Race (as a social construct) is defined as a social grouping of people who have similar physical or social characteristics deemed by society to be socially significant. It is considered a social construct because race is not an intrinsic part of a human being or the environment, but rather an identity created using symbols to establish meaning in a culture or society. Race cannot be defined biologically as there are no genes that differentiates one race from another.¹

Racial identity is defined as how one perceives their own race (internally constructed) or how others perceive them (externally imposed). Racial identity is fluid, and can shift with experience and time.¹

Health disparities is defined by the CDC as “preventable differences in the burden of disease, injury, violence, or opportunities to achieve optimal health that are experienced by socially disadvantaged populations.” These populations may be further defined by factors such as race, gender, education, income, disability, sexual orientation, geographic location etc. ²

Health equity states that everyone should have a fair opportunity to attain their full health potential and that no one should be disadvantaged by achieving this potential. It is important to differentiate this from health equality.

Health equality is defined as giving everyone the same resources or opportunities. This may seem sufficient, however populations with extensive health disparities cannot get by on the same resources as populations without as many health disparities. ³

Racism is a prejudice or discrimination against people on the basis of their race or how they racially identify. It can be seen in several forms:

• Individual (Internalized) racism refers to a person’s own racist assumptions, beliefs or behaviors. It is a form of racial discrimination that is rooted in both conscious and unconscious personal prejudice. Individual Racism lies within individuals, and is usually learned from broader socio-economic processes reinforced by systemic racism.
• Interpersonal racism refers to the bias that occurs when individuals interact with others, and their internalized racial beliefs affect their public interactions. Interpersonal Racism occurs between individuals.
• Systemic racism is seen in policies and practices carried out by established institutions that excludes, or promotes the exclusion of, designated groups. It manifests in two ways:
  • Institutional Racism derives from individuals carrying out the policies of others who are prejudiced. These individuals are taking on the power of that institution when they reinforce racial inequities. Institutional Racism occurs within and between institutions and systems of power.
  • Structural Racism is viewed as the inequalities rooted in society operations as a result of the cumulative and compounding effects that systematically privilege one population while discriminating against another. Structural Racism is a bias that lies underneath the surface across society. ⁴

Social determinants of health are conditions in the environments in which people are born, live, learn, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.⁵
Examples include:

• Availability of resources to meet daily needs (e.g., safe housing and local food markets)
• Access to educational, economic, and job opportunities
  Access to health care services
• Quality of education and job training
• Availability of community-based resources in support of community living and opportunities for recreational and leisure-time activities
• Transportation options
• Public safety
• Social support
• Social norms and attitudes (e.g., discrimination, racism, and distrust of government)
• Exposure to crime, violence, and social disorder (e.g., presence of trash and lack of cooperation in a community)
• Socioeconomic conditions (e.g., concentrated poverty and the stressful conditions that accompany it)
• Residential segregations (redlining)
• Language/Literacy
• Access to mass media and emerging technologies (e.g., cell phones, the Internet, and social media)
• Culture⁵

Social determinants of health differ from physical determinants, some examples include:

• Natural environment, such as green space (e.g., trees and grass) or weather
• Built environment, such as buildings, sidewalks, bike lanes, and roads
• Worksites, schools, and recreational settings
• Housing and community design
• Exposure to toxic substances and other physical hazards
• Physical barriers, especially for people with disabilities
• Aesthetic elements (e.g., good lighting, trees, and benches)⁵

Colorism occurs when those with lighter skin are treated more favorably. It can be seen across different races or within the same race. It is important to understand that colorism is a direct result of white ideology, and reinforces the idea that white (or lighter) communities should be valued more than Black communities.⁶

• For example, the “paper bag test” was used in Black spaces and when hiring Black people. If an applicant was the same color, or lighter-skinned than a paper bag, they would be allowed in the space or considered for hire. If they were darker, they would not.

Intersectionality is how race, ethnicity, class, gender, sexual orientation, sexual expression, age, and other individual characteristics become salient and “intersect” with one another in meaningful ways.⁷

Microaggressions are everyday insults, indignities and demeaning messages sent to people of color by well-intentioned white people who are unaware of the hidden messages being sent to them.⁸

Unconscious (Implicit) Bias is immediate, unconscious bias against people of other races and ethnicities. Implicit biases are associated with a wide range of discriminatory outcomes…everything from seemingly mundane ones—like how close or far you sit to someone or the kind of eye contact you make with them in an intergroup situation—to undeniably consequential ones like being denied an employment opportunity or being less likely to receive lifesaving medical treatments. Becoming aware of one’s implicit bias, being concerned, and learning to behave in new ways are a remedy.

Code Switching is the practice typical of individuals proficient in two or more registers, dialects, or languages who will switch from one to the other depending on the conversational context or in order to enhance linguistic or social meaning. (In current day discussions on racism, code switching is taken to be what white culture demands of blacks.)

References
1. https://nmaahc.si.edu/learn/talking-about-race/topics/race-and-racial-identity
2. https://www.cdc.gov/healthyyouth/disparities/index.htm#1
3. https://www.rwjf.org/en/library/research/2017/05/what-is-health-equity-.html
4. https://www.racialequitytools.org/resourcefiles/Definitions-of%20Racism.pdf
5. https://www.healthypeople.gov/2020/topics-objectives/topic/social-determinants-of-health
6. https://www.nccj.org/colorism-0
7. https://www.racialequitytools.org/resourcefiles/Kimberle-Crenshaw-Instructors_-Guide-1.pdf
8. https://www.psychologytoday.com/us/blog/microaggressions-in-everyday-life/201010/racial-microaggressions-in-everyday-life