Structural racism adversely affects the health of minority populations. It can open the doors to health conditions such as atopic dermatitis.

The Current State of Structural Racism

Despite its proven existence, structural racism has been questioned by general society and by professionals providing healthcare to minority populations. During a now-removed Journal of the American Medical Association podcast, the question was asked if structural racism exists. In response to the public outrage regarding this question, the American Medical Association’s CEO  and President James Madera stated, “To be clear, structural racism exists in the U.S. and in medicine, genuinely affecting the health of all people, especially people of color and others historically marginalized in society. This is not opinion or conjecture; it is proven in numerous studies, through the science, and in the evidence.” [ 1]

Structural Racism’s Effect on Atopic Dermatitis

A 2021 article published in the Journal of Allergy and Clinical Immunology proposed three pathways to atopic dermatitis (AD) that result from structural racism: socio-economic inequality, magnification of the effects of chronic psychological stress, and individual exposure to harmful physical environments [2].

Socio-Economic Inequality

Socioeconomic status strongly predicts atopic disease severity and is linked to structural racism. Black, Latinx, and Indigenous people can have lower educational opportunities, which can hinder access to well-paying employment and healthcare resources. These minority populations have poverty rates as high as 20.8%, 17.6%, and 25.4%, respectively, compared to 8.1% in the White population [2].

Chronic Psychological Stress

Racial and ethnic minorities suffer the adverse effects of systemic racism that exists across educational, employment, social, and medical spaces. Structural racism can cause chronic stress [3]. Chronic stress influences gene expression and can contribute to immune dysregulation and the development or worsening of atopic disease [2].

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Harmful Physical Environments

Black Americans are five times more likely to be incarcerated than White Americans. Incarceration leads to exposure to environmental hazards such as poor indoor and outdoor air quality. This ecological exposure is another pathway to AD [2].

Call To Action

The article lists avenues healthcare professionals can take to decrease the effects of structural racism that are pathways to conditions such as AD. These avenues include participation in policy reform, community redevelopment, advocacy, and place-based partnerships [2].

References

  1. Madara, J.L. (2021, March 10). Speaking out against structural racism at JAMA and across health care. American Medical Association. https://www.ama-assn.org/about/leadership/speaking-out-against-structural-racism-jama-and-across-health-care. 
  2. Martinez, A., de la Rosa, R., Mujahid, M., & Thakur, N. (2021). Structural racism and its pathways to asthma and atopic dermatitis. Journal of Allergy and Clinical Immunology, 148(5), 1112-1120. https://doi.org/10.1016/j.jaci.2021.09.020
  3. Physiological and Psychological Impact of Racism and Discrimination for African-Americans. (n.d.). Retrieved February 8, 2023, from https://www.apa.org/pi/oema/resources/ethnicity-health/racism-stress 

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