COVID-19 and Health System Segregation in the US

This book highlights and suggests remedies for the racial and ethnic health disparities confronting people of color amid COVID-19 in the United States. Racial and ethnic health disparities stem from social conditions, not from racial features, that are deeply grounded in systemic racism, operating through the White racial frame. Race and ethnicity are significant factors in any review of health inequity and health inequality. Hence, any realistic end to racial health disparities lies beyond the scope of the health system and health care. The book explores structuration theory, which examines the duality between agency and structure as a possibly potent pathway toward dismantling systemic racism, the White racial frame, and racialized social systems.

In particular, the author examines COVID-19 with a focus on the segregated health system of the US. The US health system operates on the doctrine of 'separate but equal', whereby the dominant group has access to quality health care and people of color have access to a lesser quality or zero health care. 'Separation' implies and enforces inferiority in health care. Through the evidence presented, the author demonstrates that racial and ethnic health disparities are even worse than COVID-19. As in the past, this contagion, like other viruses, will dissipate at some point, but the disparities will persist if the US legislative and economic engines do nothing. The author also raises consciousness to demand a national commission of inquiry on the disproportionate devastation wreaked on people of color in the US amid COVID-19. COVID-19 may be the signature event and an opportunity to trigger action to end racial and ethnic health disparities. 

Topics covered within the chapters include:

  • Introduction: Segregation of Health Care
  • Systemic Racism and the White Racial Frame
  • Dismantling Systemic Racism and Structuration Theory
  • COVID-19 and Health System Segregation in the US is a timely resource that should engage the academic community, economic and legislative policy makers, health system leaders, clinicians, and public policy administrators in departments of health. It also is a text that can be utilized in graduate programs in Medical Education, Global Public Health, Public Policy, Epidemiology, Race and Ethnic Relations, and Social Work.



    Prem Misir, PhD, is Professor in Public Health, Solomon Islands National University; Former Vice-Chancellor, The University of Fiji; Former Pro Vice-Chancellor, Solomon Islands Campus; and Professor and Head, School of Public Health, The University of the South Pacific. Professor Misir also is Dean, Centre for iTaukei Studies, The University of Fiji; Dean, Foundation Studies, The University of Fiji; and Dean, University-Wide Program, The University of Fiji.

    Professor Misir is the holder of the PhD (University of Hull, England); MPH (University of Manchester, England); M.Phil (University of Surrey, England); B.S.Sc. (Honours) (Queen's University of Belfast, United Kingdom); Fellow of the Royal Society for Public Health (FRSPH, England); and Certificate, Harvard University - Improving Global Health: Focusing on Quality and Safety. 

    Professor Misir was Visiting Professor of the University of the West Indies; Visiting Professor, Anton de Kom University in Suriname; and Honorary Professor at the University of Central Lancashire in England. He was the former Pro-Chancellor of the University of Guyana.

    In addition to journal articles, he is the author of 11 books, the most recent being: HIV/AIDS and Adolescents: South Pacific and Caribbean, Singapore, Palgrave Macmillan, 2019; The Subaltern Indian Woman: Domination and Social Degradation, Singapore, Palgrave Macmillan, 2018; and HIV & AIDS: Knowledge and Stigma in Guyana, University of the West Indies Press, 2013.


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