The Effect of Modern Day Racial and Social Stratification on African Americans

timer Asked: Mar 13th, 2019
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Question Description

This is a final research paper, it should be 7 pages long with a citations page, 12 pt font, double spaced. Please integrate all the provided papers whether it's a direct quote or paraphrase (Please no more than one or two direct quotes, paraphrasing is okay)

The paper is about how African American individuals suffer from class and racial inequality in the United States.

It should include the following aspects:

1. Power: How African American individuals lack power in the United States in comparison to the upper white class who control the corporates, economy, and the government in a way to help their business growth (An example would be how some large corporates avoid paying federal taxes)

2. Wealth: The unequal distribution of wealth when comparing the upper white class with lower class African Americans.

3. Inequality: How this racial and social stratification affects black individuals in the health and education systems.

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BETTER HEALTH THROUGH EQUITY Case Studies in Reframing Public Health Work MARCH 2015 Healthy People 2020, the nation’s health objectives for the current decade, defines health equity as the “attainment of the highest level of health for all people. Achieving health equity requires valuing everyone equally with focused and ongoing societal efforts to address avoidable inequalities, historical and contemporary injustices, and the elimination of health and health care disparities.” Such goals aren’t unfamiliar to public health practitioners—the field has a long and storied tradition of serving the most vulnerable and bringing life-saving care to communities that would have otherwise gone without. And while the nation has come a long way in identifying, acknowledging and addressing disparities1 in health and health care access, it is clear that eliminating disparities cannot be accomplished without seriously addressing the underlying social determinants of health2, many of which are shaped and perpetuated by bias, injustice and inequality. Across the country, state and local public health agencies are taking up this call to action in earnest, integrating a health equity framework at an organizational level and using equity values to drive community health work. The following are five case studies exploring the experience of public health departments as they make a concentrated shift toward achieving health equity. 1. What’s the difference between health disparities and health inequities? According to Paula Braveman in an article published in Public Health Reports, “Health equity means social justice in health (i.e., no one is denied the possibility to be healthy for belonging to a group that has historically been economically/socially disadvantaged). Health disparities are the metrics we use to measure progress toward achieving health equity. A reduction in health disparities (in absolute and relative terms) is evidence that we are moving toward greater health equity.” (Source: 2. The social determinants of health are the conditions in which people are born, grow, live, work, and age. These circumstances are shaped by the distribution of money, power, and resources at the global, national, and local levels. Examples of resources include employment, housing, education, health care, public safety, and food access. (Source: THE VALUE OF INVESTING IN HEALTH EQUITY The efforts chronicled in this series of case studies are not only designed to improve health outcomes, they are also poised to save the country billions in health care spending. According to one study published in 2009, more than 30 percent of direct medical costs faced by African Americans, Hispanics and Asian Americans can be tied to health inequities. Because of inequitable access to care, these populations are sicker when they do find a source of care and incur higher medical costs. That 30 percent translates to more than $230 billion over a four-year period. If health disparities among minorities had not existed between 2003 and 2006, direct medical care spending would have been reduced by a whopping $229.4 billion. Source: ACKNOWLEDGEMENTS With support through CDC Cooperative Agreement#5U38HM000459-05, the American Public Health Association (APHA) contracted with Kim Krisberg to conduct a series of 5 case studies of state, local and tribal health agency efforts to create health equity. We would like to acknowledge the staff at the health agencies that provided the information essential to this report. We are grateful for their participation and willingness to share their stories. The contents of this report are solely the responsibility of the authors and do not represent any official views or endorsement by CDC. CDC funds were not used to fund the work described in the report. This report is not designed to support or defeat enactment of any legislation, pending before Congress or any state or local legislature. Federal, state, tribal and local jurisdictions apply differing rules regarding engagement with legislative bodies and other policy-related activities. Jurisdictions considering legal or other policy initiatives should seek the assistance of state or local legal counsel. Additional guidance for CDC funded recipients may be found at TABLE OF CONTENTS ACHIEVING HEALTH EQUITY: LESSONS LEARNED.................................. Page IV SHIFTING THE DISCUSSION, APPLYING A NEW LENS (MULTNOMAH COUNTY, OREGON).........................................................Page 1 EQUITY IN ACTION: Multnomah County..................................................Page 5 HARNESSING THE POWER OF CROSS-SECTOR COLLABORATION (MENOMINEE INDIAN TRIBE, WISCONSIN).............................................Page 9 EQUITY IN ACTION: Menominee Indian Tribe.........................................Page 13 MAKING HEALTH EQUITY A COMMUNITY AFFAIR (VIRGINIA).......Page 16 EQUITY IN ACTION: Virginia Department of Health................................Page 21 INTEGRATE AND OPERATIONALIZE: RECOGNIZING EQUITY EVERY DAY (COLORADO) .....................................................................Page 24 EQUITY IN ACTION: Colorado Department of Public Health and Environment ..................................................................................Page 30 TRANSFORMING THE WORK OF COMMUNITY HEALTH (TEXAS) .....Page 32 EQUITY IN ACTION: Texas Department of State Health Services ............Page 36 About APHA APHA champions the health of all people and all communities. We strengthen the public health profession. We speak out for public health issues and policies backed by science. We are the only organization that influences federal policy, has a 140-plus year perspective and brings together members from all fields of public health. BETTER HEALTH THROUGH EQUITY: CASE STUDIES IN REFRAMING PUBLIC HEALTH WORK | Page III ACHIEVING HEALTH EQUITY: LESSONS LEARNED A number of lessons learned identified as essential to successfully implementing a health equity framework were gathered during APHA’s Better Health Through Equity project. The following are the most salient. WITHIN YOUR ORGANIZATION: Achieving health equity first begins with building knowledge, understanding and capacity within your organization or agency. listen and learn about the lives of the people you serve. This may throw a wrench into all of your preconceived plans and force you to go back to the drawing board. But that’s okay—achieving health equity may mean taking as many steps backward as we do forward. 