How Do People of Color Feel about the Social Determinants of Health?

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Health has become a huge priority in the wake of the coronavirus pandemic.

People of color, who face COVID-19 disparities as the virus worsens systemic social and economic inequities, are increasingly worried about holistic health.

More Black and Latino Texans believe that the areas of life not typically associated with medical care—housing, education, racism, and other social determinants—directly impact their overall health than their white peers, according to a recently published survey from the Episcopal Health Foundation (EHF).

“Texans across racial backgrounds agree that many non-medical factors like good air quality and clean water, community safety, and amount of stress are vital to a person’s health,” EHF writes in a recent press release. “But researchers discovered a larger racial divide when it comes to other social determinants of health. The poll finds that 79% of Black and Hispanic adults in Texas say that the quality of a person’s housing is essential or very important to their health, compared to 62% of White adults who say the same.”

Worse, these issues are impacting not just the disadvantaged in Texas, but across the country.

What Did the Survey Find about Social Determinants of Health?

EHF found that most Texans, regardless of race, agree that non-medical factors—clean water, community safety, air quality, stress levels—can influence health.

But the picture changes when specific social issues are on the table:

• 74% of Black and Latino Texans believe economic factors directly impact health
• 47% of white Texans believe economic factors directly impact health
• 66% of Black and Latino Texans believe educational factors directly impact health
• 53% of white Texans believe educational factors directly impact health
• 56% of Black and Latino Texans believe racial discrimination factors directly impact health
• 42% of white Texans believe racial discrimination factors directly impact health

According to the survey’s researchers, issues directly impacting people of color, but not effecting and even benefiting white Americans, are less important to the latter group.

Not only do these issues concern people of color throughout the country, but they are causing them significant harm, according to Dr. Amelie Ramirez, the Director of the Institute for Health Promotion Research at UT Health San Antonio and Salud America!.

“Latino families are burdened by high housing costs, eviction, and displacement,” she writes in a recent Salud America! research review. “The percentage of Latinos who are ‘housing cost-burdened,’ spending 30% or more of household income on housing costs, grew from 42.4% in 2000 to 56.9% in 2015. More Latinos rent their homes (54%) than their White peers (28%). They also experience significantly higher rates of eviction and involuntary displacement.”

Are POC Across the Country Facing Similar Hardship?

Latinos and other people color, and all Americans, need more significant securities when it comes to non-medical factors impacting wellness, according to Elena Marks, EHF’s president and CEO.

This is especially true amid the coronavirus pandemic.

“COVID-19 is just the latest example of why Blacks and Hispanics are more likely to appreciate the impact that underlying, non-medical conditions have on their health,” she said in a press release. “Coronavirus is shining a light on how social and economic conditions are conspiring against the health of Blacks and Hispanics in Texas. These groups are seeing more deaths and serious complications from the virus because they’re more likely to already suffer chronic conditions related to where they live that make them more susceptible.”

Among the host of issues impacting everyone amid the pandemic, people of color are also dealing with the historical, systemic barriers that harm their growth and health.

“Most people of color say they have experienced discrimination or unfair treatment due to their race or ethnicity from time to time or regularly, including 76% of Blacks and Asians and 58% of Latinos, compared to 33% of Whites,” she writes in a recent Salud America! housing research review. “More Americans say that being Latino hurts people’s ability to get ahead in this country (51%) than say it helps (18%). More Latinos than Whites also say they have been treated unfairly in hiring, pay, or promotion (26% to 19%).”

What Can You Do?

More than anything else, dedicated and wide-reaching action is needed in the Lone Star State and throughout the country.

“Texans are telling us what they want and need, and it goes beyond just being able to see a doctor or go to a hospital,” Marks said in a press release. “It’s about finally addressing all those things outside the doctor’s office that impact their health. If we really want to improve the health of Texans, then we should listen to them.”

How can everyday individuals step up? There are so many steps the nation can take to address these problems, according to Ramirez.

“Increasing affordable housing options can improve Latino communities,” she writes in a recent Salud America! housing research review. “Cities and community partners are increasingly pushing for more affordable housing. This can be achieved through easing zoning standards, buying land to give to affordable developers, adding low-income units in mixed-income housing developments, and setting up affordable housing trust funds for future projects. Localities can help keep renters in their homes with rental housing assistance or repair programs. Rent-controlled units for low-income workers are another emerging option.

“With proper political will and community activism, change is possible.”

One way to do this is by downloading the free Salud America! “Get Your City to Declare Racism a Public Health Crisis Action Pack“!

The Action Pack will help you gain feedback from local social justice groups and advocates of color. It will also help you start a conversation with city leaders for a resolution to declare racism a public health issue along with a commitment to take action to change policies and practices. It will also help build local support.

Dr. Amelie G. Ramirez, director of Salud America! at UT Health San Antonio, created this Action Pack with input from several San Antonio-area social justice advocates.

GET THE ACTION PACK!