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.