How Structural Inequality in American Society Impacts Health Inequities and Disparities with Neil Lewis, Jr.

InOn Health Podcast

In this episode of the InOn Health podcast, Neil Lewis Jr., assistant professor at Cornell University, joins KP to discuss systemic and structural issues of inequity in American society and how they relate to health inequities and disparities. Neil explains how these themes correlate to behavioral science and public health communication.

Neil’s passion for research initially led him to study educational inequality. His findings acquired understanding factors leading to disparities in educational outcomes, ultimately leading to the study of health disparities and health equity issues due to similar undermining factors demonstrated in both domains. Researching environmental injustices is also integrated into his work because it is a driving disparity in education and health. Neil explains how America’s history of class, race, and segregation created a precedent for how people live and structured society, impacting present-day outcomes. Neil breaks down the concept of behavioral science and its purpose—multi-disciplinary disciplines drawing insights from economics, communication, sociology, and psychology to understand people’s behavior. The findings are utilized to apply suitable messaging and design policies to change behavior when appropriate.

Neil explains Americans from different demographic backgrounds have distinct understandings of how the United States operates. When the COVID-19 pandemic initially hit the United States, “The Great Equalizer” misconception emerged. When shocks to the system occur, those in good positions end up better off while those in poor positions suffer. He describes how people end up living in different worlds given society’s structure, making it psychologically difficult to understand each other’s experiences. Neil addresses how policies in the U.S. have included and excluded people from different social institutions, varying access to resources, and limiting contact with people who are different than themselves. This dynamic creates segregated social networks, impacting interpersonal interactions like doctors and patients—minority patients with white doctors can be awkward and uncomfortable, undermining trust and resulting in worse health outcomes.

Neil’s research enables decision-makers to determine which strategies are appropriate, depending on the audience and which behaviors they are trying to change. Public health communication is a form of persuasion, with three primary aspects:

1) The source and how it is perceived

2) The message and what it means in the context

3) The audience and how their experiences shape the way they hear it

Links:

Why Many Americans Can’t See The Wealth Gap Between White And Black America:

https://fivethirtyeight.com/features/why-many-americans-dont-see-the-racial-wealth-gap/

Connect with Neil:

https://www.linkedin.com/in/neil-lewis-jr-551b1b18/

https://twitter.com/NeilLewisJr

Connect with KP:

linkedin.com/in/kaakpema-kp-yelpaala-379b269/

https://twitter.com/inonhealth

inonhealth.com/podcast

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