More Jumbled Thinking about Healthcare and Race

by James A. Bacon

The lead story in the Richmond Times-Dispatch today focuses on the findings from a new Virginia Commonwealth University study: “Life expectancy in the U.S. sees largest drop since 1943, ‘jolting’ decline for Black people and Latinos.”

The average life of Blacks fell 3.25 years and of Latinos by almost four years. The reasons? COVID was a contributing factor, of course. But according to the RTD article the underlying cause is systemic racism.

The article is an incoherent jumble of factoids and non sequiturs. Black mothers are more likely to die in pregnancy-related deaths…. Black infants have the highest mortality rates in the U.S…. Segregation from Jim Crow housing policies… Housing and job insecurity… Accidental overdoses and homicides… Actor Chadwick Boseman’s death from colon cancer at age 43… “In [Richmond’s] Mosby Court, a public housing community, the average life span is 68. Less than 6 miles away, a person born in the primarily white and affluent Windsor Farms neighborhood will live an average of 84 years.”

Not explained is how those factors, which are persistent through time, made disparities worse during the COVID epidemic. Not mentioned is the fact that a person born in a predominantly Hispanic or Asian neighborhood is likely to live longer than Whites and Blacks alike!

Alluded to only in passing in the RTD article is the fact that before COVID, Hispanics lived longer than non-Hispanic Whites. According to a 2016 Washington Post article, Hispanics had a life expectancy of 81.8 years compared to 78.8 years for whites and 75.2 years for Blacks. If the healthcare system was designed by Whites for Whites, to borrow a phrase used to account for racism at the Virginia Military Institute, how does one explain the fact that Hispanics were living three years longer on average before COVID hit?

Likewise, how does one explain the fact that, according to this report, Asians were living eight years  longer on average than Whites?

The racism-explains-everything paradigm is pernicious. It puts the entire onus of improving health outcomes on the healthcare system — not on individuals to take responsibility for their own health. If the longevity disparities between Asians, Hispanics, Whites and Blacks should tell us anything, it’s that individual behaviors, often reflecting cultural attitudes, play a huge role in health outcomes — likely far greater than any differences caused by “systemic racism.”

Also absent from the discussion is the possibility that socioeconomic status and education level are big influences on longevity. If you compare poor Whites with poor Blacks, you’ll see many of the same endemic health conditions — lung disease from smoking, obesity, heart disease, diabetes, and related disorders. The problem isn’t that poor, ill-educated Black people are Black, I would suggest, it’s that they’re poor and ill-educated — the same problem as for poor, ill-educated Whites.

The systemic-racism paradigm is counter productive in another way: It leads to the misallocation of resources. For example, The Virginia Mercury reports that there is now a push to require “implicit bias training” for Virginia’s medical professionals. “The idea is that poor outcomes, whether in education or health, can be linked to unconscious differences in how people of color are treated.” Is this really a better way for medical professionals to invest their continuing-education time than updating their medical knowledge?

The practice of health care, like any other endeavor, is subject to political and  ideological fashions. The systemic-racism paradigm is fast becoming dominant. Insofar as it discourages people from taking charge of their own lives, this perspective likely will prove as destructive to the health of Blacks as the application of the same idea to K-12 education is to their learning. 

Once upon a time, newspapers could be counted on to present different sides of an issue. Sadly, the RTD has embraced the systemic racism paradigm in toto, and has shown zero interest in exploring any other view. The RTD and its uber-woke news staff is doing a tremendous disservice to the community.


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Comments

14 responses to “More Jumbled Thinking about Healthcare and Race”

  1. Nancy Naive Avatar
    Nancy Naive

    Damned good thing we have the best healthcare in the world…
    https://jech.bmj.com/content/70/12/1251

  2. tmtfairfax Avatar
    tmtfairfax

    I like my health care just fine. My wife worked well more than 30 years for the federal government. We are using the federal employees health plan into retirement. Anyone who worked for the federal government can do that too.

  3. LarrytheG Avatar
    LarrytheG

    How come other developed countries don’t have this problem with their “poor” people?

    1. WayneS Avatar

      Are you certain they do not?

      https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4648377/

      It’s a bit dated but as far as life-expectancy goes, things tend not to change drastically for year to year.

