Juneteenth: Emancipation and the Road to Health Equity

June 19, 2024 | Wendy Nickel

This is the third year Juneteenth is officially recognized as a federal holiday. It is also the third year in which more Americans are becoming aware of the events that led up to declaring this historical date a holiday. It marks the date when 2,000 Union troops arrived in Galveston Bay, Texas to free 250,000 enslaved Black people, although the Emancipation Proclamation had been signed 2 ½ years earlier.

Juneteenth is a time to celebrate the myriad achievements of the African American community since emancipation, while also reflecting on how far we have to go to achieve equity for all in this country. Despite the declaration that all enslaved people were free in 1863, our country repeatedly failed to protect the most vulnerable among us, allowing laws to pass which furthered segregation and discrimination against African Americans. These actions had a significant impact on the health of the community. For example, redlining, policies that allowed individuals and institutions to deny services and loans to African Americans, had a damaging impact on communities of color. Redlining was found to be associated with higher rates of pre-term delivery in the Black community in New York City. When the Jim Crow laws were abolished in 1964, there was a considerable improvement in Black infant mortality rates. Additionally, studies reveal that redlining was associated with higher rates of breast cancer mortality in census tracts in Atlanta.

Other discriminatory and dubious practices have led to mistrust of the medical establishment. Perhaps most notorious was the Tuskegee experiment during which many African American men and their families suffered unnecessarily from lack of treatment for syphilis, despite there being a treatment. The experiment ran unchecked for 40 years before it was shut down in 1972. Another infamous case contributed to lack of trust of public health and health establishments by the Black community. Researchers removed cells from the body of Henrietta Lacks who died from cervical cancer without the consent of her family. These cells were later used to create treatments for cancer and infectious diseases, but her family never received compensation.

These policies and practices continue to contribute to disparities in health outcomes among the African American community today. These include shorter life expectancy, higher infant mortality, and higher rates of chronic disease. Additionally, Black people experienced greater rates of infection and death from COVID. This put a spotlight on the need to address the factors that cause inequities in health, such as low income, barriers to access to care, and mistrust of vaccines.

HCIF is committed to promoting policies, practices, and programs which advance health equity. Our Health Equity Data Strategy (HEDS) program supports partners in the collection, stratification, and utilization of racial, ethnicity, and language (REaL) data. This provides an opportunity to track health disparities and implement interventions to mitigate them. HCIF also facilitates the regional Community Health Needs Assessment (rCHNA), which tracks regional health indicators by race, allowing hospitals to identify health priorities for different communities. Additionally, the CHNA provides trending analysis for indicators to determine whether initiatives have made an impact. More importantly, however, HCIF partners with community trusted organizations and individuals with lived experience to provide insights on health priorities in their own communities. HCIF has also made a significant commitment to anti-racism by investing in staff development and evaluating programs to ensure they actively promote equitable practices.

We still have a long way to go in achieving health equity in the United States. Juneteenth provides an opportune time to reflect, recommit, and rededicate our work to mitigating racism in health care and improving health disparities.

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