Sorry, Can You Please Explain Again How Systemic Racism in Healthcare Works?

by James A. Bacon

The U.S. healthcare system, we hear with increasing frequency, is systemically racist. Here in Virginia, for instance, we hear that Black women suffer a higher rate of complications in childbirth than White women. But any theory of systemic racism in healthcare needs to explain certain inconvenient facts that I stumbled across recently when reviewing the Kaiser Family Foundation “Virginia Health Care Landscape.”

Perhaps the most meaningful statistic on healthcare status is longevity. The Kaiser numbers floored me. Hispanics — people of color who are widely thought to suffer from less access to healthcare — have the longest life expectancy of any racial/ethnic group in Virginia: 88 years. They are followed by Asians, who live on average 87 years. Whites live 79 years on average, and Blacks 75 years. If the system is racist, why do Asians and Hispanics live so much longer than Whites?

Why aren’t Asians or Hispanics the racial/ethnic yardstick for health rather than Whites? Why is the small, 4-percentage-point disparity between Blacks and Whites played up while the large, 13-percentage-point disparity between Hispanics and Blacks is ignored?

Here’s another factoid that doesn’t fit the narrative: “Both nonelderly White (35%) and Black (33%) adults in the state are more likely to report experiencing frequent mental distress than nonelderly Hispanics (26%).”

How is that possible? Whites experience more frequent mental distress than Blacks? I’ve been informed by the smartest people that systemic racism fills Black people with continual anxiety and that White people, who benefit from White Privilege, don’t deal with the same challenges. And how come Hispanics are, relatively speaking, so care-free? I thought Hispanics were supposed to be haunted by the insecurity and anxiety associated with the dual threats of poverty and fear of deportation.

Here’s one more factoid: “While nonelderly Hispanic (58%) and Black (72%) adults are less likely than nonelderly White adults (77%) to have a usual source of medical care, nonelderly White adults (83%) are less likely than nonelderly Black (89%) and Hispanic (85%) adults to report having a primary care visit in the past two years.

Wow, Hispanics are less likely to have a “usual source of care” but they somehow manage to live years longer? Whatever advantage is implied by by having “a usual source of healthcare,” it evidently does not translate into regular primary care visits. How does the systemic-racism paradigm square with the fact that more Blacks and Hispanics report regular access to primary care than Whites?

If I were so inclined, using the logic of the left, I could string together cherry-picked data proving that Virginia’s healthcare is systemically racist against Whites. I don’t do that because I don’t believe it to be true. Yet “progressives” string together cherry-picked data in proclaiming — with great self-righteousness and indignation against anyone who dares disagree — systemic racism favoring Whites.

Social reality is complex. Healthcare is complex. If there is bias in the system, it’s socio-economic bias favoring individuals who benefit from employer-based insurance coverage. But, frankly, I’m not sure how important that is compared to lifestyle factors such as nutrition and exercise. Of this I am confident: viewing the healthcare system through a prism of race alone does violence to reality. Insofar as the rhetoric of grievance persuades minority groups that they are victims of hostile forces, it is likely to inspire counter-productive avoidance of the healthcare system.

Sadly, the political/cultural/media elite don’t tolerate complexity and nuance. We have reached a point where people like Virginia’s Commissioner of Health are attacked and silenced for openly contesting Woke orthodoxy.

Based on what I’ve seen in K-12 education and the criminal justice system, I proffer the following prediction: The more Woke Virginia’s healthcare system gets, the more counter-productive behavior we will see and the more racial disparities will get worse.