bright light on a sore spot we have not taken seriously,” Ard said. “This pandemic has highlighted the life and death consequences of our inability to protect the most vulnerable in our society.”

Ard said providers need to take action to combat health disparities. He suggested health care professional support or fund research centered on disparities in underrepresented communities, advocate for the expansion of Medicaid and health access for these groups, and call out structural racism and become an active bystander.