- [Jiquanda] We live in a very white space.

And in much of my career, I've been the only black person in the room.

In small behaviors, people let me know, like you're not valued.

You're not seen and you're actually not welcomed in the space.

- [Dr. Sanford] I think I've experienced microaggressions every day.

There's always something I have often been told, especially by white men.

They have been shocked at how articulate I am.

That one gets me every time.

- [Edwin] I'm walking into a parking lot.

And the moment I hear four different cars locked at the exact same time.

Or when I walk into a corner store or a grocery store and I get followed.

- [Dr. Sanford] Having someone say something rude to us, you know, at the worst having the police called on us.

- [Jiquanda] Because I don't look like I belong.

Will someone approach me?

You know, am I safe in this community that I really don't know?

- [Edwin] How people ask, "Where am I from?"

That must be from somewhere else.

What languages do I speak?

- Just navigating that every day can be so draining.

It's so draining because you experience it in so many different spaces.

And that puts a toll on people.

- [Narrator] Statewide and nationwide.

The COVID-19 pandemic has hit communities of color the hardest.

Many factors that contribute to their worst health outcomes have their root in structural inequities.

Like socioeconomic factors that dictate who can work from home or who has access to healthcare.

But on top of these systemic issues, studies show that the stress of experiencing racism, may be making our communities more susceptible to illness.

- [Dr. Sanford] The physical health and the mental health of many black and brown folks is affected daily.

Based on the stressors that we deal with with racism.

- [Narrator] Dr. Katrina Sanford is a clinical psychologist and sex therapist in Seattle who serves primarily patients of color.

- [Dr. Sanford] Racism is trauma.

Our bodies are in fight-flight or freeze mode consistently because we are often worried about, "Is that cop car that just went by gonna whip back around and come and harass us."

"Is that white person over there going to come and call us a negative word."

- There's a significant amount of data that tells us the stress from experiencing racism compounded over time can lead to high levels of PTSD.

Almost similar to folks who returned from the Vietnam war.

That's how severe it can be.

- [Dr. Sanford] And that trauma that comes from racism highly affects our physical body.

- [Narrator] Research shows that chronic stress wears the body down over time, leading to a premature aging of cells and effectively giving people an older biological age.

Back in 1992, one researcher coined the term "weathering" to describe this effect.

It comes from our survival response.

When stressed, our body releases the hormone cortisol, which prepares us to deal with a potential threat.

- [Dr. Sanford] Our bodies are saying, "I feel in danger right now."

And when you have had a lifetime of repeated trauma and stress, your body just pops off in that way from time to time, because it's used to doing that.

Our cave-person brain, it's saying, "Danger danger, we're in danger."

- [Narrator] Over time, increased cortisol levels from this chronic stress wreak havoc on the body systems and cause all kinds of health problems.

- [Dr. Sanford] If you look at the top health issues in the United States, black people are at the top for nearly all of them.

And it's not because black people are sickly because actually we're quite resilient to have dealt with what we've dealt with.

It's the stress, it's the racism and oppression that leads to higher levels of diabetes, higher levels of heart disease, cancer, high blood pressure, all of these things.

- [Narrator] And these health conditions in turn make people more vulnerable to illnesses like COVID-19.

- [Edwin] Dr. David Williams from Harvard did a study where he found there's a 4.2-year life expectancy gap between a white person who graduates from college and a black person who also graduates from college.

And what he argues is that that 4.2-year difference is because of racism.

Racism takes 4.2 years of people's lives.

Racism doesn't only kill because it forces you to have poor access to healthcare, poor access to housing, poor access to good food.

It literally kills because it changes your body in a negative way.

(crowd shouting) - [Narrator] In 2020, the combination of the pandemic and black Lives Matter protests led to public awareness of issues surrounding race and health equity.

- [Paula] That was sort of a wake-up call to everybody to many people anyway, in the country.

And certainly in UW medicine.

- [Narrator] Paula Houston leads the office of healthcare equity at U-Dub Medicine.

She says that very quickly there was a huge demand for the work they were doing.

- [Paula] There's a great desire to do the right thing.

If we're really going to do that, we certainly must focus on those people who've been most marginalized and historically oppressed.

- [Narrator] In response, many city and state governments including King County in Washington, declared racism, a public health crisis.

Something critics said was long overdue.

(crowd shouting) - [Paula] It's one of those things that was just the right time.

People needed unfortunately to see a person being murdered for almost nine minutes on television.

To have the awareness finally come to the front that, "Oh, this is what people have been talking about."

This is something that is hurting our society.

When it's a public health issue that means that all institutions, all agencies, all manners of society need to come together and put resources behind something.

- You know, maybe institutions are ready to make it a priority.

And not just saying it, but also providing resources, research, investments, and to creating solutions.

- [Edwin] Nearly every presentation that I see there is now a conversation of health equity.

In grand rounds, in lectures, in national conferences, that's amazing.

Because just five years ago, it was like screaming into an empty cave.

It may be too soon to say whether we're moving towards action.

There is a lot of conversation, right?

There's a lot of talk five to 10 years from now.

We will see who was doing this because it sounded fun.

And who was doing this because it's their life's work.

It can't just sit there in the book or in the zoom meeting.

At some point we have to get in the street.

We have to serve our community.

- Someone said that it's like our ancestors fought whatever challenges they needed to fight at the time to make it better for us.

And our goal is to fight to make it better for our future generation.

I do think we can get there.

We didn't get here overnight.

We definitely won't change it overnight, but we can.

This series is made possible in part by the generous support of Premera Blue Cross.