#DisabledWhileBlack: Three Paths from Racial Bias to Poorer Health

Large disparities exist between the health of Black and white Americans. Is it because black people are uneducated, poor, or lazy? Is it because black people eat too much fast food, smoke too much weed, and drink too much? Don’t be obtuse.

GIF image showing Donald Glover on “Community” saying, “That’s racist.”

The health gap between Black and White Americans persists BECAUSE OF racism. Racism is a system that engulfs all sectors in America, including healthcare. For example, mortality rates for Black people are 20% higher than White people (1). Black people are more likely to report chronic illness, and black children are more likely than white children to have a disability (2,3). Even socioeconomic status does not account for racial health disparities (4). Rich? Doesn’t matter babe, you black. Same shit.

GIF image showing Desus on “Desus & Mero” saying, “You thought!”

Three paths can lead from racial bias to poor health outcomes for Black Americans. First, being the target of PERSISTENT discrimination takes both a physical and a psychological toll (5). Second, physicians’ perceptions about race create subpar treatments (5). Third, physicians’ implicit bias leads to poor communication and provider-patient interactions (5). And no, being colorblind or “ignoring race” does not fix this problem.

GIF image showing Stephen Colbert on “The Late Show” saying, “But then wouldn’t I be a racist if I thought about racism?

If you call a problem by it’s name, then MAYBE just maybe you can actually work towards solving it. We can't fix what we don't acknowledge. Physicians, providers, and healthcare facilities need to first acknowledge racial disparities in health care, and then work to address it. One step providers can take is to individuate patients, by treating each patient as a unique individual rather than a representative of a race (5). Hard sell apparently. Clinics and facilities can work to aggregate information and audit that data for racial disparities (5). Then use that data to fix it.

TLDR: Healthcare is racist. Might not be capital R racism in all cases, but bias be fucking us up. Do better.

1. National Center for Health Statistics. Health, United States, 2012: With special feature on emergency care. Hyattsville, MD: U.S. Government Printing Office; 2012

2. Black-white Disparity in Disability: The Role of Medical Conditions

3. Disparities in the Prevalence of Disability Between Black and White Children

4. Race, socioeconomic status, and health: complexities, ongoing challenges, and research opportunities.

5. Reducing Racial Health Care Disparities: A Social Psychological Analysis

A Deeper Dive into DGWL Podcast Episode #27

“Systemic Racism & Defund the Police”

We talked a lot of shit in Episode 27 AND got all the links to back it up!

Dig your heels in and get to it. Take these questions, articles, and resources into your circles and conversations for an even bigger impact.

What is Systemic Racism?

“Systemic racism”, or “institutional racism”, refers to how ideas of white superiority are captured in everyday thinking at a systems level: taking in the big picture of how society operates, rather than looking at one-on-one interactions. Read all about it here.

What Is Juneteenth?

Juneteenth commemorates the effective end of slavery in the United States. Read more about it here. Did you learn about Juneteenth in school? Us either. Have a read, “What Can We Learn from the Germans About Confronting Our History?”

Why are Black and Brown people disproportionately affected by COVID-19?

Well, where we live, learn, work, and play affects our health. And guess who decided those things for us? The US government funded suburbs for white Americans (link here) and redlined areas to make sure we didn’t mix well (link here).

As the CDC states, long-standing systemic health and social inequities have put some members of racial and ethnic minority groups at increased risk of getting COVID-19 or experiencing severe illness, regardless of age. Read more here.

Considering that the pandemic has forced many closures and cancellations, financial hardships are upon a lot of Americans--with a huge emphasis on minorities. For example, big banks passed vulnerable Black businesses in favor of bigger "small" businesses and handed out Paycheck Protection Program money to the LA Lakers, Shake Shake, and others. Read more here.

To make things worse, there’s been no change in the level of hiring discrimination in US labor markets. Check out this study published in 2017, “Meta-analysis of field experiments shows no change in racial discrimination in hiring over time”.

Why do Black and Brown people have worse health compared to white people?

Short answer: racism. Longer answer: BIPOC have higher death rates and illnesses because of more stress and less access to care. For example, Black expectant and new mothers in the U.S. die at about the same rate as women in countries such as Mexico and Uzbekistan. Read more black women’s mortality risk here. And stress? Slavery was definitely stressful. Jim Crow era? Stressful. This trauma and stress gets passed down from generation to generation. Historical trauma affects the health & wellness in communities of color, read more here and here.

What is this School-to-Prison Pipeline?

Students are encountering the criminal justice system as minors and often are pushed into the juvenile justice system with arrests occurring at school! Sound crazy? Well, LA was spending $70 million funding school police, so there’s that. And for a more detailed explanation on the school to prison pipeline, head over to Justice Policy for a good read.

Also, what’s Broken Windows policing about?

The broken windows theory of policing suggested that cleaning up the visible signs of disorder — like graffiti, loitering, panhandling and prostitution — would prevent more serious crime as well. NPR covered this back in 2016, have a read or listen here.

