EFFECTS OF RACISM Part 1

The murder of George Floyd, a black man, by a white police officer kneeling on his neck for nine minutes (while three other officers facilitated the killing) has brought the racism of U.S. society to the forefront. The attention to racism is going beyond this specific episode and is including the underlying, long-term racism of the U.S. economy, our society, and the policies, funding, and practices of federal, state, and local governments. (See my previous post here for more background.)

The effects of racism, of racial prejudice and discrimination, on black people today are broad and pervasive. They are the aggregation of current policies, practices, and characteristics of the U.S. economy and society, as well as the cumulative effects of 400 years of racism. I can’t do justice to all the effects in a couple of posts, but I will start by highlighting some of them. Some, particularly the better-known ones, I will just mention and others I will present in more detail. They are in no particular order, in part because they are all intertwined and the relative importance or severity of them is difficult, if not impossible, to determine.

Some of the detrimental effects of racism on black people evident today include:

Education

• Black students, on average, attend K-12 schools of lower quality (e.g., less experienced and qualified teachers, less funding, lower quality materials and facilities) than white students. Housing segregation has been widely acknowledged for decades as the driver of racially unequal access to a good K-12 education. This is a result, in large part, of the fact that funding for K-12 schools comes primarily from local property taxes. As a result:
  • Black students have less success in our K-12 school systems than white students. Notably, their graduation rates are lower.
  • After their K-12 education, black students attend and succeed at lower rates in higher education than their white peers.
• Good, development-nurturing early care and education (aka child care) is generally less accessible for black families and children than for white ones. Except for the federal Head Start program, good quality early care and education (ECE) is unaffordable and often not conveniently located for black families. The Head Start program, which targets children in families below the federal poverty line (about $22,000 in annual income for a family of three, which could be a single parent with two young children), only receives enough funding to serve about half of the eligible 3 and 4 year olds and about one in ten of the eligible infants and toddlers.

Health and health care

• Black people have a shorter life expectancy than whites: 75.5 years versus 79.1 years.
• Black mothers experience higher pregnancy-related maternal mortality rates than whites: 4.1 vs. 1.3 deaths per 10,000 live births. This difference persists even after adjusting for potentially related factors such as age, education, and income.
• Black infants experience higher mortality rates than whites: 109 versus 47 deaths per 10,000 live births.
• The coronavirus pandemic has highlighted the inequities in health and health care for black Americans. Black people in the U.S. have had somewhere between 33% and 40% of COVID-19 cases despite being only 13% of the population. Their cases tend to be more severe and the black death rate is over twice that of whites (62 vs. 26 per 100,000). (See previous posts on the disproportionate impact on Blacks and the reasons for this.)
• Research has found that respiratory conditions (including asthma) that make one more vulnerable to COVID-19 are more common among people with long-term exposure to air pollution and that a small increase in exposure to fine particulate air pollution — tiny particles in the air — leads to a significant increase in the COVID-19 death rate. Low-income and densely populated areas (whose residents are disproportionately black) have higher levels of air pollution due to higher levels of vehicular exhaust, emissions from buildings’ heating systems, and emissions from power generation and industrial facilities.
• Hospitals that serve primarily white people have 60% higher per patient funding ($8,325) than ones that serve the highest proportions of black people ($5,197). The primarily white-serving hospitals had nearly twice as much capital spending (e.g., for new equipment and modernization) as the hospitals with the most black patients. The white-serving hospitals had more specialty services, better nurse-to-patient ratios, fewer safety hazards, and lower readmission rates. [1]
• Black people have less access to health care, both based on the locations of services and due to lack of insurance. In addition, they receive lower quality and biased care when they receive health services. For example, a 2003 National Academy of Sciences report, “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care” examined 480 studies and found that for every medical intervention black people received poorer-quality care than white people, even when income and insurance were equal. [2] Medical decisions, diagnoses, and treatments have been found to be racially biased with worse outcomes for black patients than white ones.
• The high levels of stress that black people experience due to racism, economic insecurity, and other factors have been linked, for both children and adults, to chronic health problems (e.g., asthma, obesity, high blood pressure, heart disease, and diabetes) and mental / behavioral health problems (e.g., behavior and anxiety disorders and substance abuse). The stresses of what are referred to as adverse childhood experiences (e.g., child abuse or neglect, violence in the home or neighborhood, parents’ mental health problems) have been found to contribute to a higher prevalence years later of chronic adult health conditions such as high blood pressure, heart disease, diabetes, obesity, and anxiety disorders. The stresses of economic insecurity, neighborhood and household violence, and racism, collectively sometimes referred to as allostatic load, have been linked to higher rates of negative health outcomes, including shorter lifespans and more low birthweight babies. For example, the prevalence of diabetes is 66% higher among Blacks than whites and elevated blood pressure is 49% higher. Blacks have more chronic health conditions even when researchers compare them with whites with similar levels of education and income.
  • Examples of stressors that black people deal with regularly include being presumed to be dangerous or a criminal and being presumed to be in a non-professional or subservient role. For example, black people are often presumed to be staff in a hotel, restaurant, store, or golf club, rather than a customer. Or, as former Massachusetts Governor Patrick stated, “Like every other Black trial lawyer I know, I have been mistaken for a defendant awaiting trial” when arriving in a courthouse or courtroom to argue a case. [3] These types of role misidentification are commonplace. Almost every black person – if not every black person – can cite multiple times when this has happened to them. This requires them to control their anger, frustration, and sometimes their fear time after time after time. This takes a toll on one’s stress level, happiness, and well-being.
  • Black parents routinely feel anxious when their sons and daughters are not in their home because they know of the dangers that discrimination and prejudice present when they are out in public. Black parents know they must have “the talk” with their children, especially their sons, where they tell them that regardless of the situation or provocation they must stay calm, keep their hands visible, and avoid confrontation, particularly with police officers.
• Because they are concentrated in low-income neighborhoods, black people often live in food deserts, where access to affordable, good quality food is difficult. Supermarkets are typically not located in those neighborhoods, so a long trip, often on public transportation, is required to reach them.

In my next post, I will provide an overview of the detrimental effects of racism on black people in terms of economic inequality, housing, criminal justice, and voting. I welcome your comments with reactions, thoughts, and questions relative to this post and the larger issue of racism in the U.S.

[1]      Dayen, D., 6/19/20, “Unsanitized: Structural racism and the coronavirus crisis,” The American Prospect (https://prospect.org/coronavirus/unsanitized-structural-racism-and-the-coronavirus-crisis/)

[2]      Villarosa, L., 4/29/20, “ ‘A terrible price’: The deadly racial disparities of Covid-19 in America,” The New York Times Magazine (https://www.nytimes.com/2020/04/29/magazine/racial-disparities-covid-19.html)

[3]      Patrick, D., 6/16/20, “America is awakening to what it means to be Black. Will we also awaken to what it means to be American?” (https://medium.com/@DevalPatrick/america-is-awakening-to-what-it-means-to-be-black-3eb938969f7f)