O ne of the greatest challenges facing the United States are health inequities among racial/ethnic and other marginalized populations. The deep-rooted structural racism embedded in our social systems, including our health care system and health workforce, is a core cause of racial health inequities. 1 Among many definitions of institutionalized or structural racism, Dr Jones 2 best defines it as: "Differential access to goods, services and opportunities of society by race … It is structural, having been codified in our institutions of custom, practice, and law, so there need not be an identifiable perpetrator." Dr Jones further explains that to set things right in our country, we have to address this type of racism that is embedded in all of our systems. Historical and existing structural obstacles have significantly reduced access to health professions education among marginalized populations in the United States. 3,4 This has rendered an underrepresentation of Black, Latino, and Native persons in health professions schools, practice, and leadership. 5,6 This commentary presents the evidence of and potential avenues for beginning to address structural racism in the health care workforce. We discuss how historical and present-day racism impacts recruitment and retention of historically excluded groups in the health professions (eg, Black, Latino, and Native people) and the investments needed to dismantle the impacts of structural racism on the diversity of our health workforce.
Objective: A growing body of research finds that darker skin tone is often associated with poorer physical and mental health in Blacks. However, the psychosocial mechanisms underlying the skin tone-health link remain elusive. The present study seeks to address this knowledge gap by investigating the direct and indirect (through perceived discrimination, socioeconomic status, and self-esteem) effects of skin tone on self-reported physical and mental health. Design: An urban sample of 130 Blacks aged 35 and above completed a self-administered computerized survey as a part of larger cross-sectional study. Results: Self-esteem played a particularly important role in mediating the associations between skin tone and self-reported physical and mental health. This suggests that self-esteem could be a point of intervention to help Blacks with darker skin tone achieve better health. Conclusion: The present study highlights the important role feature-based discrimination plays in determining mental and physical health outcomes among Blacks.
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