dying while black: colorblind racism and€¦ · how prevalent is colorblind racism in your life or...

Dying While Black: Color-Blind Racismand Eliminating the Slave Health Deficit

4/26/2009

Professor Vernellia R. Randall 1

Dying While Black:Colorblind Racism and

Eliminating the Slave Health Deficit

Vernellia RandallProfessor of Law

The University of Dayton School of Law

Dying While Black: Colorblind Policies and Eliminating the Slave Health Deficit February 26, 2009Copyright © 2007 Vernellia R. Randall. All Rights Reserved. Contact: [email protected].


Vernellia RandallProfessor of Law

The University of DaytonSchool of Law

300 College ParkDayton, OH 45469-2772

Phone: 937-229-3378Email: [email protected]

WebsitesRace, Racism and the Law

http://academic.udayton.edu/race/

Available for Presentations and Webinars


BookDying While Blackhttp://dyingwhileblack.org/


4/26/2009


Being Black in Americais Dangerous To Our Health!



Black Population 36,419,434

Black Death Rate 1,039per 100,000

population per year

Black Actual Deaths 378,325

White Death Rate 797per 100,000

population per year

Black Projected Deaths withWhite Rate 290,409

Black "EXCESS" Deaths 87,917Percent Additional Deaths 30%

2008 World Health Organization and 2008 Health, United States


4/26/2009



White Population 216,930,975

White Death Rate 797

per 100,000population per

year

White Actual Deaths 1,729,808

Black Death Rate 1,039

per 100,000population per

year

White Projected Deaths withBlack Rate 2,253,479

White “Deficit" Deaths 523,671Percent Additional Deaths 30%


Life Expectancy


Males Females

Rank State Years

1 San Marino 80

2 Japan 79

9 Canada 78

18 United Kingdom 77

30 Cuba 76White AmericanMale

76

35 Chile 75

44 Barbados 72

57 Bahamas 71

66 Antigua and Barbuda 70

75 Jamaica 69

Black AmericansMale 69

Rank State Years

1 Japan 86

4 Switzerland 84

9 Canada 83

18 Netherlands 82

29 United Kingdom 81White AmericanFemale

81

33 Cuba 80

39 Barbados 79

46 Bosnia and Herzegovina 78Black AmericanFemale

77

55 Bahamas 77



4/26/2009


Maternal Deathsper 100000 live births

1 Ireland 1

2 Sweden 3

15 Switzerland 5

21 Canada 7

25 United Kingdom 8

30 New Zealand 9White American 9.1

34 Bulgaria 11

45 Bahamas 16

45 Barbados 16

56 Costa Rica 30Black American 31.7



Neonatal Mortality Rate(per 1000 live births)

Rank State Rate1 Japan 1

4 Andorra 2

16 Canada 3White American 3.7

32 Cuba 4

42 Bahamas 5

51 Ukraine 7

58 Barbados 8

62 Cape Verde 9

Black American 9.2

Infant Mortality Rate(per 1000 live births)

Rank State Rate1 Iceland 2

2 Japan 3

17 Switzerland 4

27 Cuba 5White American 5.7

36 Belarus 6

39 Lithuania 7

44 Chile 8

52 Antigua and Barbuda 10

58 Barbados 11

65 Bahamas 13Black American 13.6


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Low Birth Weight Newborns (percent)

Rank State Rate

1 Albania 3

3 Sweden 4

21 Cuba 6

40 Bahamas 7

White American 7.2

75 Rwanda 9

90 Barbados 10

103 Ghana 11

114 Uganda 12

123Tanzania 13

Black American 13.6


DiscussionHas Health Disparities Impacted You

Personally? How do we make policymakersaware these disparities?

Limit Comment90 seconds

15 minutesDying While Black: Colorblind Policies and Eliminating the Slave Health Deficit February 26, 2009Copyright © 2007 Vernellia R. Randall. All Rights Reserved. Contact: [email protected].


4/26/2009


Color-blindRacism


Distinguishing Race from Class

Race

Is a social construction thathas biological consequences

primarily because of:

Social isolation

Racism

Is Race an Issue? Control forclass by comparing people of thesame class but different race Middle Class Blacks have a shorter

life expectancy than Middle ClassWhites

Is Class an Issue? Control forrace by comparing people of thesame race but different class Poor Blacks have a shorter life

expectancy than Middle class Blacks.



