Science Says Sunday – Racism and Health

Screen Shot 2020-06-07 at 10.18.34 PMIt may come as a surprise to some, that scientists have documented the effects of racism on health outcomes. In fact, scientists have shown that racism can have significantly negative effects on a person’s health. Given the recent events we’ve experienced as a society, it’s important we cover just how racism affects the health of individuals who are on the receiving end of racism.

Science says that the impact of race on health stems largely from “differences in access to resources and opportunities that can hurt or enhance health”. These are systemic inequities that prevent individuals from equal access to health, resources, education, etc. that ensure they are secured with the best chance at good health. Scientists have also determined that racial and ethnic discrimination can not only have negative effects on health across the lifetime of individuals, but also across generations. Several studies have documented inequities in health outcomes, including some that are drastically persistent and significant.

For example, science says that some underrepresented groups (like blacks and hispanics) are at increased risk of heart disease, stroke, diabetes, low birth weight or premature birth and other serious conditions compared to non-black and non-hispanic individuals. Within the past few years, we have heard a lot about infant mortality in the news, and the fact that babies born to black mothers have been shown to be more than twice as likely  to die before reaching his or her first birthday as babies born to a white mother. Despite only recently making the news, these negative outcomes date back as far as 1950 in large published studies.

In 2010, social scientist, Dr. David R. Williams, shared a great review of what had been studied over the years in his article titled “Understanding Racial-Ethnic Disparities in Health: Sociological Contributions”, found here. Since then, numerous studies have documented the effects of racism on health, and some organizations have built archives of resources and scientific findings describing the associations between racism/discrimination and health. See an example list of those here.

In 2019, Dr. Williams published another article titled “Reducing Racial Inequities in Health: Using What We Already Know to Take Action”, where an overview of the scientific evidence pointing to critically needed steps to reduce racial inequities in health is presented.

“First, it argues that communities of opportunity should be developed to minimize some of the adverse impacts of systemic racism. These are communities that provide early childhood development resources, implement policies to reduce childhood poverty, provide work and income support opportunities for adults, and ensure healthy housing and neighborhood conditions. Second, the healthcare system needs new emphases on ensuring access to high quality care for all, strengthening preventive health care approaches, addressing patients’ social needs as part of healthcare delivery, and diversifying the healthcare work force to more closely reflect the demographic composition of the patient population. Finally, new research is needed to identify the optimal strategies to build political will and support to address social inequities in health. This will include initiatives to raise awareness levels of the pervasiveness of inequities in health, build empathy and support for addressing inequities, enhance the capacity of individuals and communities to actively participate in intervention efforts and implement large scale efforts to reduce racial prejudice, ideologies, and stereotypes in the larger culture that undergird policy preferences that initiate and sustain inequities.”

Recently, a colleague of mine, Dr. Chandra Ford, wrote a book titled “Racism: Science & Tools for the Public Health Professional”.

“This important publication builds on the racial health equity work that public health advocates and others have been doing for decades. They have documented the existence of health inequities and have combatted health inequities stemming from racism. This book, which targets racism directly and includes the word squarely in its title, marks an important shift in the field’s antiracism struggle for racial health equity. It is intended for use in a wide range of settings including health departments, schools, and in the private, public, and nonprofit sectors where public health professionals work. It will also benefit students still in training and will also serve as a practical reference text for courses and workshops. In this way, this book anticipates acting as a bridge connecting public health professionals, students, community members, as well as policymakers.”

The e-book is now available for purchase here.

Finally, Boston University Dean Dr. Sandro Galea gives a great talk on the “Healthiest Goldfish”, a story about story of Blind Willie Johnson, a blues singer who died in 1945.

While his cause of death was officially malaria, he actually died from the effects of racism and poverty, which created the conditions for his disease. Through his story, I argue that we cannot be healthy as a society until we have addressed the systemic racism that consigns so many people, like Blind Willie Johnson, to lives of poor health.

Finally, structural racism and inequities in the context of COVID-19. Data shows that blacks and hispanic are dying due to COVID-19 at disproportionate rates compared to non-blacks and non-hispanics in the US. Dr. Nancy Krieger is another scientist that has studied structural racism and its effects on health. Her lecture here, discusses the many ways structural racism negatively affects health and health outcomes. Most recently, she was part of a panel along with Dr. Mahassin Muhajid and Dr. Corinne Ridell.