      1. LarrytheG Avatar
        LarrytheG

        was looking at stuff like this:

        https://pbs.twimg.com/media/D7NabOoVsAET4oL.jpg

        Some think that we’d rank with the top countries if we did not have such lower life expectancy in our poorer groups.

        1. WayneS Avatar

          Okay, but comparing nations based on overall life expectancy was not the subject of the article. Your own comment, to which I was responding, mentioned nothing about a nation-by nation comparison

          Once again you have moved the goalposts, and for no apparent raeson.

          1. LarrytheG Avatar
            LarrytheG

            Nope. The issue is why does ONLY the US have this problem? Why are other countries able to also provide healthcare for their poor without saying that they don’t have good health care and therefore don’t live longer?

            Should the US continue making excuses for why their poor don’t live as long as other country’s poor?

            Jim gave the reason for lower life expectancy as being poor – how come we’re only developed country with that problem in the first place – IF we are TRULY concerned about it and finding solutions for it or are we just saying it’s a condition of being poor in our country.

            That’s too narrow a focus IMHO because we KNOW that it doesn’t have to be that way if other countries have figured it out.

            we don’t have to be stupid just because we are America – no?

            You always seem to have these problems … it’s like you can’t accept my viewpoint and have to find fault with the way I express my viewpoint.

            Don’t do that. Deal with the issue – don’t be personal.

            One more time. I’m running out of patience with you. There is no benefit in dialogue with you when this is how you do it.

          2. LarrytheG Avatar
            LarrytheG

            Steve is correct. Gun violence also plays a significant role and takes 4 yrs off black folks lives on average and 2 off of white folks on average – both from guns but in different ways. whites are more from suicide.

            So I need to admit that it’s not just health care at issue.

            Oh and this is also beyond the narrow focus of the original. no?

        2. Stephen Haner Avatar
          Stephen Haner

          Gun crime. Seriously. Gun crime and gun suicide. Not healthcare. Very simple fix to improve life expectancy for young black males. Stop killing each other.

          1. Brian Leeper Avatar
            Brian Leeper

            This average lifespan is also affected by infant mortality.

  4. tmtfairfax Avatar
    tmtfairfax

    What happened to the other side of the equation? When society makes services available to people, there is a corresponding responsibility for people not just to take advantage of what others provide, but also to make the best advantage of them by making good decisions that affect what those services can do.

    Keep in mind that one of the main goals of government spending is to keep well-educated people employed irrespective of what they produce. Why do public schools from K-12 to universities have such large central staffs?

    1. LarrytheG Avatar
      LarrytheG

      You make good points, but then I ask – does government EQUITABLY provide truly equal access to services and benefits?

  5. Jane Twitmyer Avatar
    Jane Twitmyer

    I would like to add environmental racism to the list of causes of health outcomes among different races. Working on the ACP, the issue was raised about the siting by Dominion of the compressor station in Union Hill, an historical black community. The charge is also true of the proposed generating station in Chickahominy. Stephen Metts, a part-time associate professor at The New School in New York who has studied the permitting process for gas plants for about five years. … “found minority populations of 70% to 80% 3 to 5 miles away.”

    Environmental racism impacts the health of the communities affected by poor environments. Various factors that can cause health problems include exposure to hazardous chemical toxins in landfills and rivers.

    The EPA’s National Center for Environmental Assessment found that “when it comes to air pollutants that contribute to issues like heart and lung disease, Blacks are exposed to 1.5 times more of the pollutant than whites, while Hispanics were exposed to about 1.2 times the amount of non-Hispanic whites. People in poverty had 1.3 times the exposure of those not in poverty.”

    The United Church of Christ Commission for Racial Justice (CRJ) study examined the presence of uncontrolled toxic waste sites in ethnic and racial minority communities, and found that 3 out of every 5 African and Hispanic Americans lived in communities with uncontrolled waste sites.

    AND … the concept is international. “The United States exported its hazardous wastes to the poor nations in the Global South because they knew that these countries had lax environmental regulations and safety practices, and …. because they did not have the resource and means to oppose the large companies that dump these dangerous wastes.”

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