Confronting Institutionalized Racism

The public health community in the United States has made a commitment to ridding the nation of “racial” and ethnic health disparities. This commitment was first articulated in February 1998 as the Initiative to Eliminate Racial and Ethnic Health Disparities by the Year 2010,1 and has since been formalized in the second of the two over-arching goals of Healthy People 2010.2 In order to approach such an encompassing goal with any hope of success, we must seek to understand and address the fundamental causes of these disparities.3 “Racial” health disparities are produced on at least three levels: Differential care within the health care system, differential access to health care, and differences in exposures and life opportunities that create different levels of health and disease. “Racial” health disparities must therefore be addressed on each of these levels.