By Emily Kim Jenkins, Contributing Writer
In 2021, over 600 signatures on a petition and 30 speakers from the general public at a San Diego County Board of Supervisors meeting assisted in the county’s official, unanimous declaration: racism is a public health crisis.
Authored by former Chairman Nathan Fletcher and former vice chair (now Chairwoman) Nora Vargas, the plan put in writing what many had already experienced: the effects of racism harm the mental and physical health of those on the receiving end, and San Diego County is far from immune. In 2024, with a spike in hate crimes nationwide (San Diego County included), the connection between racism and public health continues to be a relevant and important relationship to understand.
The effects of racism go beyond just personal reactions when it comes to health– one Commonwealth Fund study found that one in four Black and Hispanic adults aged 60 and older reported that they have been treated unfairly or were not taken seriously by health professionals because of their ethnicity. The same study found that over one in four older U.S. adults felt that they had not received the care they needed as a result of some form of discrimination.
Racism and hate come in more forms than just extreme cases of violence, threatening language or harassment. One National Institute of Health (NIH) study defines a “perceived discriminatory event” as a “behavioral manifestation of a negative attitude, judgment, or unfair treatment toward members of a group.” The study does note that these are self-reported events that were not verified by a secondhand party, but any such experience can cause an emotional stress response. These, the study says, frequently lead to negative emotional and psychological effects and may also be connected to physical ailments.
Instances of stress have immediate physical ramifications, such as elevated heart rate, rising cortisol levels and higher blood pressure – so repeated exposure to stressful events, such as discrimination or racism, can take a higher toll that may not seem obvious at first. The NIH study states that “repeated exposure to discrimination may work in ways that prepare the body to be more physically reactive in stressful or potentially stressful social situations,” which can be a significant factor in hypertension or lower the immune system’s ability to effectively prevent disease or infection.
Discrimination, both firsthand experienced and perceived from outside observances in the healthcare system, has rippling effects. The Commonwealth Fund study found that 49% of Black women say the healthcare system frequently discriminates by ethnicity or racial background. This can affect not only those struggling to get the care they want, but also may serve as a barrier that prevents an imperative trust from forming between patients and doctors of different backgrounds.
These national trends are reflected in data collected by Live Well San Diego, a county organization designed to partner with specific regions in the county to promote the health and well-being of San Diegans. The Health Equity data collected in 2022 found that 16.8% of Black San Diegan adults had reported delaying or not receiving needed medical care, the highest amount in an ethnic demographic to do so between Black Americans, white Americans, Asian American/Pacific Islanders and Hispanic Americans.
There are a host of reasons why a patient may delay receiving medical treatment, including worry of mistreatment or discrimination, but cost is typically the most cited reason in the U.S. According to a Kaiser Family Foundation survey. 60% of Black adults in the survey report bear the burden of worrying about the cost of medical care, with 65% of Hispanic adults saying the same thing.
Understanding the different aspects of community health is a necessity when seeking equity in healthcare. For more information on how health issues are affecting local communities by race/ethnicity, gender, sexual orientation and more, Public Health Services maintains Health Equity Dashboards through the county’s Health & Human Services where you can view dozens of surveys and maps that chart the health of San Diego. Clearly addressing discrimination and racism, in whatever form they are found, is key to efforts to stop hate and move people toward healing.
This resource is supported in whole or in part by funding provided by the State of California, administered by the California State Library in partnership with the California Department of Social Services and the California Commission on Asian and Pacific Islander American Affairs as part of the Stop the Hate program. To report a hate incident or hate crime and get support, go to https://www.cavshate.org/.