4/26/2009


Race not Class Alone

Akron Beacon Journal Low income whites live +3 years longer

than low income blacks

Middle income whites live +10 years

longer than middle income blacks

Low Birth Weight, 1999Black White

Less than 12 years of education 15.2 9.012 years of education 13.1 6.913 year or more of Education 11.7 5.8



Understanding Racism

RacismIs any action or attitude,conscious or unconscious, thatsubordinates an individual orgroup based on skin color orrace. It can be enactedindividually or institutionally.It is about power.

Institutional Racism:A system of procedures,practices and patternswhose effect is to perpetuateand maintain the power,influence and well-being ofone group over another.


4/26/2009



Old Fashioned Racism

• overt belief in white superiority

• Promotion of segregation

• Belief in biologically basedintellectual inferiority

• Overt discrimination (individualand institutional)

Tarman, Christopher & Sears, David O. 2005. The Conceptualization andMeasurement of Symbolic Racism. Journal of Politics? 67? (3),? 731-761


Color-Blind Racism• increasingly covert racial discourses and practices,

• avoidance of racial terminology

• claims by whites that they experience “reversediscrimination”,

• avoids direct racial references in political matters

• invisibility of the mechanisms of racial inequality, and

• the re-articulation of some of the elements of Jim Crowracism

Bonilla-Silva, Eduardo. 2001. White Supremacy and Racism in the Post-Civil RightsEra. Boulder, Colorado: Lynne Rienner Publishers


4/26/2009



Distinguishing Stereotypes, Bias, and Prejudices (S-B-P)

from Discrimination

Non-Racist

No S-B-P

No Discrimination

Reformed RacistS-B-P

No Discrimination

Color-blind Racist

No S-B-P

Discrimination

Old Fashioned Racist

S-B-P

Discrimination

Presence ofDiscrimination

Presence of S-B-P

*Based

onR

obert

Merton

’sform

ulation

s

IntentionalRecklessNegligentStrict


Intentionally Blank


4/26/2009


Conservative Color-Blindness

Racial hierarchy is legally irrelevant to the

Constitutional principle of Equal Protectionunless state-sponsored, consciousdiscrimination is directly implicated and isa proximate cause.

do nothing.

Convince racially marginalized groups to adoptthe proper cultural values so that they maytake advantage of the new race-blindlandscape

Proponent

Justice Clarence Thomas


Liberal Color-blindness

Race does matter— but not much.

willing, under some conditions, to be

race sensitive but very limited

Views frontal attack on racialconditions as divisive.

Convince racially marginalizedgroups to adopt the propercultural values so that they maytake advantage of the new race-blind landscape

Proponent

President Barak Obama



4/26/2009


How prevalent is colorblind racism in yourlife or the life of your family and friends?Which is more prevalent conservative or

liberal colorblindness?Which is more stressful?

Limit Comment90 Seconds

15 minutesDying While Black: Colorblind Policies and Eliminating the Slave Health Deficit February 26, 2009Copyright © 2007 Vernellia R. Randall. All Rights Reserved. Contact: [email protected].


Intentionally Blank


4/26/2009


Impact of StressDue to Racism

Or Racism the Smog ofour Life


HealthMental

Physical

Bio-chemistry

Genetics

DeprivationOppression

•Wealth/Income

•Education

•Criminal Justice

•Environment

•Health Care

•Housing

•Targeting TGAD*

•Employment

•Food, water, etc.

•Stress (Racism)

EmbeddedSocial/RacialInequalities

IndividualBehavior andChoices

• Slavery

• Legal Apartheid• Racism

**Tobacco, Guns, Alcohol, Drugs

Com

munit

ies



4/26/2009


When the Bough BreaksUnraveling the Black-White Mortality Rates.

http://www.unnaturalcauses.org/video_clips_detail.php?res_id=214


The StressResponse



4/26/2009


Health of the Parents Affects the Health of the ChildThe Slave Health Deficit and the Randall Family

???

Tom1875 –1970

Grand

Sarah1815 –1860

Great-Great

Pauline1921 –1957

Mother

Narcissus1854 –

1890Great

Manlis1845 –1935Great

Cora1881 –1927

Grand

Ernest1916 –1995

Father

TshakaSon

IssaSon

Maude1893 –1980

Grand

Jesse1895 –1970

Grand

JesseGreat

James E 1949 – 2006 [Brother]Brenda J [Sister]Vernellia

VernelliaMother

Mary A.1840

- 1913Great

Francis1868 –1948Great

En

dof

Slavery

En

dof

Legal

Ap

artheid

(19

64

)



Intentionally Blank


4/26/2009


Why a RacializedSystems can't be fixedwith Class-based, Color-blinded policies.