Are cops really racist?

The history of policing is racist. The history of most things in our country are racist. But, the history of police starts with slave patrols, the protection of white people, and treating Black people worse than pieces of property. Did police stop lynchings? Did police protect Black people from being curbed? No. No they didn’t. Instead, Black and Brown bodies are heavily criminalized and taken advantage of by economic institutions like the prison system. And there’s more. Read here.

Defund the police? But what about violent crime?

In case you somehow missed it, we’re spending a lot of money on stupid shit. Remember, $70 million for armed police officers in LAUSD schools? Defunding the police will actually make us safer by spending money where it matters. [On 6/30/2020, LAUSD cut police funding by 35%--roughly $25 million--and ordered that “460 officers be taken off campus and out of uniform until the district can look closer at the agency as a whole.” Were they listening to our podcast?! I hope so.] Police spend the most resources going after minor incidents that actually don’t threaten everyday life but do lead to mass criminalization and incarceration. Read more on the police’s misuse of police funds via the ACLU here. And to answer that question about violent crime, you have a 40% chance of getting away with murder. Does that make you feel safe? More on crime clearance rates and data on Vox here.

What is ‘qualified immunity’ for police?

Qualified immunity shields government officials from being held personally liable from constitutional violations (i.e., excessive police force, murder, coercion, sexual assault, did we say murder?) under federal law. When government officials are sued, qualified immunity is their defense. Why does this suck? Well, it has become one of the chief ways in which law enforcement avoids accountability for misconduct.

Written by Marcia D. You May find her @thatdoc.marcia

Dear white people...

Dear white people,

We are in week five of nationwide civil unrest since the murder of George Floyd.

As a 29 year old white woman, I am simultaneously ignited with hope and reeling with dismay after witnessing reactions from fellow white folks. I am hopeful because of the sheer number of white bodies I’ve marched alongside. Yet I am disturbed by those who continue to dig their heels in the ground while proclaiming “all lives matter” and those who deny the palpable problem of systemic racism as well as those who don’t believe in the need for police reform. Our society is upended.

Recently, Trevor Noah described society as a contract that we enter either spoken or unspoken as human-beings where we agree to common rules, common ideals and common practices. Noah said the contract is only as strong as the people who are abiding by it. As white people, we are not upholding our end of the contract to Black people. For centuries, we’ve contributed to and allowed systemic racism. We’ve watched as police brutalized Black bodies. And now, we’ve even managed to make racial injustices against Black people about us.

It’s time for us to talk about some of the problematic responses white people have had.

When white people hear Black Lives Matter they say “all lives matter” or “blue lives matter”. White people are unable to selflessly grasp the concept of why we need to focus on Black lives. Black people are more than 2.5 times likely to be killed by a police officer than a white person.

White people get uncomfortable when brands or public figures take a stance and join the Black Lives Matter movement. They complain and say “stop getting political” or “stick to what you know” because “I don’t follow you for this kind of content”. Can you imagine the discomfort of over 400 years of oppression?

White people deflect conversations about police brutality against Black people by asking “What about Black-on-Black crime?”

White people avoid conversations about Black slavery in America by bringing up Irish “slavery” (they were indentured servants).

White people tell Black people to “get over it” as if those words can erase the deeply-rooted oppression and brutality that has enveloped Black lives since the early 1500s when they were first captured.

White people fail to realize when slavery ended Black people were not immediately elevated to the same playing field as whites. History shows our own government would continue to implement policies to deny opportunities to Black people from the Homestead Act to Jim Crow laws. White people are unable to see the generational trauma inflicted upon Black families as a result of centuries of their mistreatment.

White peoples’ denial of systemic racism is a contributor in allowing it to continue; to those who have been silent, you are also complicit with the side of the oppressor.

So where do we go from here?

First, we ask you to understand when we chant “Black Lives Matter” that we are demanding society to recognize and elevate Black people as equals in humanity.

Next, the steps we need to take as white people will be endeavoring and uncomfortable work without instant gratification. Dismantling systemic racism starts with us as individuals. We must look inside ourselves and challenge any prejudices we hold. We can no longer brush off our racist relative(s) at family get-togethers. It’s time (really it’s been time and a lot of us are very late) to have hard conversations with ourselves, our family, our friends and coworkers. We may estrange some of these people, but it’s vital to speak up and out. We must show up at the voting polls and hold candidates accountable when they vow to implement change for our Black community. We need to push for legislation that no longer allows police to kill with impunity. The work won’t end there, but all this is part of us upholding our end of the societal contract.

Remember when you join this movement as a white person, it’s likely you will make a mistake along the way. It’s vital to acknowledge we don’t know racism or Black experiences first-hand so we must be able to take corrections from Black people.

We are glad to have you, but we have a lot of work to do so it’s time to buckle in for the long haul.

Written by Chloe Lansing. You may find her at @chlo.mae.l.