Advertisement
There are many ways to measure the destructive impact of structural racism on the African-American community. Perhaps the most important effects are on our health and physical well being. The National Medical Association of Washington D.C., initiated several years ago the “National Colloquium on African American Health,” consisting of a team of outstanding black physicians, scientists and NAACP leader Kweisi Mfume, among others. Their 2001 report, “Racism in Medicine and Health Parity for African Americans,” should be required reading in every black household.
As long as public health records have been kept in the United States, African Americans consistently have had significantly shorter lifespans than white Americans. In 1995, life expectancies for whites were 76.5 years, and were 69.6 for African Americans. The age-adjusted death rate per 100,000, however, was 466.8 deaths per 100,000 for whites, and 738.8 deaths per 100,000 among black people, about 58 percent higher.
When compared to white people, African Americans in 1989 were 6.6 times more likely to become victims of homicides than whites. In 1996, African Americans were 5.8 times more likely to die from AIDS/HIV infection than whites, 2.4 times more likely to die from diabetes mellitus, 2.8 times more likely to die from septicemia, and 1.5 times more likely to die from heart disease. Blacks are consistently overrepresented in twelve of the fifteen leading causes of death in the United States.
These statistical racial disparities were so outrageous that even the conservative Reagan administration could not ignore them. In 1985, the Department of Health and Human Services, then under Margaret M. Heckler, issued a report on the Secretary’s Task Force on Black and Minority Health, which warned that there was a clear danger of creating a permanent “health and heath care underclass.” Sadly, Heckler’s report also “glibly prescribed more healthful diets, lifestyle changes, exercise promotion and health education to reverse mounting black mortality.”
The white medical establishment presents several explanations for the health deficits between African Americans and whites. About 23 percent of all black Americans lack medical insurance, about twice higher than the percentage for whites. Low income people, regardless of race, are much less likely to have access to regular medical and dental services. The decline in funding for public hospitals and health clinics is sometimes cited as a factor. HMOs and other managed healthcare providers have been frequently accused of culturally insensitive care, and for providing unequal services to blacks and other racialized minorities. Yet even when racial differences in health outcomes can be documented and made public, the impression is left that such disparities are not a consequence of deliberate racial discrimination.
A good example of this was a 2000 survey of 347 pharmacies in New York City, conducted by the Mount Sinai School of Medicine, which found that in black and brown neighborhoods only 25 percent of pharmacies carried enough morphine or morphine-like drugs to treat severe pain, while in white neighborhoods 72 percent did. Because blacks have higher rates of cancer than whites, there should be actually a greater need for medicines treating severe pain. Some pharmacists have explained away these statistics by suggesting demand was lower in poor neighborhoods because they had higher proportions of uninsured people who could not afford to fill prescriptions. Sounds like a reasonable explanation. The problem becomes more complicated, however, when we learn that white physicians, according to another study reported in the New York Times, are much “less likely to prescribe pain killers for blacks and Latinos with broken bones or postoperative pain.”
A surprisingly large number of white physicians have limited contact with black patients. The National Medical Association observes that “African-American physicians are five times more likely to treat African-American patients and four times more likely to treat poor and undeserved patients.” One 1999 study published in the New England Journal of Medicine indicated that white physicians referred African Americans to medically necessary cardiac workups and treatment only 60 percent as often as they referred white males. Based on an extensive survey of 193 physicians, the researchers found that white doctors tended to perceive African-American patients and poor people generally “more negatively than their white counterparts and upper class patients.” A patient’s socioeconomic status was associated with physicians’ perceptions of patient’s personality, abilities, behavioral tendencies and role demands.
A survey of six hundred minority-based healthcare studies found that black Americans consistently receive “less care and less intensive care than do white counterparts. This pattern was found not only for such high technology interventions as coronary artery bypass grafting, advanced cancer treatment, renal transplantation, and hip and knee replacement, but also in basic clinical care such as adequacy of physical examinations, histories and laboratory tests.
Despite this overwhelming new evidence, most white Americans are unable or unwilling to acknowledge racial health disparities. According to one 1999 national survey funded by the Kaiser Family Foundation, 61 percent of all whites surveyed believed that “African Americans with heart disease were as likely as their white counterparts to receive specialized medical procedures and surgery.” When asked if racial discrimination could be a “major problem” for blacks attempting to receive quality healthcare, “77 percent of whites responded that it was a minor or nonexistent problem.” It seems that the white majority is still incapable of judging black people not by “the content of their character” and by the unequality of their lives, but instead, only “by the color of their skin.”
