Recently, I was asked where I was from by the 5-year-old child I was babysitting. I told him I was from Colorado and, looking confused, he replied, “No, where are you really from?” Apparently he thought I was from Africa, because of my “bwown” skin (he’s still learning his r’s). Race and ethnicity are confusing for kids, so I was happy to have that conversation with him. However, it also reminded me of the countless times adult strangers have posed the question, “No, where are you really from?” When I answer, there is always the clarifying, “Okay, where are your parents from?” marked by a tone of frustration as they struggle to pinpoint my ethnicity. As it turns out, race and ethnicity can be just as confusing for adults.
These issues can be tough to talk about because they are so inextricably connected to our life experiences and the formation of our personal identity. However, our health is intricately tied to our skin color, and so it’s important that we do discuss these issues, despite our discomfort. Considerable research has shown that our race affects our health care experiences; from the way that race is linked to health status (PDF), to the discrimination faced by patients of color. In fact, research shows that white and black physicians unconsciously associate certain negative stereotypes with black patients, and that ultimately affects the treatment recommendations they make.
The data is clear that health disparities and race-based bias exist, but figuring out how to address these issues is challenging. Many factors make it difficult: the complex relationship between health and race, the way racial tensions are both politically and emotionally charged, and how often this type of bias is unintentional and unconscious, and thus hard to identify. However, there is a first step to beginning to address these issues: collect more data. We need to know more about how our efforts in Colorado are impacting communities of color. We need performance metrics from health plans, public programs, and health care providers, differentiated by race and ethnicity, so we can better understand the scope of the problem in order to address its root causes. More data can bring us greater awareness of the differences in our lives caused by the color of our skin, as well as the ways in which another person’s race can influence our own actions.
This is an important conversation, one that CCMU has made a dedicated effort to supporting, and one we’re happy to see gaining momentum in Colorado. We’ve developed some educational materials on the health of African Americans, American Indians, Hispanics and Latinos, and Asian American and Pacific Islanders; we’ve published an issue brief and developed opportunities for action. In addition to more data, we need more tactful and respectful ways to engage in conversations about race and ethnicity. It’s often frustrating, but I’m glad I’m reminded regularly of the ways in which my life experience differs from others. I’m also thankful to be working to productively contribute to conversations on race, and I look forward to hearing new voices in this important dialogue.