Racism, Chronic Disease, and Mental Health: Time to Change Our Racialized System of Second-Class Care.

In this article, we describe how the "weathering hypothesis" and Adverse Childhood Experiences set the stage for higher rates of chronic disease, mental health disorders and maternal mortality seen in African American adults. We illustrate the toll that untreated and overtreated mental health disorders have on Black individuals, who have similar rates of mental health disorders as their white counterparts but have fewer outpatient mental health services and higher rates of hospitalizations. We discuss the history of Medicaid, which, while passed alongside Medicare during the Civil Rights era, was Congress's concession to Southern states unwilling to concede federal oversight and funds to the provision of equal healthcare for poor and Black people.