Systemic

April 8, 2024
Nature reporter Liverpool debuts with a damning investigation of how racism affects health outcomes across the globe. People of color are disproportionately harmed by environmental pollution, Liverpool contends, citing research that found Black and South Asian Brits are hospitalized for asthma at higher rates than their white counterparts due to living in areas with poorer air quality. Healthcare systems often exacerbate existing racial disparities, Liverpool warns, citing as an example one American health insurance algorithm that selected patients for preventive treatment based on anticipated future costs. Because Black Americans face obstacles to accessing medical care, insurers often spend less on their treatment, which led the algorithm to estimate Black patients weren’t as sick because they weren’t receiving as much care and to consequently deprioritize them. Elsewhere, Liverpool studies the biological consequences of racist policies, suggesting that studies showing early childhood trauma increases the risk of late-life dementia explain the high rates of dementia documented in aboriginal Australian peoples, who were subject to forced assimilation policies that separated children from their families between the 1910s and 1970s. The extensive research captures the alarming scope of the problem, yet Liverpool also includes reason for hope, highlighting efforts to “sequence DNA from traditionally unrepresented groups” and to support “aspiring and current doctors of African and Caribbean heritage” in the U.K. It’s a troubling assessment of a pervasive problem.