Professor Nancy Krieger (Harvard, UCB Alum) along with Professors Mahasin Muhajid and Corinne Ridell (UCB) will engage in conversations about the impact of racial discrimination, social class and place on the excess disease and death rates from COVID19 among African American and other communities of color. The session will focus on some of the thorny issues related to collecting and analyzing relevant social data on COVID19; and also on advancing a social justice agenda in addressing racial/ethnic disparities in disease rates. The conversation will be moderated by Professor Rachel Morello-Frosch.

So how do we address racism as a society, so as to ensure better health for all? We start with ourselves, and address any actions that may inject racism into our communities and environments. Parade recently published “The Anti-Racist Starter Pack: 40 TV Series, Documentaries, Movies, TED Talks, and Books to Add to Your List“. Because many of my readers are avid Instagram users, here is a list of Instagram accounts you can follow as well.

To close, let me say that ending racism starts with us. With our children. With our loved ones. One small step can make a big difference. It is never too late to reflect, to assess ones own racism, and find ways to make a change. Start today.

Science Says Sunday – Summer Safety

Screen Shot 2020-05-31 at 8.19.29 PM

This past week I was asked by Univision Noticias to give insight into what people should do as states begin to lift stay-at-home orders. Many people are interpreting this in two main ways:

  1. That everything is fine now and we’re good to go “back to normal”. While that would be amazing, in many states, we’re not quite there yet. In fact, some states in the US – Alabama included – are just now starting to surge, with an increase of cases seen daily. Here’s a good link where you can determine how your state is doing and determine what activities are safe to resume if you are still seeing a lot of COVID-19 activity in your state:
  2. That lifting the orders happened too soon and the state is not ready for a return to “normal”. This may be the case in states where there hasn’t yet been a decrease in case and death counts. This applies to Alabama. In this case, people want to know how they go grocery shopping, for example, safely, since a lot more people are out and about now.

Either way, you’re likely experiencing what many are calling “quarantine fatigue”. You haven’t seen your friends, your family, your coworkers, or your neighbors. You likely haven’t been to a restaurant or movie theater in months. Perhaps you, like me, have only been out of the house for essential items and the occasional takeout meal and then straight back to the safety of your family and/or home. With the lifting of stay-at-home orders, and honestly a completely disregard by some to follow public health recommendations, it is highly uncertain if we will ever get this virus under control, so we need to figure out ways to start to find some normalcy in our lives, while being SAFE. How do we do that?

Below are two great articles that describe the risk associated with a number of activities that you may consider this summer.

From Camping To Dining Out: Here’s How Experts Rate The Risks Of 14 Summer Activities

How to weigh the risk of going out in the coronavirus pandemic, in one chart (see below)

Table showing how different places present more risks during the coronavirus pandemic: Your home is the safest place. Outdoor environments present moderate and higher risk. Indoor spaces with people you don’t live with present the highest risk.

The bottomline is that you should try to avoid the three C’s:

COVID-19 Information and Resouces

Crowded places

Closed spaces

Close-contact settings

This means that outdoor activities can provide some much needed reprieve this summer. Go for a bike, a run, a hike, perhaps an not so crowded lake or body of water, to get some fun in the sun and some much needed activity. Here are some tips that have been adapted from the CDC, Seattle Children’s, and the NIH.

Sun Safety

  • Protect yourself and your children from getting too much sun. The sun’s rays are strongest between 10 a.m. and 4 p.m., so be extra careful during that time.
  • Use sunscreen with a sun protection factor (SPF) of 15 to 30 and apply 30 min before going outside or in the water. Reapply every two hours and after being in the water or sweating. This one is tough with littles, so be creative about this step. Often, this is a good time to go over pool/beach/lake rules.Choose one that protects against UVA and UVB rays.
  • Keep children under 1 out of the sun as much as you can. Dress babies in lightweight, light-colored clothing with long sleeves and long pants, and always cover their head.
  • Note that when it is 90° or above and humid, it is recommended that children should not play outside or exercise for more than 30 minutes at a time. This means you should…

Travel Safety

  • Always wear a seat belt and strap kids into an age/weight/height appropriate seat accordingly. You can always check with your pediatrician about what that seat may be, and stop by the fire department if you need help fitting one into your rear seats.
  • Never leave children alone in a car, even for a minute. Children left in cars are at risk for heat stroke, which can lead to death. Other risks are setting the car in motion and getting injured by playing with power controls.

