California’s repair plan should consider racial health gap

Californians are publicly weighing the idea of ​​reparations for Black Americans, with the state’s Reparations Task Force due to report on its recommendations by July 1. This initiative builds on smaller-scale efforts, like in my hometown of Evanston, Illinois, which in 2021 became the first U.S. city to pledge limited financial reparations for slavery and sanctioned discriminatory housing policies. by the city.

Nationally, much of the conversation about reparations has focused on the financial burdens put in place by slavery and the racist government policies that followed. As a direct result of these factors, the median wealth of white households today is about eight times greater than that of black households in the United States.

This racial wealth gap alone is a strong case for reparations. But it should be joined by an equally glaring and often less recognized health gap: In the United States, black lives are on average years shorter than white lives. And as with the wealth gap, racism is a key culprit.

I’m an anthropologist and epidemiologist who studies health inequalities, and last year I began my testimony before the California Reparations Task Force by recounting stark numbers compiled by the National Center for Health Statistics: life expectancy for black women in the United States is three years lower than for their white counterparts. For men, the difference is a striking five years younger.

This race gap in health is largely attributable to stress-related illnesses like heart attacks and strokes, and it is not linked to genetic differences. In fact, racial groups do not perfectly match our genes. Rather, they are fluid categories that societies establish in response to cultural norms, defined and perpetuated by those in power to maintain social control.

An example in the United States is the arbitrary Jim Crow-era “drop rule”, aimed at preserving white racial purity in some former slave states. It specified that Americans could only be considered white if they showed no signs of previous intermarriage with people of non-European ancestry. This meant that an American could have majority European ancestry and still be considered black, and the same is true today.

Studies of human genetic diversity tell us that humans evolved in Africa and then relatively recently migrated to other continents. As a result, all human populations outside of Africa, including Europeans and Asians, are in fact only slightly modified subsets of the original African genetic diversity of the human species. Although we may vary in superficial ways, such as skin color or hair type, all people share the vast majority of the same gene pool.

Genetics does not explain the huge racial health gap in America. However, the experience of being Black in America does. Specifically, decades of public health research show that racism is a crucial factor. Racism makes daily interactions more stressful and influences many other factors that affect illness, including quality and access to health care, educational opportunities, and neighborhood characteristics such as air quality, exposure to industrial pollutants and access to healthy food.

Or consider the prevalence of cardiovascular disease among black Americans, which contributes to the black-white mortality gap more than any other cause of death. A 2015 review in the American Journal of Epidemiology examining relevant studies found that the evidence for genes causing these disparities is “essentially zero”. Instead, research links this gap to social inequalities. For example, a 2020 analysis of the Jackson Heart Study, which tracked the health of thousands of people for 25 years, found that lifelong discrimination significantly increased the risk of heart disease among black participants. A separate 2021 study found that black participants had higher levels of the stress hormone cortisol – which has effects on conditions such as blood pressure and heart disease – on the days they reported experiencing racial discrimination.

The health gap looms the minute black babies are born in the United States. Black Americans are more likely to have low birth weight, which can lead to health problems in childhood and higher rates of high blood pressure, stroke and heart disease later in life. life. A landmark 1997 study in the New England Journal of Medicine showed that African immigrants in Illinois had babies with birth weights close to those of white mothers – but later research found that after a generation or two spent in the United States, that community began to experience lower birth weights resembling those of African Americans whose families have lived here for many generations.

The low birth weight of these mothers had nothing to do with genetics and everything to do with the cumulative stress of being Black in America.

Although my testimony to the California Reparations Task Force began with grim statistics, it ended on a hopeful note: because the racial health gap is not genetic, we can reverse it. Health improves when we reduce stressors — and when families have access to adequate resources. In a Chicago-area study, upward economic mobility reduced black mothers’ chances of giving birth to a small-for-gestational-age baby. Initial studies of pilot programs to ensure minimum income are improving mental health outcomes, including depression, for affected communities.

Economists can measure the wealth gap between black and white families created by centuries of racist policies in the United States. The serious health inequalities caused by systemic racism are more difficult to assess, but they are another historic injustice that deserves redress. The material resources offered by remedial programs will also help fill health gaps. And the years lost in black lives matter.

Christopher Kuzawa is Professor of Anthropology and Fellow of the Institute for Policy Research at Northwestern University and an elected Fellow of the National Academy of Sciences and the American Academy of Arts and Sciences.

Leave a Comment