Is Systemic Racism a Global Medical Problem and Epidemic?

Brooke Tahir

Author: Brooke Tahir Bsc. Biomedical Science, Post grad Education

Systemic racism is not limited to any one country, in fact it is a global issue with profound impacts on the public health.

 Across all continents, racial and ethnic minorities face barriers to equitable healthcare access, poorer health outcomes, and discrimination in medical systems which, in turn, can cause other medical conditions. The pervasive nature of systemic racism makes it a significant medical problem and a public health epidemic, necessitating urgent attention on a global scale that should have been answered to, yesterday.

Systemic racism is a pervasive issue affecting millions worldwide, shaping social and economic systems in ways that directly impact health outcomes. Individuals who experience systemic racism often suffer from physical and mental health concerns, driven by chronic stress, limited healthcare access, and exposure to adverse social determinants of health. So, how being a victim of systemic racism contributes to medical difficulties across the world.

Just a note: Not one person can fix this concern, but, one person at a time, creating shifts in community culture, can.

Systemic Racism and Global Health Disparities, Systemic Racism Causes Medical Problems Globally.

Systemic racism manifests differently around the world, yet the underlying patterns of inequity and discrimination remain consistent. In the United States, Black, Hispanic, and Indigenous populations face higher rates of chronic illnesses and reduced life expectancy compared to white populations (Bailey et al., 2017). Similarly, in Australia, Aboriginal and Torres Strait Islander peoples experience significantly worse health outcomes than non-Indigenous Australians. Life expectancy for Indigenous Australians is approximately eight years lower than for non-Indigenous Australians, and rates of preventable diseases, such as diabetes and cardiovascular conditions, are disproportionately high in these communities (Australian Institute of Health and Welfare [AIHW], 2022).

In Europe, systemic racism also contributes to health disparities. Migrant and refugee populations often face barriers to accessing healthcare due to language differences, legal status, and discriminatory practices. A 2020 European Union report highlighted that migrants were more likely to receive substandard healthcare and were at increased risk of mental health issues due to experiences of racism and exclusion (European Union Agency for Fundamental Rights, 2020).

Globally, disparities in maternal and infant health outcomes provide a stark illustration of systemic racism in healthcare. In the United States, Black women are three to four times more likely to die from pregnancy-related complications than white women (CDC, 2022). This trend is mirrored in other countries with colonial histories, such as Australia and Canada. Aboriginal women in Australia are more likely to experience complications during pregnancy, and infant mortality rates among Aboriginal and Torres Strait Islander babies are double those of non-Indigenous infants (AIHW, 2022).

These disparities often stem from systemic barriers, including geographic isolation, socioeconomic disadvantage, and implicit bias in healthcare systems. For instance, Indigenous women in remote areas of Australia frequently lack access to culturally safe maternity services, further exacerbating health inequities (Kildea et al., 2021).

How do we think the Asain community felt when blame was placed on them and physical abuse was hurled towards them during the COVID-19 Pandemic? In the United States, the organisation Stop AAPI Hate documented over 9,000 anti-Asian incidents from the pandemic's onset through August 2021.

Already having these issues, we face a much more important one. How does Systemic Racism lead to biological medical problems for minority groups?

Chronic Stress and Its Biological Impact

One of the most direct ways systemic racism causes medical concerns is through chronic stress. Individuals subjected to racial discrimination experience prolonged activation of the body’s stress response, which includes elevated levels of cortisol and other stress hormones. This chronic stress can lead to “weathering,” a term used to describe the accelerated ageing of the body due to the cumulative effects of stress over time (Geronimus et al., 2006). This stress leads to things like tumours caused by ongoing elevated stress, adrenal fatigue, identity disorders and mental health issues just to name a few!

Weathering has been linked to a range of health issues, including hypertension, cardiovascular disease, diabetes, and weakened immune function. For example, studies in the United States show that Black populations, who face systemic racism daily, have higher rates of hypertension and heart disease than their white counterparts (Bailey et al., 2017). Similarly, Indigenous populations in countries like Australia and Canada report higher rates of chronic illnesses due to the stress of enduring systemic discrimination and social exclusion.

On top of all this, we have young people who are feeling the effects of racism biologically and aren't old enough to understand what they are going through. Their innocence is being taken away by the cruel world, subjecting them to racism and bias.

Racism in Clinical Settings

Implicit bias among healthcare providers further exacerbates health disparities. Victims of systemic racism often report being dismissed or disbelieved when seeking medical care. Studies have shown that Black patients in the US and Australia are less likely to receive pain management or advanced diagnostic testing compared to white patients (Hoffman et al., 2016).

This phenomenon is not unique to the United States or Australia. In the United Kingdom, ethnic minority groups have reported unequal treatment in the National Health Service (NHS), leading to worse outcomes for conditions like cancer and cardiovascular diseases (Nazroo et al., 2020). In Australia, the dismissal of Aboriginal patients' symptoms has been documented as a contributing factor to delayed diagnoses and avoidable deaths (Kelaher et al., 2014). When will these deaths of equally deserving citizens stop? When will practitioners be able to move their conscious or unconscious bias to the side when treating patients before we lose more people from it?

Social Determinants of Health

Systemic racism influences health indirectly by shaping the social determinants of health, such as income, education, housing, and employment. Victims of racism are more likely to live in under-resourced neighbourhoods with limited access to healthy food, clean water, and safe environments. These conditions increase the risk of obesity, respiratory diseases, and other chronic conditions.

