In New Jersey residents with greater privilege and access to opportunities not only lead healthier lives but also are less likely to acknowledge that systemic factors including racism and discrimination contribute to poor health.
A recent poll among about 2,500 New Jerseyans by the Eagleton Center for Public Interest Polling at Rutgers University for the Robert Wood Johnson Foundation (RWJF) reveals significant differences in perceptions of health equity. Just as a combination of personal experiences, race, gender, income, education, location, and other factors determine health in New Jersey, so too do they influence public awareness and perception of health inequities and their causes.
“Structural racism is not just history. Unjust and unfair policies, practices, and norms underlie every aspect of society, enabling health inequities to persist despite medical advancements,” said Maisha Simmons, RWJF’s senior director of New Jersey grantmaking. “It’s time we truly believe that every neighborhood can be health promoting and look beyond a person’s race to ensure they have the same opportunities as someone else living just a few miles away.”
Despite glaring health disparities along racial lines in New Jersey, only a third of those polled say they feel race and ethnicity have major influence on someone’s ability to lead a healthy life. Black residents (54%) are more likely to believe a person’s race or ethnicity significantly influences health outcomes, compared to white (30%), Hispanic (29%), and Asian (28%) respondents.
The poll results will guide RWJF’s work in its home state to raise awareness of the roles that racism, discrimination, and social and environmental health factors play in achieving and perceiving health equity. Such awareness is crucial to build consensus and garner public support for policies that combat inequity by eliminating racial and economic barriers to good health.
“This first-of-its-kind poll explores New Jerseyans’ perceptions about public health determinants and disparities, with an emphasis on the crucial role that social forces play in accessing health-related opportunities,” said Ashley Koning, an assistant research professor and director of the Eagleton Center for Public Interest Polling at Rutgers University–New Brunswick. “The common threads are the stark differences in opinion by race and ethnicity and the overall lack of recognition by New Jerseyans of the root causes of these disparities.”
Among other major findings:
- Most New Jerseyans perceive unequitable healthcare access, but fewer than half (39%) feel racial discrimination interferes with New Jersey residents’ ability to get quality healthcare a “great deal” or a “good amount.”
- Women (81%) and urban residents (84%) are more likely than men and rural or suburban residents–by double digits–to say some people have a harder time accessing quality healthcare.
- Black residents (56%) are more likely to say racial discrimination affects access to quality healthcare either a “great deal” or “good amount” compared to white (36%), Hispanic (39%), and Asian residents (40%).
- Women (80%), Black residents (86%), and those living in urban areas (82%) are more likely than their counterparts–often by double digits–to strongly agree that all people should have the opportunity to lead a healthy life without disadvantages related to social position or other social determinants.
- Perceptions differ along demographic lines on the role of individual-level and societal factors on health. About 80% feel such individual factors as personal health practices (82%) and a steady, well-paying job (81%) are major influences, but similar numbers say the same about such societal factors including affordable healthcare (80%), access to healthy foods (79%), safe, affordable housing (77%) and one’s physical environment (76%).
- About 70 percent say quality childcare and education (72%), community safety (69%), access to safe and green spaces (67%), income (65%), and social support (64%) are major influences.
- About 40 percent say genetics and biology are major influence on health, and a third say the same about race and ethnicity. Women, Black, and urban residents tend to believe individual factors–particularly race and ethnicity, and genetics and biology–are major influences.
“Research clearly shows that health is strongly influenced by factors outside of anyone’s individual control,” said Dr. Leslie Kantor, chair of the Department of Urban-Global Public Health at the Rutgers School of Public Health. “These poll findings underscore the need to better educate New Jersey residents about the real challenges faced by people of color, lower- income people, women, and people living in urban areas, and the ways that systems need to change to ensure everyone’s ability to lead healthier lives.”