By Larry Consenstein
I read Peter OIiver’s My View piece and found myself struggling to understand how I felt about it. Intertwined with the great, universal goals of communicating with all people, regardless of their educational or social background, and identifying the problems of directing messages to an elite, were the contemporary taglines of Critical Race Theory (a law school discussion how historic slavery and racism has impacted contemporary creation of laws and regulations) and the 1619 Project (a comprehensive historical review of the role of slavery in the U.S., from the first slaves in North America to current racial inequities). Although these ideas, from the 1970s and 2019, respectively, could have been identified as exclusively academic and relegated to higher education, they have become the war cry of those who want to push back the advances in civil rights over the last 50 years. The advances our country made in civil rights are essential parts of our democracy: the form of government of, by, and for the people that has made our country great. Many of the foundations of civil rights are now being broken down in our politics and in our courts, thus imperiling our democracy writ large.
My personal path through civil rights began with my parents, who in the 1950s lived in post-WWII low-income housing in NYC and worked to desegregate the homes. Interesting concept. Why was it that housing built with the help of federal funding ended up all white, when veterans who died for our country were also Black? It turns out that much of the rebuilding of our economy after the Great Depression included building housing that was segregated, a compromise reached by Roosevelt with the southern Democrats in Congress, that was necessary to get the funding. My point here is to show the throughline that segregation and racism has followed, that influences so many aspects of our life today.
I work as a pediatrician. As a physician I work hard to focus on what is real and proven, rather than that which is anecdotal or incidental. As a result, issues of racism in health care should be approached based on empiric data. And of late there has been a great deal of scientific literature that reviews that question.
The first set of facts is that health outcomes for non-white U.S. residents are significantly worse than for white residents. Not just a little. Life expectancy is lower by several years for Black citizens, and death from several treatable diseases, such has heart disease, cancers, hypertension and diabetes is significantly worse for Black individuals than whites. Back in 2003 the Institute of Medicine, a bipartisan arm of Congress, worked with the National Academy of Medicine to review all the literature on the role of race in contributing to these health disparities. Physician experts reviewed what had been written, as well as setting up focus groups to explore issues that had not yet been studied. They asked whether there were racial differences in susceptibility to illness, whether race was a proxy for socioeconomic status (and therefore, since non-white citizens are significantly poorer than whites, that poverty alone was the cause), or whether racism was really the cause.
Amongst other conclusions, they found that bias, stereotyping, and prejudice by providers “contribute to racial and ethnic disparities in healthcare.” In the 20 years since this publication, this conclusion has been further solidified. Now every issue of the New England Journal of Medicine and the Journal of the American Medical Association has articles on the role of race and bias in health outcomes, and there have been many comprehensive reviews as well.
Now, back to Critical Race Theory and the 1619 Project. Our country was built on the backs of enslaved, mostly African-American individuals. The Civil War was fought to maintain this system. During Reconstruction, laws were passed to limit the ability of former slaves to vote and participate in government. Legal segregation, with far fewer resources for non-white Americans, continued in this country through the middle of the last century, and defacto segregation continues today. The manifestations of this race-based bias and discrimination include the dramatic health care and economic disparities on one end, and the Buffalo terrorist murders on the other.
Learning about history helps us to understand the present and helps to improve the future. If our past makes us uncomfortable, so be it. We should embrace the discomfort and learn how working together, helping our neighbors and all getting smarter will help us create a better world. Lyndon Johnson, in a 1964 graduation speech at the University of Michigan, said, “So, will you join in the battle to give every citizen the full equality which God enjoins, and the law requires, whatever his belief, or race, or the color of his skin?” Seems like a good question for today.
Consenstein lives in Fayston.
