Written by: Connie Zhang
The social injustice of racial inequality is a global issue that runs skin deep. In essence, the ethnic equity gap in skin health is rooted in unequal standards of living, visual underrepresentation, and bias in treatment. Dermatologic disparities create unjust challenges for minorities, including adverse health outcomes. However, agencies, like Neutrogena and more, have launched skin health initiatives in the fight for equity.
Image Source: Formidable Woman Magazine
As a result of unequal standards of living due to racial discrimination, the skin of certain minority groups pays the price. The research of Alexandra Shields, an associate professor of medicine at Harvard Medical School, theorized the possibility that trauma, poverty, and exposure to air pollution negatively affect epigenetic mechanisms. This inequity can be attributed to a predisposition to experience certain environmental exposures among disadvantaged communities. For the most part, low and unequal standards of living conditions potentially increase the risk of chronic diseases and impact the skin. For instance, minorities in displaced surroundings suffer from specific risk factors that make them especially vulnerable to diseases, like atopic dermatitis which is an inflammatory skin disease. Potentially, poor living conditions and lack of access to medical care expand the susceptibility to atopic dermatitis.
Another racial inequity is the visual underrepresentation of health conditions that affect darker skin. Based on a 2011 U.S. survey, 47% of dermatologists reported that their medical education provided inadequate training on skin diseases in dark skin. In fact, it has been proven that patients of color are underrepresented in research and clinical trials. Consequently, the medical community often has unconscious bias and a lack of preparation for the extent of needs in dark skin health. These effects can be understood by the experiences of Kerry Washington, a mixed-race model for InStyle who experienced dermatologic inequities in her treatment for eczema, a condition characterized by dry and itchy skin and more. In the past, dermatologists have suggested a type of topical medication and laser exfoliation that wasn’t healthy for her pigmented skin. Without wanting younger generations to undergo the same issues she did, Kerry Washington, using her platform as an InStyle model, advocates for the underrepresentation of minorities in dermatology and the effects this can have on patients such as herself.
Discriminatory bias in treatment causes a lack of equality in the clinical care of minority skin health. Unfortunately, the late diagnosis, misdiagnosis, and missed diagnosis of diseases occur for many minorities. For example, 25% of African American people are diagnosed with melanoma cases at a late stage. By that time, cancer has often already spread to lymph nodes. As a result, the survival rates for people of color are often lowered, since it is harder to treat skin cancer at later phases.
In an effort to improve the equity of skin healthcare, professional agencies have launched public dermatologic projects that aid and represent ethnic communities. In particular, Neutrogena announced its ‘Heroes of Skin Health Equity’ initiative, where there are partnerships with individuals who strive to make dermatology more equitable. Specifically, Neutrogena is the first official sponsor of Hutano, a social platform that was created by the health wellness influencer, Malone Mukwende. It gained recognition in the advocacy of the health outcomes of minorities.
This collaboration pairs Neutrogena’s SkinU platform and Mukwende’s Hutano society to promote skin health knowledge and empower the voices of the disadvantaged. Another global initiative is Project IMPACT, which was launched by Dr. Elbuluk, a dermatologist and professor at the University of Southern California’s Keck School of Medicine. It addresses research and education in skin health and spreads the word about the health disparities of ethnic populations. Along with more organizations, voices in society are working together toward closing the racial equity gap in dermatology.
References:
BARLOW, ELLEN. “Under the Skin | Harvard Medical School.” Harvard Medical School, 18 October 2017, https://hms.harvard.edu/news/under-skin.
Behrens, Michele. “Neutrogena Announces 'Heroes of Skin Health Equity' Initiative.” Cosmetics & Toiletries, 1 February 2022,
https://www.cosmeticsandtoiletries.com/news/companies/news/22030553/neutro gena-corp-neutrogena-announces-heroes-of-skin-health-equity-initiative.
Cochran, Raechele. “Equity in dermatology: Visual representation of darker skin is key.” Medical News Today,
https://www.medicalnewstoday.com/articles/disparities-in-dermatology-visual-repr esentation-of-darker-skin-is-key#13.
“Hutano.” Neutrogena, 16 February 2022,
https://www.neutrogena.com/the-bar/hutano-and-neutrogena-for-black-and-brow n-skin-health-equity.html.
Lukas, Erin. “Neutrogena Launches Heroes of Skin Health Equity Initiative.” InStyle, 31 January 2022,
“The Impact of Global Health Disparities on Atopic Dermatitis in Displaced Populations: Narrowing the Health Equity Gap for Patients with Skin of Color.” PubMed, 19 October 2022, https://pubmed.ncbi.nlm.nih.gov/36261772/.
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