Teri Dobbins Baxter

Volume 71, Issue 3, 535-588

When health policy experts noticed that health outcomes for African Americans were consistently worse than those of their White counterparts, many in the health care community assumed that the poor outcomes could be blamed on poverty and lifestyle choices. Subsequent research told a different story. Studies repeatedly showed that neither money, nor marriage, nor educational achievement protect African American men, women, or children from poor health. Instead, the disparities were more likely explained by racism. Specifically, multiple studies have shown that experiencing racism has been linked to increased infant and maternal mortality rates, elevated stress levels, and an increased risk of numerous diseases, including cardiovascular disease, high blood pressure, and breast cancer.

Mounting evidence makes it clear that health disparities cannot be eliminated simply by changes in diet or socioeconomic status; it requires eliminating racism and building a more just society. A just society starts with a just government, but racially-biased government policies and practices have existed since the founding of our country and have had—and continue to have—a direct and devastating impact on the health of African American individuals and communities. This Article traces the racially discriminatory laws and policies enacted or tolerated by state and federal governments in America from colonial times to the present—including slavery, Black Codes, convict leasing, lynching, segregation, and discriminatory policing—and links that racism to poorer health outcomes for African Americans. It concludes by discussing the need for criminal justice and social reforms to explicitly consider their impact on the health of the African American community.