Riding Safely

  • Wear a helmet! Make sure kids wear one as well.
  • Teach kids about road safety, especially those who will be allowed to ride around in the neighborhood this summer. Look both ways, look for cars…they may not see you!

Water Safety

  • Never leave children alone in or near the water, even for a minute. You have to watch kids, but also adults closely. The latter is especially important when drinking. Lots of horrible accidents happen on boats when people are drinking and having a good time on lakes/oceans, etc. Be diligent. Call 800-336-BOAT for additional information on boating safely.
  • Make life jackets a cool thing to wear! Even the most experienced swimmers can tire, so when in doubt, and when in groups, especially with kids, consider wearing a life jacket.


  • Continue to wear a mask when going out of the house, wash your hands frequently, and continue to practice physical distancing from others.
  • Outdoor is best, and continue to limit interactions outside your household if possible. Some, done safely (refer to chart) may be possible, but stay vigilant.
  • Finally, we are all witnesses to the injustices faced by the African American community in the past weeks, months, years. This week you may have heard about many protests and you may be wondering, what about COVID-19? Hats off my to my friend and colleague who put together these recommendations for keeping safe while protesting:

Continue to be safe friends. We’re in for a long summer, but together, we will get through this. I close with a quote from Dr. Martin Luther King, Jr.:

The time is always right to do what is right.

And now, is the time, to do just that.

Science Says Sunday – R & R


New unicorn floating to make R&R a little less boring!

Whether you’re zooming all day, back to working your regular job, and/or doubling as a butler/playmate/chef for your kids/family, there’s no doubt 1) you’re likely getting very little down time and 2) getting very little time to yourself. The latter is less important for some than it is for others, but the former is likely important for most. Prioritizing rest and relaxation, even in the busiest or stressful of times, is important to maintain sustained levels of productivity.

I personally fall in the zooming all day and catering to my kids’ needs simultaneously. As such, the lines between work and play are often blurred, especially during this pandemic, where I find myself working all hours of the day, whenever I can fit in some time to work, zoom, or check items off my to-do list.

As I struggled with what topic to address in today’s Science Says Sunday post, my good friend and colleague Dr. Amanda Willig reminded me that talking about the “science of the importance of rest for productivity” would be a great topic to cover. In fact, two articles were primed for sharing on this very topic. The first, published March 20, 2019 titled “Stanford professor: Working this many hours a week is basically pointless. Here’s how to get more done—by doing less” based on a discussion paper series article titled “The Productivity of Working Hours” suggests that:

“…productivity per hour declines sharply when a person works more than 50 hours a week. After 55 hours, productivity drops so much that putting in any more hours would be pointless. And, those who work up to 70 hours a week are only getting the same amount of work done as those who put in the 55 hours.”

Bottom line: working longer does not necessarily mean you’re working longer or better. Working smarter is the key to checking those things off your list. So how do we do that? Keep reading.

If you are back to working on campus, in the office, or your regular worksite away from home, keeping track of hours may not be difficult because being away from home enables a clear separation of work from home in most cases. However, if you’re working from home, keeping track of hours spent working might be a bit more difficult. More and more I hear from friends and colleagues that zooming is exhausting and there are more and more meetings scheduled than ever before. Some call it the “after COVID-19 email and zoom meeting avalanche”. To some extent, that’s because of the ease of communication enabled by Zoom, but also, of course, because figuring out how to move on with work-life required a lot of meetings about how best to work remotely while accomplishing everything that once required in person interactions.

I’ve always known that resting allows me to re-group, to re-energize, and provides a recharging period that pre-kids, was easy to carve out. With kids, and especially with them at home now with me, getting that time is harder, and carving it out is guilt-inducing. So what do we do? We prioritize.

Rest and relaxation should be something you prioritize in your day or week. This is easier said than done, trust me. Advice I need to remind myself to follow quite often. Also recognize though, that rest and relaxation does not look the same for all people. For some, relaxing means going for a long run; while for others, like me, it may mean alone time including some hours to binge watch some shows on Netflix. Nevertheless, carving out that time, per day or week, is essential, and will ensure that you’re able to take on the next day, the next week, or that next big project that awaits in the wings.

