Abstarct
Substantive evidence links racism and poverty to a host of chronic health conditions, adverse mental health outcomes and excess mortality, particularly among African Americans (Brondolo, ver Halen, Pencille, Beatty, & Contrada, 2009; Harrell, Hall, & Taliaferro, 2003; Jones, 2000, 2003; Krieger, 2000, 2005; Krieger, Rowley, Hermann, Avery, & Phillips, 1993; Kwate, Valdimarsdottir, Guevarra, & Vovbjerg, 2003; Mays, Cochran, & Barnes, 2007; Randall, 2006; Williams, 1999; Williams & Williams-Morris, 2000). The legacy of historic and contemporary forms of racism and discrimination towards African Americans (Latif & Latif, 1994; Washington, 2006), has also contributed to conditions of poverty and inequality (e.g., limited access to educational and employment opportunities and quality healthcare). According to the CDC (2009), African Americans are disproportionately affected by HIV/AIDS and continue to shoulder the burden of infections. However, prior prevention and control efforts have largely been limited in reducing such disparities. Critical inquiries into the range of social, economic and political forces impacting African Americans’ health are urgently needed. Unfortunately, to date, there is but a dearth of research examining the complex interplay between these broader level contextual factors and HIV/AIDS-related outcomes. Although discussions about racism and poverty are mentioned in public health literature (Clark, 2001; Darity, 2003; Krueger, Wood, Diehr, & Maxwell, 1990; Utsey & Hook, 2007), few attempts have been made to extensively address their relationship to HIV in research or health promotion or prevention interventions. The authors assert that understanding the social and economic realities faced by African Americans is a necessary requisite to effectively address this epidemic. This chapter reviews definitions of racism and poverty. The authors then discuss more generally disparate health outcomes associated with the effects of racism and poverty. The extent of these factors in the context of HIV among African Americans is elaborated. Lastly, recommendations are provided that address both theoretical and methodological implications for research and intervention development and implementation.