Understanding the systems that lead to racism is needed to end inequities, new book says.
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Racism continues to have a foothold in the U.S., impacting quality of life and health for tens of millions of people. A new APHA Press book peels back the layers of how systemic and structural racism in America creates a foundation on which social and racial injustices grow, leading to poor health outcomes.
“Systems That Impact Population Health: Past and Present” illuminates how various systems of inequities — based in social, health care, education and criminal justice systems — lead to health inequities. Authors of the new book, which was released this fall, explore not only how systemic racism impacts underrepresented groups, but also the underlying structure, which delves into how laws, policies, institutional practices and cultural norms oppress people of color daily.
Negative experiences create barriers to health care, increase crime and perpetuate chronic stress, which can lead to substance use, infant mortality, depression, insomnia and chronic ailments, the authors write.
“There is a history of policies created to suppress different groups for economic or territorial advantage that continue to have effects on those populations,” said Antonia Villarruel, PhD, RN, a professor and dean of nursing at the University of Pennsylvania's School of Nursing, who is one of the book's authors.
The book explores racism, oppression, marginalization and discrimination toward historically disadvantaged people, such as American Indian and Alaska Native, Asian, Black, Hispanic and Pacific Islander populations. It also showcases system approaches that address specific ways to advance health equity.
“We know science isn't enough to achieve health equity,” Villarruel told The Nation's Health. “Combining our collective strengths to work toward the goal of good health for everyone is what we hold dear.”
The volume grew out of the National Academy of Medicine's Culture of Heath Program, which seeks to build understanding of racial injustice and health inequity and identify pathways to overcome barriers. Readers get a deep picture of the issues from a dozen authors working in research, academic health and public policy.
To bring realness to the texts, authors included first-person experiences when appropriate.
“Tell us in your own words and your own way about the history,” Villarruel said of the approach. “Help us understand the systemic barriers to health equity experienced by the population. Incorporate the lived experience.”
Oppressed groups are not the only ones harmed by racism, authors note.
“We're all drinking from the same river,” said Villarruel, paraphrasing a book passage. “You may be more upstream, you may have cleaner water, but it is the same river. Whatever affects this river is also going to affect you at some point.”
Ivory Clarke, MS, senior program officer and equity and inclusion officer at the National Academy of Medicine and one of the book's authors, will be signing the new volume during an APHA Press event at APHA's 2025 Annual Meeting and Expo on Nov. 2.
For more information or to purchase “Systems That Impact Population Health: Past and Present,” visit www.aphabookstore.org.
- Copyright The Nation’s Health, American Public Health Association
