1. Laskowski-Jones, Linda MS, APRN, ACNS-BC, CEN, NEA-BC, FAWM, FAAN

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I recall the first time that I heard about racial disparities in healthcare. A wise hospital CEO gave a presentation on what was, then, a new concept to the vast majority of highly seasoned and well-educated healthcare leaders in the audience. What year was this? Surely, some time in the 1990s when outcome measurement came of age, perhaps? Alas, no. It was only about 12 years ago. Notably, all but a few of those leaders were White. The dialogue that followed was themed with denial and incredulity that racial disparities could exist in this day and age, certainly not in their organizations. How wrong they were.

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We are no better off today. The morbidity and mortality statistics for COVID-19 alone reveal striking racial disparities. Black and Brown people are far more likely to contract COVID-19 and die from it than White people. The literature is replete with data showing significant health outcome disparities in cancer, heart disease, diabetes, hypertension, and even infant mortality in people of color. Yet scientific research focused on minority populations is lagging. Although the concept of healthcare disparities related to race is now well established, its foundation remains widely unnamed. It is racism.


In all truth, I did not initially associate racism with health disparities. However, by exploring the history of slavery, unethical research methods, racial oppression, the social determinants of health, and the conscious and unconscious biases in the healthcare workforce that have caused patient harm, I recognized racism as the root cause. Mistrust, chronic psychological stress that compromises health, and anger still run deep in many people of color. It is easy to understand why.


The problem of racism is systemic. Its tentacles are embedded in the fabric of our society, producing exactly the injustice and disparate healthcare outcomes that exist today. The environment where a person lives impacts choices and opportunities. Urban areas with high poverty rates are known for their food deserts and limited access to healthcare and other essential resources that enable a healthy lifestyle.


As nurses, we adhere to a Code of Ethics that calls on us to "advance health and human rights and reduce disparities."1 That takes intentional efforts by nurses on all fronts to recognize racism and take effective action to address health inequities and improve healthcare quality. The time is now.


Until next time,



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1. American Nurses Association. Code of Ethics for Nurses with Interpretive Statements. Silver Spring, MD:; 2015. [Context Link]