Understanding historical contexts is valuable when seeking to understand and address the social and structural determinants of health that drive HIV-related health disparities.

During a visit by staff from the HHS Office of Infectious Disease and HIV/AIDS Policy (OIDP) to learn more about Oklahoma’s Ending the HIV Epidemic in the U.S. (EHE) activities, staff from the Oklahoma State Department of Health (OSDH) explained that one of the key disparities they are working to address is the disproportionate share of HIV among Black/African Americans. While Black/African Americans represent only about 7% of the state’s population, 28% of new HIV diagnoses occurred among this population in 2021.

Later, while visiting community partners engaged in EHE activities, OIDP and OSDH staff paused to visit the Greenwood neighborhood in Tulsa, which was known as “Black Wall Street” before the 1921 Tulsa race massacreExit Disclaimer. They also visited the Black Wall Street Chamber of CommerceExit Disclaimer for a discussion about this history and its impact today on HIV and other health issues.

“Understanding the historical trauma of the Tulsa race massacre and other unfortunate events in our history that adversely impacted the African American community is crucial to understanding the root causes of medical mistrust and health disparities that still persist in the African American community today," observed CAPT John Oguntomilade, PhD, OIDP’s EHE Coordination Lead. “It is of vital importance that as we strive to end the HIV epidemic, we continue to intentionally address the structural and historical factors that have limited access and uptake of HIV services in the African American community by optimizing models of care that integrate holistic, culturally sensitive and trauma-informed approaches that will move us closer towards achieving health equity for the community.”

The Chamber is a nonprofit membership organization that works to unify, promote, and empower the African American community through entrepreneurship, programming, economic development, education, and training in Tulsa. Inspired by the state’s participation in the EHE initiative, the Chamber was exploring opportunities to engage and lend support.

“Visiting Black Wall Street allowed me to be immersed in the historic event that took place and how it has shaped the stigma and trauma still relevant today,” observed LT Erica Bussey-Jones, MPH, a member of OIDP’s Engagement Team in HHS Region VI and one of the visit participants. “In order to progress in EHE, we must gain the trust of the community by involving trusted local leaders when making decisions that will affect their community, and address community needs holistically to improve future generations.”

As CDC’s Racism and Health website notes, “A growing body of research shows that centuries of racism in this country has had a profound and negative impact on communities of color. The impact is pervasive and deeply embedded in our society—affecting where one lives, learns, works, worships, and plays and creating inequities in access to a range of social and economic benefits—such as housing, education, wealth, and employment. These conditions—often referred to as social determinants of health—are key drivers of health inequities within communities of color, placing those within these populations at greater risk for poor health outcomes.”

CAPT Oguntomilade led the visit to Oklahoma and has visited several other EHE jurisdictions in recent months along with members of the OIDP Engagement Team and other OIDP colleagues. Read more about those visits to Alabama, Kentucky, Mississippi, Missouri, Oklahoma, and South Carolina.