Racism is a key social determinant of health,1 and there is extensive evidence that shows differences in life expectancy experienced by people of different racial identities.2 Racism is also a key factor in determining how people access health services, receive diagnoses, treatment and care, and are perceived within the health system.3 A lack of cultural safety within the health sector means that many are unable to access the care they need.
Racism in health is about more than just individual attitudes impacting on a person’s experience, such as when the bias of a particular healthcare professional impacts their engagement with a particular patient.4 Experiences of racism are often the result of policies, practices, and institutional biases that inform the very architecture and culture of our health system.5 This means that individual prejudices are often left unchallenged, or even reinforced within the health system, or that reports of racism may not be adequately dealt with.
In addition, experiences of racism in health are compounded by racism experienced in other parts of society, and mutually reinforce one another. For example, consider how unequal opportunities in employment and education, discrimination in housing, or racism within the justice system might impact or be impacted by an individual’s health. Racism has economic, social and political implications that can increase or limit an individual’s life expectancy.
Different health outcomes based on race are not inevitable. In many cases, communities are working to address this inequity, and advocating for systemic reform. This includes sustainable and adequate funding to, and expansion of, the Aboriginal and Torres Strait Islander Community Controlled Health sector, or programs to support the growth of First Nations and culturally and linguistically diverse workforces across health sectors to improve on cultural safety. Initiatives such as the Queensland Aboriginal and Torres Strait Islander Health Equity Framework are working to centre community voices in the design of healthcare services that impact them.
By reflecting on the impact of racism, and taking a stand against it, we can build a fair and equal society – for all.
It stops with me.
1 Department of Health, National Aboriginal and Torres Strait Islander Health Plan 2013-2023 (Report, 2013) <https://www.health.gov.au/resources/publications/national-aboriginal-and-torres-strait-islander-health-plan-2013-2023>.
2 Australian Institute of Health and Welfare, Deaths in Australia (Web Report, 2021) <https://www.aihw.gov.au/reports/life-expectancy-death/deaths-in-australia/contents/life-expectancy>.
3 Yin Paradies, Mandy Truong and Naomi Priest, ‘A Systematic Review of the Extent and Measurement of Healthcare Provider Racism’ (2014) 29(2) Journal of General Internal Medicine 364; Chloe FitzGerald, Samia Hurst, ‘Implicit bias in healthcare professionals: a systematic review’ (2017) 18(19) BMC Medical Ethics 1.
4 Chelsea Watego, David Singh and Alissa Macoun, ‘Partnership for Justice in Health: Scoping Paper on Race, Racism and the Australian Health System’, (Discussion Paper, The Lowitja Institute, May 2021) 19 <https://www.lowitja.org.au/content/Image/Lowitja_PJH_170521_D10.pdf>.
5 Chelsea Watego, David Singh and Alissa Macoun, ‘Partnership for Justice in Health: Scoping Paper on Race, Racism and the Australian Health System’ (Discussion Paper, The Lowitja Institute May 2021) 19 <https://www.lowitja.org.au/content/Image/Lowitja_PJH_170521_D10.pdf>; Christopher John Burke, Henrietta Marrie and Adrian Marrie, ‘Transforming institutional racism at an Australian hospital’, (2019) 43(6) Australian Health Review 611.