[IBARW] free to die: on racism and health
I meant to have this posted far earlier in the week, but each time I sat down to work on this post I struggled bitterly with the phrasing. At this point, I’m still not entirely sure I’ve managed to say what I wanted to say how I wanted to say it, but I’m not going to let that delay me any longer.
One of the arguments that I often hear presented in discussions of racism is that since these days ‘things have gotten so much better,’ surely racism can’t really be that bad- at least not any more, not like it was ‘back then.’ The kindest interpretation I can put on this viewpoint is that the speaker in question truly believes that things have improved and are continuing to improve, and that this is good enough to warrant not worrying overmuch about difficult and ‘outdated’ topics. The corresponding and extremely unpleasant implication, of course, is that whoever is arguing otherwise is blowing things out of proportion and therefore should really just quit making such a fuss; or, in other words, sit down in the back of the bus and shut up.
Unfortunately, even if held with the best of intentions, this view is akin to walking into a condemned building and being delighted at seeing a fresh new coat of paint slapped up over a rotten wall.
I’m not a person of color; I’ve never suffered from racism directed against me, and I know that the ‘isms’ I have experienced are not the same. I can’t speak from my own experience in that way. What I am, though, is a researcher, and what I do have to offer in answer to this argument are the sort of facts and observations that I see and work with every single day, and what it adds up to is this:
No. You’re wrong. It is that bad.
Consider the following:
• In 2006, there were 39.5 million people worldwide who were estimated to be living with HIV1. Over 62 percent of those people live in sub-Saharan Africa. Of the 4.3 million new HIV infections that year, 24.7 million of them -- 65 percent -- were in sub-Saharan Africa. And of the 2.9 million people who died of AIDS in 2006, 2.1 million were among sub-Saharan Africans. Let me repeat that clearly: we’re talking about 72 percent of AIDS deaths worldwide. Seventy-two percent.
• A look at the impact of the same disease in the United States alone doesn’t paint a brighter picture. Although black Americans only comprise 12% of the nation’s population, 50% of AIDS cases diagnosed in 2005 were among this group2. Black Americans also suffer from the highest HIV death rate per 100,000 men aged 25 - 44: a rate of 39.9 in 2004, compared to a rate of 5.5 for white men. Another 19% of new cases were diagnosed among Hispanic Americans - who only comprise 14% of the nation’s population3.
• It’s not only AIDS, either. The 2005 National Healthcare Disparities Report found that disparities associated with race, ethnicity, and socioeconomic status not only still exist today, but are present in almost every aspect of the American health care system, including both quality of and access to care (including type of/lack of insurance coverage)4. Included also is the acknowledgement of disparities in treating conditions such as cancer, diabetes, asthma, and heart disease; in settings such as hospitals, nursing homes, primary care providers, and emergency departments; in preventive care, acute care, and chronic care.
• A 1985 task force report found that 60,000 deaths per year were taking place due to health disparities. In comparison, a study using 2002 mortality data found 83,570 deaths due to health disparities5.
Study after study, report after report, and it all comes down to the same thing: yes, it is that bad. Racism is alive and well in the world today, unlike the hundreds and thousands who die as a direct result of it. It’s a cost counted in lives, paid daily in suffering and pain, in blood and death.
I’m not denying that there has been progress made in combating racism; there has, and that’s something to be glad of, there’s no question. My point is that it’s not over, and that this needs to be recognized. We can’t afford to allow ourselves to become complacent.
To be colorblind is to be blind. It's to turn away from admittedly-harsh reality. The thing is, not everyone can do that.
And no one should.
1 UNAIDS. 2006. “AIDS epidemic update: special report on HIV/AIDS: December 2006.” UNAIDS/06.29E; accessed online at http://www.unaids.org/en/HIV_data/epi2006/default.asp
2 Kaiser Family Foundation. 2007. “Fact Sheet: Black Americans and HIV/AIDS: July 2007.” Accessed online at http://www.kff.org/hivaids/upload/6089-04.pdf
3 Kaiser Family Foundation. 2007. “Fact Sheet: Latinos and HIV/AIDS: July 2007.” Accessed online at http://www.kff.org/hivaids/upload/6007-04.pdf
4 AHRQ. 2005. “2005 National Healthcare Disparities Report.” U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, publication no. 06-0017. Accessed online at http://www.ahrq.gov/qual/nhdr05/nhdr05.pdf
5Satcher, D.S., G.E. Fryer, Jr., J. McCann, et al. 2005. “What if We Were Equal? A Comparison of the Black-White Mortality Gap in 1960 and 2000.” Health Affairs 24(2): 459-464. doi: 10.1377/hlthaff.24.2.459 .
