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August 17, 2021

Ending Structural Racism in the US Health Care System to Eliminate Health Care Inequities

Author Affiliations
  • 1Department of Health Management and Policy, Dornsife School of Public Health, Drexel University, Philadelphia, Pennsylvania
  • 2Department of Health Policy and Management, School of Public Health, University of Maryland, College Park
JAMA. 2021;326(7):613-615. doi:10.1001/jama.2021.11160

Racial and ethnic inequities in the US health care system have been unremitting since the beginning of the country. In the 19th and 20th centuries, segregated black hospitals were emblematic of separate but unequal health care.1 Racism resulted in hospitals refusing to desegregate despite the passage of the Civil Rights Act in 1964 until they were forced to under threat of losing federal funds from the newly enacted Medicaid and Medicare programs in 1966.2 For American Indian and Alaska Native persons, health care has always been and remains to be segregated.3,4 Recently, the COVID-19 pandemic has highlighted long-standing, persistent inequities, with American Indian, Black, Latino, and Native Hawaiian and Pacific Islander communities being at high risk of morbidity and mortality.5