For example, in the United States, historically redlined neighbourhoods or areas where black residents were denied home loans, continue to suffer from disinvestment, leading to poorer health outcomes for residents (Bailey et al., 2017). In Australia, Aboriginal communities disproportionately face overcrowded housing and poor sanitation, which contribute to higher rates of infectious diseases such as rheumatic heart disease (AIHW, 2022).

Mental Health Consequences

The mental health toll of systemic racism is massive. Constant exposure to discrimination and microaggressions as a result of long past history contributes to anxiety, depression, post-traumatic stress disorder (PTSD), and substance abuse. Studies have shown that victims of systemic racism are more likely to experience suicidal ideation and self-harm compared to those who do not face such discrimination (Dudgeon et al., 2016).

In Canada, the mental health crisis among Indigenous populations is a stark example. Generations of systemic racism, including the legacy of residential schools, have led to intergenerational trauma, manifesting as higher rates of suicide and addiction (Kirmayer et al., 2009). Similar patterns are observed among Aboriginal Australians, where the impact of colonisation and ongoing discrimination has left a lasting imprint on mental health (Dudgeon et al., 2016).

How would you feel if you lived in a world where you felt you were a insuperior citizen? That you didn't derserve to live with such superior people that seen you as someone who didn't deserve the same rights they did. These minority groups have to live with the "looks" people give them, the questions regarding their heritage and then being looked down at, the comments regarding how they became so educated etc.

Addressing Systemic Racism in Global Healthcare and Breaking the Cycle

Recognising systemic racism as a global health crisis requires a coordinated, worldwide effort to dismantle inequities in healthcare and community systems. This includes more than just policy reforms and public health interventions. What we need is education to address implicit bias among healthcare providers, institutions and more importantly, the public.

These structural inequities are deeply intertwined with health outcomes and must be targeted to achieve meaningful progress. Collaborative frameworks, such as the World Health Organization's (WHO) focus on equity in healthcare, can provide a road map for global action, they can also show that these targets aren't being met.

Addressing the medical problems caused by systemic racism requires tackling both direct and indirect factors. Policymakers must implement reforms to dismantle structural inequities, such as income inequality, housing disparities, and unequal access to education. Investments in community-based healthcare models and culturally safe medical services can help bridge gaps in care.

Training healthcare providers to recognise and address implicit bias is also essential. Initiatives like Australia's Indigenous-led health programs and the United States’ focus on anti-racism education in medical schools are steps in the right direction (Kildea et al., 2021), what is the measure of success for these programs? Is it measured statistically or is it measured by a change in the way communities tackle and see racism, OR, is it measured by police in america not asking a black man to do anything different they would a white man or not shooting a young black man when he reaches for his phone?

On a societal level, combating systemic racism involves amplifying the voices of marginalised groups and fostering inclusivity, everywhere and all the time. Public health campaigns should focus on raising awareness about the health impacts of racism and advocating for equitable policies, I can say personally that I haven't seen a meaningful sign around a hospital or school that explains the biological health risks of systemtic racism, ever. Could we have all the training and education around this topic for medical professions and the public and still have the same problem? Probably. And that is the sad part. The public health system should admit that this issue costs them money, the actions of the public, the bias, the racism does actually cost them money.

My daughter is half Indonesian and half Australian, she has come home from school and talked about the other kids commenting on her skin colour and giving her nicknames for it. How long will it take for parents to lead by example and teach their children that racism is not OK and that being different is a wonderful thing? I certainly want my daughter to be seen for her talent, creatively and academically and not for her skin colour.

 The colour of our skin does not dictate the harm we can inflict on another person and the colour of someones skin doesn't mean they are more dangerous than their white peer. Perhaps another point is that the colour of someones skin shouldn't dictate how many years in prison they recieve. I am so tired of seeing people of colour being looked at as a deficit or of higher danger to the community.

Does media inflict this bias on the community, please, riddle me this?

Conclusion

Systemic racism is a global epidemic with far-reaching implications for public health, last generation, this generation and possibly the next. From the United States to Australia and beyond, racial and ethnic minorities face persistent health disparities rooted in systemic inequities. Addressing this crisis requires a global commitment to equity, justice, and culturally saftey. By recognising and combating systemic racism, we can work toward a healthier, more equitable world for all.

Who is with me?

References

Australian Institute of Health and Welfare (AIHW), 2022. Australia's health 2022. [online] Available at: https://www.aihw.gov.au [Accessed 19 Jan. 2025].

Bailey, Z.D., Krieger, N., Agénor, M., Graves, J., Linos, N. and Bassett, M.T., 2017. Structural racism and health inequities in the USA: evidence and interventions. The Lancet, 389(10077), pp.1453-1463.

CDC, 2022. Racial and ethnic disparities continue in pregnancy-related deaths. [online] Available at: https://www.cdc.gov [Accessed 19 Jan. 2025].

Dudgeon, P., Milroy, H. and Walker, R., 2016. Working together: Aboriginal and Torres Strait Islander mental health and wellbeing principles and practice. 2nd ed. Canberra: Department of the Prime Minister and Cabinet.

European Union Agency for Fundamental Rights, 2020. Migrants in an irregular situation: Access to healthcare in 10 European Union Member States. [online] Available at: https://fra.europa.eu [Accessed 19 Jan. 2025].