Twenty years after a landmark report tied systemic racism to health disparities, experts say little has changed (Source: “20 Years Ago, A Landmark Report Spotlighted Systemic Racism in Medicine. Why Has So Little Changed?,” Stat News, February 23, 2022).
“Unequal Treatment” was the first major report to point to longstanding systemic racism — not poverty, lack of access to health care, or other social factors — as a major reason for the nation’s deeply entrenched health disparities. The authors, a blue-ribbon panel of the National Academies’ Institute of Medicine, hoped their work would kick start a national discussion and lead to much-needed change.
At the time, the report sent shock waves through medicine. But today, the disparities — poorer outcomes and higher death rates for nearly every medical condition the panel examined — and the structural racism underlying them, remain. That grim truth has been made startlingly clear by both the pandemic and by statistics that show Black Americans continue to die up to five years earlier than those who are white.
“There hasn’t been a lot of progress in 20 years,” said Brian Smedley, a health equity and policy researcher with the Urban Institute who served as the report’s lead editor. “We are still largely seeing what some would call ‘medical apartheid.’”