April 13, 2021

History of Racism and Public Health

Public health is impacted by systemic and institutional racism.

Racism is ingrained in our systems, policies, and norms. Recognizing racism as a public health crisis requires a historical lens to help us understand how we got to where we are today.

As we learned in the blog Racism is a Public Health Crisis, racism is absolutely linked to health outcomes based on a person’s environment. Social determinants of health are the conditions of the environments in which people are born, live, learn, work, play, worship, and age that affect wide-ranging health and quality-of-life outcomes and risks.

Decades of unfair social, economic, and political systems have created inequitable communities that are disproportionately burdened by injury, disease, and premature death. These unfair systems aren’t random; they are rooted in racism.

Racism led to some of the following discriminatory policies in housing and transportation in the 20th century:

  • Segregated public housing
  • Defunding transit
  • Enforcing discriminatory mortgage lending practices (known as “redlining”)
  • Zoning that separated single-family homes from multi-family dwellings
  • Destroying low-income, minority neighborhoods for highways or in the name of urban renewal (gentrification)

Although laws such as the Federal Fair Housing Act (enacted April 11, 1968) sought to address housing discrimination, effects from these racist policies are still present.

For instance, homeownership in the United States is the primary way most families build wealth, but Black and Latinx families are more likely to be turned down for mortgages and have historically low homeownership rates. According to the Urban Institute, the homeownership gap between Black and white families is larger today than in 1960, when housing discrimination was blatantly legal.

One form of historic housing discrimination is racial restrictive covenants. Housing covenants are written into the contract or deed of a property that outlines permissible actions by the homeowner. Racial restrictive covenants prohibited members of a specific minority group or groups from purchasing the property.

In Seattle and King County, researcher Andrea Weiler mapped racial restrictive covenants and health indicators (such as low birth-weight, infant mortality, life expectancy, and overall mortality) and found a geographic connection between restrictive covenants and poor health outcomes. Racial restrictive covenants were common from 1926-1968 and although they are no longer legal, they can still be found on property deeds today.

Historically there has been reduced funding in communities of color, from schools to fewer parks, sidewalks, and bike lanes. Along with other key determinants of health, this blocks access to:

  • Quality education
  • Safe and affordable housing
  • Government-financed homeownership
  • Financial development opportunities
  • Transportation options
  • Clean air and water
  • Affordable and healthy food

The history of racism in America is long and complex. Structural racism has determined the conditions in which we are born, raised, work, live, and age that in turn influences our health outcomes and well-being. Over the generations, structural inequalities have resulted in clear racial and ethnic health disparities.

If you have…

5 Minutes


10 Minutes


15 Minutes

and and
Read this article
from historian of medicine Dr. Katherine Ott on racism as a public health crisis.
and  Watch this video
on the history of systemic residential race discrimination in Spokane
and Read this article
about old housing practices and poor health outcomes today in Seattle and King County.

Stand Against Racism 2021: Addressing Racism as a Public Health Crisis

Stand Against Racism will be held on April 22nd from 5:30pm – 7:00pm. To learn more and register, visit ywcaspokane.org/sar2021.

Register Today!

By: Jemma Riedel-Johnson

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