Disparate Impact: How Colorblind Policies Exacerbate Black–White Health Inequities
Authors: Scott W. Delaney, Utibe R. Essien, Amol Navathe
Journal: Annals of Internal Medicine (2021)

Ideas and OpinionsOctober 2021Disparate Impact: How Colorblind Policies Exacerbate Black–White Health InequitiesScott W. Delaney, ScD, JD, MPH, Utibe R. Essien, MD, MPH, and Amol Navathe, MD, PhDScott W. Delaney, ScD, JD, MPHHarvard T.H. Chan School of Public Health, Boston, Massachusetts (S.W.D.), Utibe R. Essien, MD, MPHCenter for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (U.R.E.), and Amol Navathe, MD, PhDCenter for Health Equity and Research Promotion, Corporal Michael J. Cresencz Philadelphia VA Medical Center, and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (A.N.).Author, Article, and Disclosure Informationhttps://doi.org/10.7326/M21-1748 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail The collision of the epidemics of COVID-19 and structural racism in 2020 focused attention on ways in which Black Americans receive less and poorer-quality health care than White Americans. One common response to these inequities is to implement race-neutral or “colorblind” practices and policies designed to ensure that all persons are treated the same regardless of race. However, colorblind policies are deeply misguided (1). They often affect individuals differently—to the detriment of Black Americans—because they fail to account for structural racism and the unequal social structure in which our health care system operates.In civil rights law, race-neutral policies that ...References1. Bonilla-Silva E. Racism Without Racists: Color-Blind Racism and the Persistence of Racial Inequality in America. 5th ed. Rowman & Littlefield; 2017. Google Scholar2. Berry KN, Daniels N, Ladin K. Should lack of social support prevent access to organ transplantation. Am J Bioeth. 2019;19:13-24. [PMID: 31647757] doi:10.1080/15265161.2019.1665728 CrossrefMedlineGoogle Scholar3. Wilson V, Rodgers WM III. Black-white wage gaps expand with rising wage inequality. Economic Policy Institute. 20 September 2016. Accessed at www.epi.org/publication/black-white-wage-gaps-expand-with-rising-wage-inequality on 22 March 2021. Google Scholar4. Western B, Wildeman C. The Black family and mass incarceration. 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Chan School of Public Health, Boston, Massachusetts (S.W.D.)Center for Health Equity Research and Promotion, VA Pittsburgh Healthcare System, and University of Pittsburgh School of Medicine, Pittsburgh, Pennsylvania (U.R.E.)Center for Health Equity and Research Promotion, Corporal Michael J. Cresencz Philadelphia VA Medical Center, and Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania (A.N.).Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M21-1748.Corresponding Author: Scott W. Delaney, ScD, JD, MPH, Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Sixth Floor, Boston, MA 02115; e-mail, [email protected]harvard.edu.Current Author Addresses: Dr. Delaney: Harvard T.H. Chan School of Public Health, 677 Huntington Avenue, Sixth Floor, Boston, MA 02115.Dr. Essien: University of Pittsburgh, 3609 Forbes Avenue, Second Floor, Pittsburgh, PA 15213.Dr. Navathe: University of Pennsylvania, 1108 Blockley Hall, 423 Guardian Drive, Philadelphia, PA 19104.Author Contributions: Conception and design: S.W. Delaney, U.R. Essien, A. Navathe.Drafting of the article: S.W. Delaney, U.R. Essien, A. Navathe.Critical revision of the article for important intellectual content: S.W. Delaney, U.R. Essien, A. Navathe.Final approval of the article: S.W. Delaney, U.R. Essien, A. Navathe.This article was published at Annals.org on 14 September 2021. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byAfrican American Perceptions of Service Provided by Supplemental Nutrition Assistance Program-Education: A Qualitative ExplorationCommunity sociodemographics and rural hospital survivalPursuing Pharmacoequity: Determinants, Drivers, and Pathways to ProgressSocial support criteria in vascularized composite allotransplantation versus solid organ transplantation: Should the same ethical considerations apply?Structural Racism In Historical And Modern US Health Care Policy October 2021Volume 174, Issue 10Page: 1450-1451KeywordsCOVID-19CaregiversHealth careHealth care policyMedicarePrevention, policy, and public healthPublic policyStructural racism ePublished: 14 September 2021 Issue Published: October 2021 Copyright & PermissionsCopyright © 2021 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...