1 ACKNOWLEGE THAT EQUITY IS MORE THAN ANY ONE, SINGLE INTERVENTION: Health equity truly is a state of mind. It’s a framework within which public health practitioners from all disciplines can work. Making a purposeful shift toward achieving health equity forces us to consistently view health status within the larger context of society and history and will ultimately bring public health farther upstream than it’s ever been before. 2 6 BUILD TRUST: Trust is the foundation of all health equity work. In fact, it may be the only starting point that will lead to sustainable progress. Building trust requires having an open mind, being flexible, listening to people’s stories, respecting and integrating traditional ways, engaging community leaders and empowering people with the means to seek change for themselves and their communities. WITHIN YOUR PRACTICE: Achieving health equity means allowing community values and priorities to shape and inform interventions. Science-based evidence is always important to measuring needs and progress, but gaining community buy-in is critical to sustainability. HAVE AN OPEN AND HONEST DIALOGUE: Start a conversation in your health agency—and ideally across fellow public agencies—about racism, bias and inequality and how they contribute to disparate health outcomes. Use an icebreaker such as the documentary “Unnatural Causes: Is Inequality Making Us Sick?” and make sure you tailor the event to fit your audience and create a respectful environment. Talking about inequity is not always a comfortable exercise—in fact, it can put some people on the defensive—but it is vital to gaining buy-in and shifting the focus from traditional disease prevention to tackling the social determinants of health. 7 PARTNER, PARTNER, PARTNER: Moving toward health equity means zeroing in on the social determinants of health, which also means that the public health sector can’t achieve health equity on its own. Transportation, housing, health care, employment, environmental quality, working conditions, education, child care, law enforcement—all of these sectors and many more have a role in creating the conditions that enable all people and communities to attain and sustain good health. Public health workers are uniquely skilled at convening players across sectors, and this skill will be invaluable in achieving health equity. 8 3 WITHIN YOUR COMMUNITY: Achieving health equity requires an empathetic approach that acknowledges a community’s history, respects its traditions, listens to its stories and actively engages its members as leaders in any health equity intervention. 4 COMMUNITY OWNERSHIP IS PARAMOUNT: Community participation is intrinsic to health equity work. This is probably a nobrainer for most practitioners, as community engagement is a fundamental component of public health work. However, ensuring that the community is involved in every aspect of health equity work—from data gathering to implementation to evaluation—is key. 9 10 BE MINDFUL OF HISTORY: Government and public policy played enormous roles in perpetuating the very biases, injustices and inequalities that created the health disparities and inequities we seek to address today. Be mindful that many communities are still very much experiencing and facing the effects of historical trauma. As a public official, coming into such a community with a predetermined plan and top-down approach only perpetuates that trauma. 5 FOLLOW THE DATA, BUT…: Data are essential to the work of public health. We need data to pinpoint problems, deploy resources, track progress, evaluate effectiveness and justify continued support. But in the work toward health equity, data can’t be the only driver. For example, worrisome data on prenatal care may lead you to initiate contact with a community. However, residents might have more pressing concerns, such as few employment opportunities, difficulties affording enough food and unsafe housing conditions. These are the issues you have to tackle first if you want to positively impact infant health in the long term. LET GO OF YOUR AGENDA: Avoid going into a community that has a long history of experiencing health and social inequities with a predetermined agenda. Instead, go in with an open mind and simply PAY ATTENTION TO PROCESS: The process of developing strategies to create health equity is as important as—and sometimes even more important than—the actual initiatives. If you can create a process for developing interventions that is truly community-driven and founded on trust, you have a better chance of sustaining momentum on the long journey toward health equity. KNOW WHEN TO STEP ASIDE: Despite your skills, experience, education and competencies as a public health practitioner, you might not be the best person to implement a strategy to create health equity on the ground. Many successful health equity efforts recruit and train workers from the community who have the same lived experience as the residents you are hoping to reach. Keeping this in mind will help build trust, community ownership and sustainability. Page IV | BETTER HEALTH THROUGH EQUITY: CASE STUDIES IN REFRAMING PUBLIC HEALTH WORK SHIFTING THE DISCUSSION, APPLYING A NEW LENS Multnomah County Health Department, Oregon “When we talked about disparities it was simply reflecting the data. We weren’t telling the whole story, we weren’t talking about the structural pieces. …Until we started looking through a lens of race, power and poverty, we really weren’t moving upstream. Now we’re focusing on the conditions that lead to the outcomes we see.” — BEN DUNCAN FORMER PROGRAM MANAGER OF THE MULTNOMAH COUNTY HEALTH DEPARTMENT HEALTH EQUITY INITIATIVE AND CURRENT DIRECTOR OF THE COUNTYWIDE OFFICE OF DIVERSITY AND EQUITY I n 2008 and in the wake of a report on racial and ethnic health disparities in Multnomah County, Ore., local officials launched the Health Equity Initiative, a countywide effort to raise community awareness of the root causes of health inequities and put forth real solutions. The effort—led by the Multnomah County Health Department with strong support and