In the United States, health inequities — defined as differences in death and disease that have been imposed systemically by unequal access to social or economic resources — are major public health and economic concerns.
In a recent article published in the Journal of the American Medical Association, health inequities expert Dr. Thomas LaVeist and colleagues reported the economic burden of racial/ethnic health inequities is estimated to be between $421 billion and $451 billion. Additionally, the estimated burden of education-related health inequities is between $940 billion and $978 billion. According to the report, most of this burden is attributable to the poor health of Black Americans and adults whose highest level of education is high school.
Education is a driver of health and in the U.S. race/ethnicity, education and health are inextricably linked. Black adults, who on average have lower levels of education and less wealth due to systemic inequities and structurally racist policies, experience the highest premature death rates. For example, in Virginia the maternal mortality rate is 14.1 per 100,000 persons for white women, compared to 38.2 per 100,000 persons for Black women.
Although health is ultimately the responsibility of the individual, an individual’s health is influenced by a complex interaction of factors. For example, policies influence access to quality education. An individual’s education influences their health literacy, health behaviors and access to resources that impact health. Therefore, improving the educational outcomes of Black Americans will have a positive impact on this group’s health.
Historically Black colleges and universities are in a unique position to help achieve health equity. HBCUs make up only 3% of the country’s colleges and universities. However, they enroll 10% of Black undergraduate students and award 13% of bachelor’s degrees earned by Black graduates.
Virginia is home to five HBCUs. Despite their significant role in educating Black people, public HBCUs in the commonwealth receive less funding than their majority white counterparts. According to a 2022 report published in Forbes, Virginia State University has received $147,735,930 less funding than white public universities since 1987. By and in large, the unequal funding of HBCUs can be ascribed to racist policies and practices. Specifically in Virginia there is no formula for allocating money to public universities. To some extent, funding depends on successful lobbying. This inherently biased practice and the lack of fair guidelines for distributing funds are detrimental to the growth and development of HBCUs.
Indisputably, a legislature that supports the impartial funding of HBCUs is essential. However, the burden of improving the educational outcomes of Black Americans does not fall solely on policy makers. HBCUs must do their part to ensure their students receive an education that prepares them to be competitive in a global market.
To achieve this, HBCUs must embrace a sort of diversity and inclusion that involves adopting hiring practices that go beyond relying on small networks to fill leadership positions. They must adopt practices and policies that yield highly qualified governing boards and administrators capable of cultivating innovative solutions, fiscal conservatism and academic excellence.
Additionally, administrators must immediately rise to the challenge of creating strong research programs. This is imperative because the unique contributions of Black scientists are crucial to the design and implementation of efficacious health interventions, as well as for training the next generation of leaders.
In sum, ridding the nation of health inequities is a complex problem and shared responsibility. Thus, accomplishing Healthy People 2030’s goal of health equity will require sustained investments by institutions and individuals. Through equitable funding and effective leadership, HBCUs can make significant contributions to improving the health of Black Americans and eliminating health inequities.
Leah Floyd, Ph.D., is a behavioral scientist trained in psychology and public health. She has more than 20 years of experience in research and higher education, holding an appointment as associate professor of psychology at Hampton University from 2015-2018 and associate professor of psychology at Norfolk State University from 2018-2023.