Health Care Lack of Universal Access

Barriers to Hospitalsand Other Health Care Institutions

Barriers to Nursing Homes

Barriers to Physicianand Other Providers

Racial Disparities in Medical Treatment



4/26/2009



Racial Discrimination in Medical TreatmentAfter controlling for severity of illness and ability to pay, when

receiving medical treatment Blacks are…

Less likely to receive anti-retroviral therapy (AIDS)

3x less likely to receive aggressive treatment (Cardiology )

Less likely to be referred for renal transplantation (Kidney

disease)

Less likely to get adequate pain medication (Pain/Cancer)

More likely to receive amputation (Diabetes)

Half as likely to receive surgery for glaucoma

(Children) Likely to receive fewer medications when ill


Implicit Bias

Implicit Bias Test 88% of white people biased for whites 83% heterosexuals biased for straight people

66% of non-Arab, non-Muslim volunteers biased for non-Arab, non-Muslim

48% of blacks biased for whites 36% Arab Muslims biased fro non-Arab, non-Muslims 38% gays and lesbians biased for straight people.

To take the Implicit Association Test, go tohttps://implicit.harvard.edu.


4/26/2009


Alternative to Colorblind Approach

Comprehensive

• Must focus on all importantissues almost simultaneouslyfor everyone

Universal

• Must address issues asuniversally as possible

Targeted

• Must assure thatadministration, designand outcome of all effortsaddress issues of racialminorities

• Must prioritize aroundeliminating inequalities


Slavery, Apartheid, and Racismwhat meaning does that have for

the lives of blacks in 2009?


15 minutes



4/26/2009


ReduceMorbidity and

Mortality

IncreaseHealth Care

Use

Assure QualityHealth Care

EliminateDisparities or

Discrimination inHealth Care

AssureAccountability

A Multi-cultural Approach for

Eliminating Racial Health Disparities

Copyright © 2006. Vernellia R. RandallAll Rights Reserved.


Increase Health Care Use Universal

Provide universal health carecoverage

Targeted Locate health facilities in black

community (Hospitals, Clinics,Alcohol and Drug Detoxcenters)

Assure health care work force inblack community (Physicians,Nurses, Dentists, Psychologists)

Obama• Not Universal coverage

• No

• No, but


4/26/2009



Reduce Morbidity and Mortality Universal Obama

Eliminate disparity in poverty (assure livable income) no

Eliminate Guns and/or bullets no

Eliminate environmental hazards and topic dumps no

Decrease availability of Alcohol and Cigarettes no

Targeted Priortize Communities of Color no

Increase educational achievement ??

Increase Economic development of neighborhoods no

Increase Availability of fresh foods no


Eliminate Health Disparities Through TargetedPrograms on Specific Issues

Obama

Example

Diabetes

Cardiovascular disease

Maternal and infant mortality

HIV/AIDS No, but

Cancer No, but

Violence (including domestic violence)


4/26/2009



Provide Quality Health Care`

Universal

Improve Quality

Assure cultural competence of thehealth care workforce (i.e. requiremedical schools/ and CME)

Targeted

Increase knowledge about health ofblack persons and translate it intoclinical practice

Provide health care in accordance withrealities of the needs of the various“classes” of the Black community

ObamaYes

No

No

No


Assure Accountability Universal

Establish an Equality Health Care Council

Targeted Require deep data collection and reporting,

data collection on different racial groups,different subgroups, all institutions andproviders

Require a racial equity report card for healthagency, provider or facility

Make all providers and institutions responsible


ObamaNo but,

No, but

Possibly

Possibly


4/26/2009



Adopt and Enforce andEffective Anti-discrimination Law

Recognize multiple forms ofdiscrimination (intentional,reckless and negligentdiscrimination)

Authorize and fund the usemedical testers

Allow both individual andorganizational right of action

Assure adequate fines andregulatory enforcement


Obama’s Approach

•Invigorate enforcement ofExisting civil rights law

Inadequate for addressing’21st century discrimination


How do we influence health carereform so that it is multicultural

(universal, comprehensive, targeted)?


15 minutes


4/26/2009


Racism, Health and the 21st Century

W.E.B. Dubois said that “the problem of the 20th

century was the problem of the color line.”

That color line was overt and legally enforced.

Here at the beginning of the 21st century, theproblem of the color line continues - but now it isinstitutionally and structurally enforced. In theabsence of laws, policies, practices andreparations that address institutional racism anddiscrimination, the problem of color line in healthcare will continue for another hundred years .


dying while black: colorblind racism and€¦ · how prevalent is colorblind racism in your life or...

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