A new series published in The Lancet highlights how public health researchers have neglected the significant influences that racism, xenophobia, and other forms of discrimination like casteism have on health disparities globally. While medical research has repeatedly claimed minoritized people are more prone to a wide range of conditions like cardiovascular disease, cancer, and even Covid-19 because of genetic differences, in the Lancet series, the authors said they are “inaccurate and unfounded assumptions.”
So far, a lot of medical research has focused on the myth that different races have genetic and physiological variations despite the fact that humans are genetically similar compared to other species. The authors emphasized that race and ethnicity are nothing but socio-political constructs.
“Racism and xenophobia exist in every modern society and have profound effects on the health of disadvantaged people. Until racism and xenophobia are universally recognised as significant drivers of determinants of health, the root causes of discrimination will remain in the shadows and continue to cause and exacerbate health inequities,” said lead author Delan Devakumar at UCL.
The authors further argue that public health research has failed to see the big picture by merely focusing on the individual. That has resulted in overlooking the structural inequalities and processes that have contributed to individual manifestations of diseases.
Devakumar and colleagues listed environmental, ecological, and geographical factors that affect health like racial segregation, access to green spaces, availability of nutritious food, and exposure to environmental pollutants and poor air quality.
On a structural level, they further explained that discrimination plays out via two processes — separation — where some people or communities “see themselves as being different.” Secondly, hierarchical structures that dictate race and caste determine people’s capabilities and access to privilege or capital.
“One group is separated from another, physically or socially, and an order is imposed whereby some people are seen as intrinsically of more value and more deserving of care and attention than others. For example, this process is seen explicitly in the caste systems of south Asia; however, it is often less explicit in other forms of discrimination,” the authors wrote in an executive summary published as a part of The Lancet series.
The authors listed six key principles in the Lancet series that can address the health harms of racism and xenophobia: decolonization, understanding intersections between multiple axes of discrimination, increasing diversity & inclusion, reparative and transformative justice, active promotion of racial equity by opposing racism, and human rights-based approaches.
In a Lancet press release, Gideon Lasco at the University of the Philippines, said, “Over the past few years, we have witnessed the persistence of colonialism in the present day. The COVID-19 pandemic saw access to life-saving vaccines structured along colonial and racial lines, with high-income countries in the Global North receiving privileged access to life-saving vaccines.”
“Latest estimates suggest that while 70% of people in Europe have had at least one vaccination, this number is still only 32% in Africa. An all too familiar situation is occurring in the context of the climate crisis, with minoritized populations already being adversely affected by the health impacts of climate change, despite often contributing the least to historical carbon dioxide emissions,” added Lasco. “Unless we take action to transform the systems that uphold racism and xenophobia, we will be unable to tackle racial health inequities in full, or indeed, the greatest health challenges of our day.”