Within the US, racial disparities in health have remained stark: Blacks have higher rates of sickness and infant mortality than other races, and the shortest life spans. Racial stereotypes, exclusion and discrimination are chronic stressors and take a toll on black health. Institutionalized racism operates in less visible ways to undermine health, such as less spending on public services in black neighbourhoods. The adverse effects of these policies are compounded in a society that emphasizes social mobility through hard work yet offers limited opportunities for the disadvantaged to achieve that mobility. The nation’s poor health outcomes reflect racial and class inequalities in access to health care and decent living conditions, and tarnishes the reputation of its medical system and its image as a world leader.
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