Here are some things I have done to ensure I get some R&R when needed:

  1. Come up with a plan. Everything I do, goes on the calendar. If it’s not on the calendar, it’s not happening. Lately, that means that I add in the time the kids will need to eat, do homework, play, etc. I have been breaking up my day such that I concentrate on work in the morning. Take a “break” around 1-2pm, and dedicate the afternoon to the kids and all their needs. On occasion I do have meetings or work that overlaps with this afternoon kid time, but for the past two months, this schedule has worked well. After dinner, the kids get to do their own thing (eg play xbox, watch tv, play catch outside, ride bikes) while I catch up on a bit more work. We all do bedtime together, and I carve out some me-time after they go to bed.
  2. Communicate. Sharing my need to have “quiet time”, to “sleep in”, or to do whatever I need to do, requires communication with both my kids and husband. I can’t expect them to read my mind and have them know exactly when I am in need of time to recharge, especially since we all need such different amounts of recharge time and/or “me time”. My kids are older now, so they can be left alone for an hour or so in another room in the house, long enough for me to shut the door and take a cat nap or have a moment of much needed quiet. When they were younger, my hubs and I would take turns sleeping in on the weekends, or alternate who would put the kids to bed. Lately, we also do this when we want to get a workout in early or late in the day. Communication is key to ensuring you are able to get what you need.
  3. Figure out your zen. Identify what recharges you and what rest and relaxation means TO YOU. For me, sleep is a big part of it. I need at least 8 hours of sleep to feel normal. Cleaning, organizing, keeping busy also sometimes re-energizes me. It depends on the day. Other days, it means absolute quiet, no phone, and Netflix binging or a good book.
  4. Figure out what distracts you. Part of the reason I sometimes work long hours is because I entertain distractions. Social media, staring off into space, you name it. Sometimes, if the task I need to accomplish doesn’t align with my current state of mind, it will not happen efficiently. Working efficiently means you identify when you work best for what tasks. For example, I write best in the afternoon and evenings. Mornings are great too, but they are best for me to execute small tasks like email and checking small things off my list. The feeling of accomplishment propels me into a more focused state later in the day/evening. Combined with the right setting, efficient work can happen if you identify your work style and plan for that according to what you have on your to-do list.
  5. Set limits. I’ve had to learn this the hard way over the years, but there are a few things that have helped me find some balance. A clear separation between the work week and weekends has been crucial. I do still work weekends on occasion, but they are less frequent than they used to be. This provides me a true opportunity to get some rest and relaxation in on the weekends. Evenings are similar. With kids and their extracurricular activities or other needs, working evenings becomes nearly impossible anyway, but it has taught me that working efficiently during the day is essential and that I’m able to get just as much done during the day and just as quickly, as I used to before I had kids and had hard stops. This can be tough when you have littles, especially now that many of us are working at home. Finding a way to balance the unpredictability of life with babies/toddlers and work is key to being able to set limits when able. Sometimes, though, this means that you simply acknowledge that during this time, you simply will have to accomplish less than you are used to. Being realistic about what can be accomplished, under promising and over delivering at work is likely the way to go, all to ensure that you don’t burn out and that you’re able to be physically and mentally present for those babies.

The National Institutes of Health recommends sleep and rest for your overall well-being. In fact studies show that sleep/rest may be important for:

While additional research is needed on the the effects of rest alone on health, much research (linked above) suggests that sleep is super restorative and that lack of sleep has been associated with poor health outcomes. Nevertheless, rest is necessary above and beyond sleeping (says the PhD, anecdotally, but trust me nonethless?? :D), so make sure to get it in as best as possible.

On this Memorial Day weekend, you may have to do things that don’t enable you to rest and relax. Perhaps because you have to work, or because you have littles to take care of, or an elderly parent to watch after…whatever the reason, if not this weekend, make sure to figure out a way to carve out time for some R&R. Your body and brain will thank you for it. Personally, if you’re looking for me this weekend, you’ll find me floating around in our pool or sitting in front of a TV ingesting brain candy. 😉