An American Health Dilemma

Perception is Reality, and Reality Drives Perception: No Time to Celebrate Yet

“…The list is startling: transportation policies that decimated parks and gathering places and tore communities of color in half; environmental policies that located incinerators and diesel bus routes in specific vulnerable communities; public education policies that chronically underfunded certain communities compared to others; public housing policies that allowed only women and children as residents, instead of fathers and intact families; criminal justice sentencing policies that delivered harsher punishment for drugs, such as crack, seen predominately in communities of color and more lenient sentences for forms of the same drug (powder cocaine) seen predominately in communities of higher socioeconomic status. 9,10 A good example is the shift in management of the heroin (and opioid) epidemic. In the 1970s and '80s, when these drugs were the scourge of minority communities, a punitive, criminal justice-based approach was used for those who were addicted, resulting in mass incarceration.…”

The evolution of healthcare for Louisville's African American community, 1865-1990.

“…Similar to the presented study, the authors paint a picture of the evolution of health and health care for black Americans from America's earliest history. Although Byrd & Clayton (2000) provide a clear picture of race and health care in the United States in general, it does not reveal the more intimate details of a single community, the specific stereotypes and bias that excluded the black citizens from participating in the health care system managed by whites of that community and how that system came to adjust to the current, integrated one.…”

“…In addition, there have been historical studies about the segregated health care available to black Americans (Byrd & Clayton, 2000;Savitt, 2007). For most of the periods following the end of the Civil War to the mid-20 th Century, the availability of many goods and services was restricted to individuals according to race.…”

“…What began as a racially segregated system is now a racially integrated health care system throughout the United States. Progress toward an integrated health care system was influenced by many factors including legislation, historical events, socioeconomic forces and geographic setting, especially for the black American population (Byrd & Clayton, 2000;Gilman, 1985;Gordon, 2003;Savitt, 2007).…”