One of the arguments that I often hear presented in discussions of racism is that since these days ‘things have gotten so much better,’ surely racism can’t really be that bad- at least not any more, not like it was ‘back then.’ The kindest interpretation I can put on this viewpoint is that the speaker in question truly believes that things have improved and are continuing to improve, and that this is good enough to warrant not worrying overmuch about difficult and ‘outdated’ topics. The corresponding and extremely unpleasant implication, of course, is that whoever is arguing otherwise is blowing things out of proportion and therefore should really just quit making such a fuss; or, in other words, sit down in the back of the bus and shut up.
Unfortunately, even if held with the best of intentions, this view is akin to walking into a condemned building and being delighted at seeing a fresh new coat of paint slapped up over a rotten wall.
I’m not a person of color; I’ve never suffered from racism directed against me, and I know that the ‘isms’ I have experienced are not the same. I can’t speak from my own experience in that way. What I am, though, is a researcher, and what I do have to offer in answer to this argument are the sort of facts and observations that I see and work with every single day, and what it adds up to is this:
No. You’re wrong. It is that bad.
Consider the following:
• In 2006, there were 39.5 million people worldwide who were estimated to be living with HIV1. Over 62 percent of those people live in sub-Saharan Africa. Of the 4.3 million new HIV infections that year, 24.7 million of them -- 65 percent -- were in sub-Saharan Africa. And of the 2.9 million people who died of AIDS in 2006, 2.1 million were among sub-Saharan Africans. Let me repeat that clearly: we’re talking about 72 percent of AIDS deaths worldwide. Seventy-two percent.
• A look at the impact of the same disease in the United States alone doesn’t paint a brighter picture. Although black Americans only comprise 12% of the nation’s population, 50% of AIDS cases diagnosed in 2005 were among this group2. Black Americans also suffer from the highest HIV death rate per 100,000 men aged 25 - 44: a rate of 39.9 in 2004, compared to a rate of 5.5 for white men. Another 19% of new cases were diagnosed among Hispanic Americans - who only comprise 14% of the nation’s population3.
• It’s not only AIDS, either. The 2005 National Healthcare Disparities Report found that disparities associated with race, ethnicity, and socioeconomic status not only still exist today, but are present in almost every aspect of the American health care system, including both quality of and access to care (including type of/lack of insurance coverage)4. Included also is the acknowledgement of disparities in treating conditions such as cancer, diabetes, asthma, and heart disease; in settings such as hospitals, nursing homes, primary care providers, and emergency departments; in preventive care, acute care, and chronic care.
• A 1985 task force report found that 60,000 deaths per year were taking place due to health disparities. In comparison, a study using 2002 mortality data found 83,570 deaths due to health disparities5.
Study after study, report after report, and it all comes down to the same thing: yes, it is that bad. Racism is alive and well in the world today, unlike the hundreds and thousands who die as a direct result of it. It’s a cost counted in lives, paid daily in suffering and pain, in blood and death.
I’m not denying that there has been progress made in combating racism; there has, and that’s something to be glad of, there’s no question. My point is that it’s not over, and that this needs to be recognized. We can’t afford to allow ourselves to become complacent.
To be colorblind is to be blind. It's to turn away from admittedly-harsh reality. The thing is, not everyone can do that.
And no one should.
1 UNAIDS. 2006. “AIDS epidemic update: special report on HIV/AIDS: December 2006.” UNAIDS/06.29E; accessed online at http://www.unaids.org/en/HIV_data/epi2006/default.asp
2 Kaiser Family Foundation. 2007. “Fact Sheet: Black Americans and HIV/AIDS: July 2007.” Accessed online at http://www.kff.org/hivaids/upload/6089-04.pdf
3 Kaiser Family Foundation. 2007. “Fact Sheet: Latinos and HIV/AIDS: July 2007.” Accessed online at http://www.kff.org/hivaids/upload/6007-04.pdf
4 AHRQ. 2005. “2005 National Healthcare Disparities Report.” U.S. Department of Health and Human Services, Agency for Healthcare Research and Quality, publication no. 06-0017. Accessed online at http://www.ahrq.gov/qual/nhdr05/nhdr05.pdf
5Satcher, D.S., G.E. Fryer, Jr., J. McCann, et al. 2005. “What if We Were Equal? A Comparison of the Black-White Mortality Gap in 1960 and 2000.” Health Affairs 24(2): 459-464. doi: 10.1377/hlthaff.24.2.459 .