How racism impacts health, from MDH's Dr. Brooke Cunningham

Earlier in her practice as a physician in a Minneapolis clinic, Dr. Brooke Cunningham met a patient from Bemidji. He had driven four hours just to seek care.

She remembers being surprised he’d travel so far.

“I like primary care to be easily accessible, and a four-hour drive does not seem that,” she said. She asked him about it.

“And he said, ‘Well, you know, they don't treat us right up there,’” Cunningham recalled in an interview with MPR News host Cathy Wurzer.

“And by ‘us,’ he meant American Indians, right? He meant the people in his community, and he wanted to make sure he got good care. Because that's so important. We all want to be healthy.”

To Cunningham, the experience was an example of how racism can affect care and well-being— whether implicitly or explicitly.

“Much of what we know about racism is, it's not about intent,” Cunningham said. “And much of what we know how our health systems operate to produce disparate outcomes is not about intent.”

Cunningham oversees the new Minnesota Department of Health Equity Bureau as assistant commissioner. The bureau, which was launched in March, works on initiatives across the entire agency, and houses the MDH’s Center for Health Equity, the office of American Indian Health and the Diversity Equity and Inclusion office.

“I think it's important for us to really think from a trauma informed lens,” she said. “And really take the lens off of individuals or communities as something being wrong with them, but rather, something wrong has happened to them, right? Harm has happened.”

That’s everyday experiences of racism, but also ultra-traumatic events, such as witnessing the murder of George Floyd at the hands of a police officer. It was most traumatic for folks who share his social demographics, she said — other Black men.

And that lived trauma has an impact on health.

Black Americans are more likely to experience high blood pressure, chronic conditions such as diabetes and heart disease.

“All of those discrete health outcomes … are the downstream results of structural racism in particular,” Cunningham said.

“And that's why it's so important that we in public health, as well as health care, focus on racism as a fundamental cause of disease … if the context of their lives were different, they may not even have hypertension, or may be able to better control it.”

Use the audio player above to listen to the full conversation.

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