Dr. Manning Marable is Professor of History and Political Science, and the Director of the Institute for Research in African-American Studies at Columbia University in New York. “Along the Color Line” is distributed free of charge to over 350 publications throughout the U.S. and internationally. Dr. Marable’s Column is also Available on the Internet at www.manningmarable.net.
As long as public health records have been kept in the United States, African Americans consistently have had significantly shorter lifespans than white Americans. In 1995, life expectancies for whites were 76.5 years, and were 69.6 for African Americans. The age-adjusted death rate per 100,000, however, was 466.8 deaths per 100,000 for whites, and 738.8 deaths per 100,000 among black people, about 58 percent higher.
When compared to white people, African Americans in 1989 were 6.6 times more likely to become victims of homicides than whites. In 1996, African Americans were 5.8 times more likely to die from AIDS/HIV infection than whites, 2.4 times more likely to die from diabetes mellitus, 2.8 times more likely to die from septicemia, and 1.5 times more likely to die from heart disease. Blacks are consistently overrepresented in twelve of the fifteen leading causes of death in the United States.
These statistical racial disparities were so outrageous that even the conservative Reagan administration could not ignore them. In 1985, the Department of Health and Human Services, then under Margaret M. Heckler, issued a report on the Secretary’s Task Force on Black and Minority Health, which warned that there was a clear danger of creating a permanent “health and heath care underclass.” Sadly, Heckler’s report also “glibly prescribed more healthful diets, lifestyle changes, exercise promotion and health education to reverse mounting black mortality.”
The white medical establishment presents several explanations for the health deficits between African Americans and whites. About 23 percent of all black Americans lack medical insurance, about twice higher than the percentage for whites. Low income people, regardless of race, are much less likely to have access to regular medical and dental services. The decline in funding for public hospitals and health clinics is sometimes cited as a factor. HMOs and other managed healthcare providers have been frequently accused of culturally insensitive care, and for providing unequal services to blacks and other racialized minorities. Yet even when racial differences in health outcomes can be documented and made public, the impression is left that such disparities are not a consequence of deliberate racial discrimination.
A good example of this was a 2000 survey of 347 pharmacies in New York City, conducted by the Mount Sinai School of Medicine, which found that in black and brown neighborhoods only 25 percent of pharmacies carried enough morphine or morphine-like drugs to treat severe pain, while in white neighborhoods 72 percent did. Because blacks have higher rates of cancer than whites, there should be actually a greater need for medicines treating severe pain. Some pharmacists have explained away these statistics by suggesting demand was lower in poor neighborhoods because they had higher proportions of uninsured people who could not afford to fill prescriptions. Sounds like a reasonable explanation. The problem becomes more complicated, however, when we learn that white physicians, according to another study reported in the New York Times, are much “less likely to prescribe pain killers for blacks and Latinos with broken bones or postoperative pain.”
A surprisingly large number of white physicians have limited contact with black patients. The National Medical Association observes that “African-American physicians are five times more likely to treat African-American patients and four times more likely to treat poor and undeserved patients.” One 1999 study published in the New England Journal of Medicine indicated that white physicians referred African Americans to medically necessary cardiac workups and treatment only 60 percent as often as they referred white males. Based on an extensive survey of 193 physicians, the researchers found that white doctors tended to perceive African-American patients and poor people generally “more negatively than their white counterparts and upper class patients.” A patient’s socioeconomic status was associated with physicians’ perceptions of patient’s personality, abilities, behavioral tendencies and role demands.
A survey of six hundred minority-based healthcare studies found that black Americans consistently receive “less care and less intensive care than do white counterparts. This pattern was found not only for such high technology interventions as coronary artery bypass grafting, advanced cancer treatment, renal transplantation, and hip and knee replacement, but also in basic clinical care such as adequacy of physical examinations, histories and laboratory tests.
Despite this overwhelming new evidence, most white Americans are unable or unwilling to acknowledge racial health disparities. According to one 1999 national survey funded by the Kaiser Family Foundation, 61 percent of all whites surveyed believed that “African Americans with heart disease were as likely as their white counterparts to receive specialized medical procedures and surgery.” When asked if racial discrimination could be a “major problem” for blacks attempting to receive quality healthcare, “77 percent of whites responded that it was a minor or nonexistent problem.” It seems that the white majority is still incapable of judging black people not by “the content of their character” and by the unequality of their lives, but instead, only “by the color of their skin.”
Dr. Manning Marable is Professor of History and Political Science, and the Director of the Institute for Research in African-American Studies at Columbia University in New York. “Along the Color Line” is distributed free of charge to over 350 publications throughout the U.S. and internationally. Dr. Marable’s Column is also Available on the Internet at www.manningmarable.net.