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Racial, Social Factors Contribute to Mental Health Inequity, Baker Institute Experts Say

Inequities throughout society influence mental health research, where they can become self-perpetuating and contribute to persistent disparities in mental health services, according to new research from Rice University’s Baker Institute for Public Policy. 

The researchers argue that the same inequities that affect access to education or job security affect both mental and physical health. 

Health equity is a concept that acknowledges systemic and societal barriers to achieving health and wellness, framing health "in terms of equal opportunity to be healthy, as opposed to simply the outcome of health,” wrote Quianta Moore, MD, JD, fellow in child health policy at the Baker Institute, and Patrick Tennant, PhD, project mananger for child mental health at the institute. “The implicit declaration of this framing—that not only are we not all equally healthy, but we do not all have an equal opportunity to be healthy—is critical in addressing mental health equity.” 

Moore and Tennant say influences on the opportunity to be healthy include race, immigration status, and political, economic, and community factors. 

“In fact, decades of research demonstrate that social, environmental, and economic factors have a greater impact on health outcomes than clinical care, with 80% of health outcomes attributed to these social determinants of health (SDOH),” they wrote. 

SDOH are influenced by “conditions in the places where people live, learn, work, and play,” according to the Centers for Disease Control and Prevention. These conditions are affected by the distribution of money, power, and resources at the individual, community, and national levels, according to the paper. 

Due to historical racial and ethnic discrimination, minority populations are more likely to experience negative SDOH and are also more likely to distrust the health care system, the authors argue. 

“A critical, reflective review of the participation and contribution of the health care field to adverse conditions and community mistrust is necessary as a first step toward achieving equity,” they wrote. “We focus our inequity discussion on race because the social construct of race compounds and perpetuates disadvantage in the United States, and racial disparities exist in every outcome of individual and community well-being.” 

Despite progress, “remnants of racism and false beliefs” contribute to health inequities, the authors wrote.

The paper argues that partnering with communities and leveraging community expertise “can help remove inequities and barriers in the research-to-practice pipeline and help to correct mistaken assumptions and biases.”

“By including community-articulated needs, priorities, and recommendations we resist replicating existing service disparities in our clinical and research practice, thereby optimizing opportunities for socially disadvantaged populations to achieve mental health and well-being,” the authors wrote.

Source: Rice University