University of Wisconsin–Madison Medical College of Wisconsin

The Effect of Racism and Discrimination on the Health of Milwaukee’s African American Population

Julie L. Ellis, PhD, RN; Lynne Woehrle, PhD; Sandra Millon-Underwood, PhD; Darryl Davidson, MS; Lucy Mkandawire-Valhmu, PhD; Paru Shah, PhD; Nicole Brookshire, MBA; Jeylan Turkoglu, PharmD; Marques Hogans, MPH

WMJ. 2022;121(2):132-140,144

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Background: This scoping review focuses on the intersections of racism, health, and health care, as well as interventions for the African American population in Milwaukee, Wisconsin—one of the most hypersegregated regions in the country. We investigate what existing research provides about the impact of segregation and racism on health and consider how community setting informs health interventions, practice, and policy.

Methods: We analyzed studies that address racism and health in Milwaukee to assess the state of the science in this area. We searched databases using the terms “African American,” “racism,” “segregation,” and “health.” A total of 296 studies resulted, and 54 met the inclusion criteria.

Results: Racism is a known determinant of health. However, a lack of research investigating the impact of racism on health in Milwaukee County leaves a knowledge gap necessary for improving health among African American residents. The adverse effects of racism on health are compounded by the social, economic, and policy context of geographic and social segregation that limit access to care and resilience. Themes identified in the review include measures of physical and mental health, community factors related to health (eg, housing, environmental contamination, economic and social exclusion), intervention strategies, and theoretical gaps.

Discussion: Professionals must work across disciplines and social sectors to address the effects of racism on the physical and mental health of African American individuals in urban metropolitan environments. Health research and medical interventions in hypersegregated communities must center structural racism in their analysis.

Author Affiliations: University of Wisconsin (UW)-Milwaukee College of Nursing, Milwaukee, Wisconsin (Ellis, Woehrle, Millon-Underwood, Mkandawire-Valhmu); City of Milwaukee, Wisconsin (Davidson D); UW-Milwaukee College of Letters and Science, Political Science, Milwaukee, Wisconsin (Shah); Brookshire Customized Solutions LLC, Milwaukee, Wisconsin (Brookshire); UW-Milwaukee, Milwaukee, Wisconsin (Turkoglu); Milwaukee County Office on African American Affairs, Milwaukee, Wisconsin (Hogans).
Corresponding Author: Julie L. Ellis, PhD, RN; email; ORCID ID 0000-0001-8568-8315
Funding/Support: This work was supported by grants from the Milwaukee County Office of Arican American Affairs and Advancing a Healthier Wisconsin through the Medical College of Wisconsin, as well as Fromkin Memorial Grant from the University of Wisconsin-Milwaukee.
Financial Disclosures: None declared.
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