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Of all the forms of inequality, injustice in health care is the most shocking and inhumane.

—Martin Luther King, Jr.


The first question which the priest and the Levite asked was "If I stop to help this man, what will happen to me?" But . . the Good Samaritan reversed the question: "If I do not stop to help this man, what will happen to him?"

—Martin Luther King, Jr.


For this third edition of the Color Atlas, we decided to focus on what we consider some of the most pressing social justice issues that face our country—issues that also influence healthcare and over which health providers have some influence. Most of us carry the stories of patients who were victims of racism, bullying, and hatred that sometimes escalated to direct violence or, more insidiously, undermined confidence, health, and self-esteem. All of us are aware of health disparities. What we may not realize is that data confirm that an individual's health is more strongly linked to their zip code than their genetic code; it is estimated that social and economic factors contribute 40% to health outcomes compared to 30% for health behaviors, 20% for clinical care, and 10% for the physical environment.1 In fact, a Medline search using the terms racism and health yielded 970 articles linking the two in the last 5 years.

The U.S. Office of Disease Prevention and Health Promotion has set goals for 2020 to achieve health equity, eliminate disparities, and improve the health of all groups.2 To set our sights on this goal, we, as health providers and educators, need to act by speaking out against social injustice, participating in anti-hate groups, reaching out to our communities and beyond, and creating safe and welcoming spaces in our clinical offices. Our most vulnerable patients should expect nothing less.


  • According to the Southern Poverty Law Center (SPLC), there were 917 active hate groups in the United States in 2016.3 In addition, since this past presidential election, there has been a dramatic rise in hate violence and incidents of harassment and intimidation. The SPLC fights racial and social injustice through exposing and monitoring hate groups, creating materials to teach tolerance in our schools, and using the courts and other forms of advocacy to fight on behalf of victims of bigotry and discrimination.

  • Authors of a meta-analysis of 293 predominantly U.S. studies published between 1983 and 2013 found that racism was associated with poorer mental, physical, and general health.4 These negative effects were not moderated by age, sex, birthplace or education.

  • Among black American women, perceived racism was most strongly associated with adverse birth outcomes.5

  • That racism is still a systemic problem, negatively influencing health and healthcare, was ...

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