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Commentary

Racism, Chronic Disease, and Mental Health: Time to Change our Racialized System of Second-Class Care

1
Independent Researcher, Pittsburgh, PA 15215, USA
2
Southwood Psychiatric Hospital, Pittsburgh, PA 15241, USA
3
Independent Researcher, Pittsburgh, PA 15208, USA
4
Department of Pediatrics, University of California, San Francisco, CA 98158, USA
*
Author to whom correspondence should be addressed.
Academic Editors: Shelley White-Means and Altha J. Stewart
Healthcare 2021, 9(10), 1276; https://doi.org/10.3390/healthcare9101276
Received: 1 July 2021 / Revised: 18 September 2021 / Accepted: 22 September 2021 / Published: 27 September 2021
In this article, we describe how the “weathering hypothesis” and Adverse Childhood Experiences set the stage for higher rates of chronic disease, mental health disorders and maternal mortality seen in African American adults. We illustrate the toll that untreated and overtreated mental health disorders have on Black individuals, who have similar rates of mental health disorders as their white counterparts but have fewer outpatient mental health services and higher rates of hospitalizations. We discuss the history of Medicaid, which, while passed alongside Medicare during the Civil Rights era, was Congress’s concession to Southern states unwilling to concede federal oversight and funds to the provision of equal healthcare for poor and Black people. Medicaid, which covers 33% of all Blacks in the US and suffers from chronic underfunding and state efforts to weaken it through demonstration waivers, is a second-class system of healthcare with eligibility criteria that vary by state and year. We propose the adoption of a national, single payer Medicare for All system to cover everyone equally, from conception to death. While this will not erase all structural racism, it will go a long way towards leveling the playing field and achieving greater equity in the US. View Full-Text
Keywords: racism; weathering hypothesis; adverse childhood experiences; mental health disparities; Medicaid; national single payer; Medicare for All racism; weathering hypothesis; adverse childhood experiences; mental health disparities; Medicaid; national single payer; Medicare for All
MDPI and ACS Style

Albert, J.L.; Cohen, C.M.; Brockmeyer, T.F.; Malinow, A.M. Racism, Chronic Disease, and Mental Health: Time to Change our Racialized System of Second-Class Care. Healthcare 2021, 9, 1276. https://doi.org/10.3390/healthcare9101276

AMA Style

Albert JL, Cohen CM, Brockmeyer TF, Malinow AM. Racism, Chronic Disease, and Mental Health: Time to Change our Racialized System of Second-Class Care. Healthcare. 2021; 9(10):1276. https://doi.org/10.3390/healthcare9101276

Chicago/Turabian Style

Albert, Judith L., Claire M. Cohen, Thomas F. Brockmeyer, and Ana M. Malinow 2021. "Racism, Chronic Disease, and Mental Health: Time to Change our Racialized System of Second-Class Care" Healthcare 9, no. 10: 1276. https://doi.org/10.3390/healthcare9101276

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