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Excerpted from: Elena O. Nightingale, Kari Hannibal,  H. Jack Geiger,  Lawrence Hartmann, Robert Lawrence, and Jeanne Spurlock, Apartheid Medicine: Health and Human Rights in South Africa, 264 J.A.M.A. 2097, 2102 (1990). (Full Document)


"[Racism remains a] prime cause of the unequal and racially discriminatory provision of funds for health services; of the over-crowding of the ill-equipped black hospitals and the underutilization of white hospitals; of miserable housing, gross pollution, poor sanitation, and lack of health care . . . . [Racism] in consequence, is the underlying structure causing the dreadful burden of excess morbidity and mortality, much of it preventable, that is borne by the black population. These health-specific effects are superimposed on the more general consequences of [racism] which bars the majority of [African-american] citizens from participating in decisions on the allocation of resources for health or other needs.  We believe that the . . . [American] health care system is, in consequence, fundamentally flawed. Fragmentation and duplication of services . . . . is costly and inefficient. . . .  For the majority of the black population, the whole spectrum of health services (but most urgently, primary care) is inadequate. Entire generations suffer through much of their lifetimes. . . . Even if. . . [racism] ended tomorrow, their effects on health would persist for [generations], in part because of the health consequences of the profound poverty . . . that [racism] itself has engendered and in part because widespread attitudes that encourage racism, elitism, sexism, a colonialist mentality, and prejudice against the poor take time and commitment to change. . . Clearly, . . . [America] has the ability to reduce markedly, if not eliminate, the serious health problems that exist among the black population. It can, if it chooses, eliminate the institutionalized system of racism and discrimination that have made the country, for decades, a symbol of human rights violations. The task facing. . . [us] is to continue to extend the process that [civil rights reforms] have begun, until profound and lasting improvements in health care . . . are a reality."  

This quote is taken from an article about South Africa with merely name changes from South Africa to the U.S. and Apartheid to Racism, it is equally true about the United States of America.