Racism is a “profound” and “insidious” driver of health inequalities worldwide and poses a public health threat to millions of people, according to a global review.
Racism, xenophobia and discrimination are “fundamental influences” on health globally but have been overlooked by health researchers, policymakers and practitioners, the series published in the Lancet suggests.
Inaccurate and unfounded assumptions about genetic differences between races also continue to shape health outcomes through research, policy and practice, the review of evidence and studies found.
“Racism and xenophobia exist in every modern society and have profound effects on the health of disadvantaged people,” said the lead author, Prof Delan Devakumar of University College London.
“Until racism and xenophobia are universally recognised as significant drivers of determinants of health, the root causes of discrimination will remain in the shadows and continue to cause and exacerbate health inequities.”
The Lancet series argues that discrimination is a significant driver of racial health inequities and outlines the ways in which it harms health – including directly affecting the body via stress responses, profoundly shaping living environments and limiting individuals’ opportunities to improve health.
The authors call for wider recognition of racism and xenophobia as fundamental determinants of health and for the implementation of measures that focus on the structural causes.
The Guardian has exposed the consequences of these political and social drivers in a series of stories focusing on major health disparities.
In August, it was revealed that black and Asian people in England have to wait longer for a cancer diagnosis than white people, with some forced to wait an extra six weeks.
The analysis of NHS waiting times and the world’s largest primary care database by the University of Exeter and the Guardian discovered minority ethnic patients wait longer than white patients in six of seven cancers studied. Race leaders called the results “deeply concerning” and “absolutely unacceptable”.
In the series from the Lancet, the authors also outline how medicine has historically shaped and supported the categorisation of humans that have led to modern-day social hierarchies.Across a wide range of health conditions – from cancer to cardiovascular disease to Covid-19 – ethnicity and race are often listed as risk factors.
But the reasons why ethnic minorities are at greater risk have received “inadequate scrutiny” from health professionals and researchers, and there is a tendency to assume these inequities are genetically determined and unchangeable, said the Lancet.Its review challenges this notion and the argument that disparities can be explained by patterns of socioeconomic deprivation among racial and ethnic groups.
“Racism is a health issue,” said Richard Horton, the editor-in-chief of the Lancet. “Our structurally racist societies are unsafe for too many communities, families and individuals.”
The Lancet series marks a moment for health professionals “to recommit ourselves” to “defeat these insidious social pathologies – pathologies that for too long we have chosen to ignore”, he added.