participation from county leadership—began with the seemingly simple but critical step of encouraging honest, reflective and often challenging conversations about the connections between racism, injustice and health disparities. Those community conversations eventually led to the creation of the Equity and Empowerment Lens: Racial Justice Focus, a health equity tool that is slowly transforming the everyday work of public health in Multnomah County. BETTER HEALTH THROUGH EQUITY: CASE STUDIES IN REFRAMING PUBLIC HEALTH WORK | Page 1 VISUALIZING INEQUITY Tackling health equity in a meaningful way means confronting the social determinants at the root of poor health and engaging the officials and community stakeholders who are well positioned to drive change. But first, organizers in Multnomah County needed a way to jumpstart cross-sector collaborations, community conversations, and the slow, sustained drive toward systemic change. Taking on the social determinants of health would mean talking openly about oppression, racism and personal bias—topics that can make people uncomfortable or even defensive—and organizers needed an inclusive conversation starter. Health Inequity by the Numbers Out of 33 counties in Oregon, Multnomah ranks 15 in health outcomes. Some examples of health inequities in Oregon and Multnomah County include: In 2011, 26 percent of Multnomah County children younger than 18 were living in poverty, as compared with a statewide rate of 23 percent and a national rate of 14 percent. 26% Multnomah County 23% 14% USA Oregon An estimated 108,000 of Oregon’s children ages 0–6 are at risk of not being ready for kindergarten as a result of poverty, adverse childhood experiences, and other risk factors that are highly associated with or most often predicted by race and ethnicity. 108,000 In 2010–2011, only 63 percent of Multnomah County ninth-graders graduated from high school within four years, as compared with 68 percent statewide. Multnomah County Oregon 63% 68% Source: 3 To do that, staff from the Health Equity Initiative turned to film, specifically the four-hour PBS documentary Unnatural Causes: Is Inequality Making Us Sick?  3 In 2008, they began hosting local screenings of the documentary, using the film to develop a shared understanding of the social determinants that contribute to poor and disparate health outcomes. In all, the initiative hosted 57 screenings open to both county officials and community members, eventually reaching more than 500 people. The screenings had three main goals: raising community awareness, building the capacity to address inequity, and advancing relevant policy solutions. During the screening events, trained volunteers from county agencies and the community facilitated open and honest discussions on the topic. According to Ben Duncan, former program manager of the Multnomah County Health Department Health Equity Initiative and current director of the countywide Office of Diversity and Equity, Unnatural Causes “gave us new ways to talk about equity…the concepts and values weren’t new, but all of a sudden we had a language to talk about it.” “Unnatural Causes created a platform to shift the conversation from disparities to inequities—it was Page 2 | BETTER HEALTH THROUGH EQUITY: CASE STUDIES IN REFRAMING PUBLIC HEALTH WORK a very intentional shift,” Duncan says. “We used the screenings as catalysts to start having conversations about what people were experiencing, but also to start thinking about the types of needed policies to address [health inequities] and the root causes that actually lead to lifelong negative health impacts. We went from a typical public health approach…and we created a vision for building partnerships, addressing issues like education, and getting engaged in activities that were traditionally out of the purview of public health.” “FINDING OUR TRUE NORTH”: APPLYING A HEALTH EQUITY LENS In the fall of 2012, the Multnomah County Office of Diversity and Equity launched the Equity and Empowerment Lens (E&E Lens, link on page 8) to address inequities in services, policies, practices, and procedures across the county. Based on the health department’s pilot equity framework, the E&E Lens was developed to help county agencies integrate key questions rooted in justice and inclusion into their decision making. The new movement was a priority—the county’s Office of Diversity and Equity had even created a new position dedicated to institutionalizing the lens countywide. In an introductory letter outlining the new equity lens, then health department Director Lillian Shirley wrote: “This work takes stepping into an unknown space, a space that makes us vulnerable. Answering the Lens questions and institutionalizing clear, systemically-based recommendations based on equity and empowerment requires us to be brave, courageous, and persistent in our efforts. Focusing specifically on racial justice is essential for the health of all of our communities, because racial and ethnic inequities are the most prevalent and pronounced according to our data.” The E&E Lens also benefits organizations by driving quality improvements, providing a more accurate assessment of client needs, and offering an enhanced ability to explain how the work and role of an agency contribute to the community. The E&E Lens leads agencies through nine questions that “seek to uncover patterns of inequities, separate symptoms from [the] actual causes of such inequities, and maintain the visibility of impacts on communities of color, immigrants, and refugees.” For example, questions urge agency officials and staff to consider which particular group will be affected by a policy or decision or to think about how certain processes contribute to the exclusion of populations that disproportionately experience inequities. At the county health department, according to Duncan, an administrative policy dictates that all programs use the E&E Lens. “You’ll see the language of equity within almost every program within the agency,” he says. T he lens can help workers realize that regardless of their competencies and professional education, they might not be best positioned to effectively deliver public health services within every cultural context. BETTER HEALTH THROUGH EQUITY: CASE STUDIES IN REFRAMING PUBLIC HEALTH WORK | Page 3 “There is no doubt that if you asked what a core value of the health department was, all staff would talk about equity.” H OUSIN CRIMIN A JUS T IC L E G TRANSP ORATIO N PU HE BL IC AL TH N ow, because of the deeper understanding of social deter- minants brought about by the equity initiative, public health is regularly at the table with officials from transportation, criminal justice, education, and housing. All agencies better ...
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The Effect of Modern Day Racial and Social Stratification on African Americans




