At the Health Disparities Symposium last night, I was struck by the prevalence and diverse nature of health care inequities between different racial groups. Although some of the issues are obviously attributable to basic socioeconomic and educational status, two speakers presented data showing that race itself played a role independent of other markers. Dr. Thomas pointed to a difference in health care outcomes between white and black individuals even when adjusted for income. Rev. Robinson also made a compelling case for race as a determining factor regardless of other variables; the data about infant mortality among African-American mothers of different class and educational status was particularly compelling in this regard.
I think it has become all too easy for white activists and do-gooders (like the many we have at our college) to focus in an almost condescending way on the social ills that influence black healthcare outcomes such as drug use, gang violence, and obesity. While these are obviously problems, as the speakers all addressed, they are problems borne out of structural and institutional racism, and a top-down agenda that attempts to change them without changing the structure that produces them is racist in and of itself. It’s clearly more comfortable and convenient for us to distance themselves from the problems of poor health in minority communities, to pretend that it is a problem better school lunches or anti-drug programs can fix. However, these superficial measures do little more than make us feel better. Race is a factor; pretending it is not means this problem will never be alleviated.
On the one hand, the fact that race, even when adjusted for other possible causes of health disparities, is still a determinant of poor health and lack of access to proper health care speaks to the continued effects of discrimination in our society. On the other hand, as Rev. Robinson demonstrated with maps of the Memphis area, the linkages between race, space, poverty, and disease mean that race cannot be separated from problems like obesity and drug use. They are all intertwined; racial disparities function as both a cause and a product of the socioeconomic climate in which many African-Americans and other minorities live. This inextricable connection means that we are going about trying to resolve health inequities in entirely the wrong way when we look at the symptoms instead of the root cause. As tough as it is for us to do so, the speakers last night demonstrated many different ways communities as a whole can be changed by a holistic and respectful approach that aids, not impinges upon, the agency of minority communities. It is not our place to be paternalistic and tell minorities how they ought to change themselves to fit better into our racist societal structure. We need to listen to their voices.
How do you think institutional racism, specifically in regards to healthcare, can be deconstructed? What responsibility do we all bear for this continuing problem?