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How history impacts the health of a community

The social determinants of health—the economic, social and political circumstances that impact the health of individuals—was an important topic of focus during the 5th Annual National Conference on Health Disparities, where the W.K. Kellogg Foundation’s Dr. Gail C. Christopher and others shared insights as part of a
December 1, 2011 plenary discussion.

It is no coincidence that a conference focusing on the health disparities in communities of color was held in Charleston, SC.

The port city of Charleston figured prominently in early American life. Its main industry—the importation of hundreds of thousands of African slaves—fueled the economy of our young country. Though slavery was not an American invention, its impact on South Carolina and the rest of the nation was, as Abraham Lincoln would later call it, “peculiar” to our shores.  Supported by the belief that someone’s humanity was tied to the color of their skin, all privileges including physical freedom could be denied to African slaves as they were perceived as less human than other races. This mythology of race continued well after the official end of slavery and affected law, politics, commerce, church, education and yes, even our public health system.
The legalized segregation that followed slavery often meant that black people received medical care only from other black people.  Unfortunately, the number of qualified medical professionals in the black community was extremely low, a direct result of access to education and the availability of financial resources.

This history and a range of other social determinants serve as the foundation for health disparities inflicted on communities today. This was underscored by other panelists at the National Conference on Health Disparities, including Steve Suitts of the Southern Education Foundation.  Mr. Suitts shared the story of how in the 1920s the black community in Birmingham, Alabama—once described as the most segregated city in the US—suffered an outbreak of tuberculosis.  With only two black doctors in town, it was not long before there were many people afflicted with tuberculosis, both black and white.
State Representative Harold Mitchell described how segregation in his hometown of Spartanburg, SC affected the environment in which children grew up.  Decisions to dump chemical waste on the black side of town meant generations of African American children exposed to sulfuric acid and its adverse health effects as recent as this past decade.
These stories about the inequities children face today serve as the threads that connect the social injustices of the past to the health outcomes of communities of color across the U.S. today. This is why the W.K. Kellogg Foundation has made the strategic decision to work toward becoming an anti-racist organization and to promote racial equity.  It is our belief that only when we as Americans—through awareness, dialogue, understanding and finally action—deal with our underlying and often unconscious attitudes on race, a child’s demographics will not determine his or her health.
Dr. Gail C. Christopher is the vice president for program strategy at the W.K. Kellogg Foundation and leads the foundation’s work on Food, Health & Well-Being, Racial Equity, Civic Engagement, New Orleans and New Mexico place-based programming. To connect with others working to promote racial healing and equity please visit America Healing on Facebook. To learn more about the social determinants of health visit these resources provided by various conference participants:

CDC: Social Determinants of Health

CDC: Adverse Childhood Experiences Study

United Health Foundation: America’s Health Rankings

Southern Education Foundation: A New Majority: Low Income Students in the South’s Public Schools

University of South Carolina: Institute for Partnerships to Eliminate Health Disparities

AARP: What the New Health Care Law Means for Hispanics and Latinos

AARP: What the New Health Care Law Means for African Americans

Healthcare.gov: New Health Care Law Benefits for Asian Americans and Pacific Islanders


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