The Effect of Modern Day Racial and Social Stratification on African Americans
Racial and social stratification are still prominent in the United States in spite of the
measures which different stakeholders are adopting to contain the problem. While the country
has adopted a wide range of strategies to end discrimination of any form in the United States,
especially racial discrimination, it is important to note that the practice is still rampant in the
United States. The African Americans are some of the groups which are worst hit as a result of
the problem in the country. Since the era of the slave trade, African Americans in the United
States have faced a wide range of racial and social discriminations, and these have had adverse
effects on their life in the country. Racial and social stratification affect the social, economic, and
cultural aspect of the lives of African Americans. In areas such as education, healthcare and
access to the justice systems, the African Americans have always faced a tremendous level of
discrimination. These issues have in many cases had adverse effects on the status and quality of
life of the African Americans. The modern-day racial and social stratification has denied African
Americans an opportunity to have equal access to education, healthcare, and the justice systems
and that has had adverse effects on the status and conditions of their lives.
African Americans’ access to education in the United States
Access to education is an important factor which impacts the well-being of any
individuals in any county. Apart from access to the economic resources in the country, education
also plays an important role in helping individuals to fit into society. While examining the access
to education among African Americans, many people usefully forget about the discrimination
which African Americans faced in the education sector before the onset of the Civil Rights
Movement. During this period, African Americans did not attend the same schools as whites.



They schooled in separate environments where there was poor infrastructure as well as lowquality conditions of learning. The whites were determined to ensure that African Americans did
not receive the highest quality of education. After the Civil Rights Movement of the 1960s, there
was a change in the approach to the provision of education since it was no longer legal to
practice segregation in education. The period of the 1970s was a significant increase in
equalization funding, and that was evidenced by the increase in the performance between African
American and other minorities against the whites in major national tests such as the National

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