The contribution of research to racial health equity? Blame and responsibility in navigating the status quo of anti-black systemic racism

Thirty-seven years ago, the Secretary's Task Force on Black and Minority Health called attention to a “national paradox” of persistent Black-White health disparities despite overall health improvements for the nation (HHS, 1985). Subsequent updates to the “Heckler Report” came to the same conclusion; Black Americans continued to exhibit poorer health in comparison to White Americans (Satcher et al., 2005). Current population health statistics demonstrate Black-White health disparities comparable to 1985 (AHRQ, 2018; Shiels et al., 2021; Wall et al., 2018). Although psychological, behavioral, social, and economic factors all contribute to Black-White differences in health, there is a noticeable increase in discussions about the importance of systemic racism in producing racial health disparities. This article addresses three questions relevant to research on racism and the health of Black Americans: (1) Why has academic public health research on racism failed to reduce racial health disparities? (2) What can academic public health scientists do differently to reduce the impact of systemic racism on inequities among Black and White Americans? (3) What can Black Americans do in the face of present-day anti-Black systemic racism? We argue that to convert the vision of health equity into a visible reality, health equity research scientists must move beyond discussion, observation, and description. We also argue that to demonstrate progress in reducing racial health disparities, health equity scientists will need to work much more directly on eradicating racism as a fundamental cause of health differences between Black and White Americans. As scientists, the challenge we face is how to accomplish this mission without leaving the realm of science. Racism is a social determinant of Black health and social determinants are political problems. Political problems require political solutions.