JUNETEENTH -- June 19, a time to commemorate freeing of the final remaining U.S. population of black slaves, months after the Civil War ended. It is also a time for sober reflection about lingering heritages of race-based disparity such as in public health. For Juneteenth 2020, we responded to the timely context of George Floyd's murder, and published our Against Racism page (at racism.p-pod.org), with a detailed Racism vs. Public Health historical analysis, plus a pictorial tour of citizen outcry about violence against unarmed African Americans.
For Juneteenth 2023, we now cover the equally timely context of worsening black maternal mortality in the U.S., and the shocking death of an Olympic champion, in our OTHER June 19 news post. In THIS post, we reprint a Juneteenth article written by our nonprofit Board of Directors member, Qadira Malika Ali (Huff), MD MPH FAAP DipABLM, on behalf of ACLM's Health Equity Achieved through Lifestyle Medicine (HEAL) Initiative, which she co-chairs. She discusses increasing race-based disparities reflected in premature deaths within the U.S. African American population overall.
On this Juneteenth holiday, we reflect on the meaning of freedom, particularly for Americans descended from enslaved Africans. Freedom takes many forms and holds a unique value to every individual. Freedom from slavery was the direct result of news of the Emancipation Proclamation reaching the enslaved communities in Galveston, Texas in the context of the very first Juneteenth in 1865. In the intervening centuries, freedoms in so many realms of society have blossomed for descendants of these survivors and for many other historically marginalized groups. Yet, we are facing an urgent threat to the future freedom of the African-American population in the form of astounding years lost due to premature death.
A recently published study in JAMA by Caraballo et al. (May 2023) reveals a staggering gap in life expectancy between White and Black US populations from 1999 to 2020. The study authors noted: "Over a recent 22-year period, the Black population in the US experienced more than 1.63 million excess deaths and more than 80 million excess years of life lost when compared with the White population. After a period of progress in reducing disparities, improvements stalled, and differences between the Black population and the White population worsened in 2020."
The COVID-19 pandemic exposed damning socio-economic and structural inequities that perpetuate racial health disparities. From racism to poverty to food insecurity and many other influences, the social determinants of health were compounded by the massive stress of the COVID-19 pandemic. According to the study analysis, heart disease was the number one contributor to excess mortality for men and women, closely followed by cancer for men. Of note, the first year of life contributed the most excess years lost between Black and White Americans. Health disparities do not wait until adulthood to develop, as we know from the crisis in Black maternal health and related racial infant mortality gap.
The health crisis highlighted in this paper urgently demands an "all hands on deck" mindset to broadly implement a health equity-driven, multi-modal approach to facilitate the chance for lasting freedom through physical, mental, emotional and spiritual health across the lifespan. Every level of health impact must be engaged - from policies to improve socioeconomic conditions and eradicate racism to redesigning the built environment to optimize health through outdoor spaces and nutritious food access. As we advocate for these broader societal changes, we must wield our Lifestyle Medicine tools in a health equity-informed manner to lead the charge around the powerful individual-level interventions that can begin to transform not just Black health, but the health of our nation, and the world, as a whole.
How may we collaboratively take up this charge as Lifestyle Medicine practitioners?
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Written by HEAL Co-Chair Qadira Malika Ali (Huff), MD MPH FAAP DipABLM on behalf of HEAL leadership, including Dr. David Bowman, MD (Co-Chair) and Dr. Daphne Bascom (Secretary).
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