How Is Racism A Health Threat? Consider The Phrase 'So-Called Race'

Steve Inskeep

April 09, 2021 / 2:25 pm

caption: People line up to receive a rapid COVID-19 test on Feb. 17, 2021 in Immokalee, Fla. Immokalee, which has a poverty rate of around 40% and whose population is made up primarily of agricultural workers, has joined with the Coalition of Immokalee Workers and Partners in Health to test, educate and vaccinate the community during the COVID-19 outbreak.

President Biden's CDC director made a striking statement for a federal official Thursday. "Racism," said Dr. Rochelle Walensky, "is a serious public health threat that directly affects the well-being of millions of Americans."

Walensky pointed to the disproportionate impact of COVID-19 on communities of color, and noted that there are long-standing structural barriers — like where someone lives and works and where their children play — that impact racial and ethnic groups differently. "These social determinants of health have life-long negative effects on the mental and physical health of individuals in communities of color," Walensky said.

This is, to say the least, a different view than the previous administration offered. Former Attorney General Wiliam Barr questioned the idea that systemic racism has even existed in recent decades, much less that it's a factor in public health. The Trump administration maintained that racial sensitivity training was itself racist.

Walensky's statement is the kind that strikes different ears differently — blindingly obvious to some, jarring to others — so Morning Edition asked Dr. Camara Phyllis Jones, an epidemiologist formerly of the CDC and now with Morehouse College and Emory University, to lay out the longstanding case for a link. "There are differences in health outcomes by so-called race across the country that have been documented for decades," Jones said.

More than once she referred to "so-called race," which is a vital part of her argument. She is observing what science shows: that humans are not genetically very different. Race, she said, is merely, "the social interpretation of how we look."

In other words, race is largely a matter of how society chooses to categorize you (and sometimes, if society allows it, how you choose to identify). There are long-term studies showing people's race may even change in their lifetimes.

This social reality is important, argues Jones, because different racial groups have different health outcomes.

"We know enough now to know that they are not based on our genes," she said, adding it's also "not in our cultures." And yet, she noted, people of color are "overrepresented in poverty." Less wealth, more debilitating jobs and poor health care and diet can lead in turn to poor health.

The differences in wealth and poverty come about, Jones said, because "opportunity is differently structured by this so-called race, and even the basic value that we assign to different people differs." The pandemic made longstanding disparities even more obvious, she said.

So what to do about public health disparities?

This subject came up in a 2019 Morning Edition interview with Kamala Harris, who was then running for president and is now vice president. In it, Harris was asked about reparations for slavery. Reparations cannot be paid to those who were enslaved, and who died long ago: but, Harris said, the U.S. could have what she called an "intervention, to correct course" after studying the effects of generations of post-slavery discrimination and institutional racism.

Jones picked up on this thought to talk of investments in the "root causes" of health outcomes, such as poor housing. "In this country we don't even pay much attention to history. ... We act like the present was disconnected from the past," she said

By declaring racism a public health threat, is the Biden administration just making a statement, or laying groundwork for change?