Two decades ago, a landmark report called Unequal Treatment, from the National Academies’ Institute of Medicine, found that systemic racism was a major reason why people of color in the U.S. experience poorer health outcomes and higher premature death rates than white Americans. A February 23, 2022 STAT article looked back at the report’s findings and recommendations, and noted that despite the awareness it raised, little has changed.

According to the report, “Racial and ethnic minorities experience a lower quality of health services, and are less likely to receive even routine medical procedures than are white Americans.” It offered detailed recommendations in areas such as availability of translators and community-based care.

David Williams, Florence Sprague Norman and Laura Smart Norman Professor of Public Health and chair of the Department of Social and Behavioral Sciences at Harvard T.H. Chan School of Public Health, was a member of the panel that produced the report. He said at the time that it was “a wake-up call for every health care professional.” He has noted that the number of Black Americans who die prematurely—many from chronic conditions that could have been treated—was equivalent to the number of people who would be killed if a fully loaded jumbo jet crashed every day. In a previous interview quoted in the STAT article, he asked, “Why are we so laid back about this loss of life on an unprecedented scale?”

Other experts quoted in the story noted that while racism is now discussed more openly in health care and academia, there has been some frightening cultural backlash. They also pointed to other reasons why more progress hasn’t been made on health equity, including complacency, the country’s fragmented health care system, and a lack of quality racial and ethnic data to track disparities.

Read the STAT article: 20 years ago, a landmark report spotlighted systemic racism in medicine. Why has so little changed?