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Racism

Note: Racial discrepancies in the criminal justice system are discussed under the issue: Drug War and Mass Incarceration. See also Immigrant Rights.

The Awful Race Disparities That Still Haunt Us

Even though a black family lives in the White House, hardly anyone seriously argues that we live in a postracial society.

By Sam Fulwood III 
Center for American Progress, April 17, 2012

Even though a black family lives in the White House, hardly anyone seriously argues that we live in a post-racial society.  That aspirational description of 21st century America came into vogue about four years ago, as President Barack Obama raced to victory in the 2008 presidential election, and a great number of black and white Americans wanted to believe the nation was finally closing the books on its discriminatory history.

But no. President Obama’s election didn’t suddenly sweep away all the accumulated consequences of past racism in our society. The preexisting racial disparities, so engrained in the fabric of our economy and culture, didn’t erase themselves in the wake of his victory.

As my Progress 2050 colleagues Christian E. Weller, Julie Ajinkya, and Jane Farrell make regrettably clear in their recently released report, “The State of Communities of Color in the U.S. Economy: Still Feeling the Pain Three Years Into Recovery ,” racial and ethnic minority groups aren’t living in a paradise free of racial disadvantage. Quite the contrary, their research demonstrates that people of color aren’t benefiting apace with white Americans as our nation gradually rebounds from the financial collapse and economic recession that gripped us all when President Obama took office:

[T]he data we summarize in this report shows that communities of color are substantially less likely than their white fellow citizens to enjoy the opportunities that come from having a good job, owning a home, and having a financial safety cushion in the form of health insurance, retirement benefits, and private savings.  This difference exists because economic opportunities eroded faster for communities of color than for whites during the Great Recession—and those opportunities have been coming back much more slowly for communities of color than for whites during the economic recovery.

The disparities Weller, Ajinkya, and Farrell write about aren't new. Anyone who’s paid scant attention to the drumbeat of sour economic news knows that white unemployment, while at near-record heights, never drew within spitting distance of the chronically high rates suffered by African Americans and Latinos. As a result of this one fact, my colleagues write, a host of other calamities followed for people of color during the economic downturn like toppling dominoes, including:

-- Black Americans enjoying fewer job opportunities than all other racial and ethnic groups.

-- Poverty rates, already higher for communities of color, rising faster in the recession and declining slower during recovery than for white Americans

-- Homeownership, a major source of financial security, disappearing faster for black Americans during the recession and recovery than for white Americans

Those are old, bitter, and racially disparate facts. But what is especially galling is the yawning silence and indifference that seems to accompany the periodic recitation of them. Worse, there exists in  some conservative quarters a refusal to acknowledge the truth and an eagerness to embrace discredited notions about postracialism.  Acting as if racial disparities don’t exist or believing we’re now living in some fantasy world free of racial divisions is nothing more than an excuse to preserve the status quo. It serves to protect the advantages of those who are already employed and comfortable, while keeping racial and ethnic minorities locked out of the improving economy.

But despite the cloudy pessimism disclosed in the report, there also exists the opportunity for hopeful change. More than a catalogue of racial disparities, the report provides a roadmap for policies that, if implemented, would help equalize the burdens faced by people of color. Specifically, it suggests federal policies that would accelerate job creation, shore up unemployment insurance, raise the minimum wage, increase access to health insurance, and implement comprehensive immigration reform to protect workers’ rights.

Armed with the facts of disparity and a prescription for change, policymakers have no excuse for inaction. Reporting the bad news, as Weller, Ajinkya, and Farrell have done, removes the blinders from their eyes. Policymakers’ indifference to the pain of their fellow citizens can only be interpreted as willing refusal to ensure that all Americans—including communities of color—share equitably in the rebuilding and recovery of the nation’s economy.

Sam Fulwood III is a Senior Fellow at the Center for American Progress and Director of the CAP Leadership Institute . His work with the Center's Progress 2050 project examines the impact of policies on the nation when there will be no clear racial or ethnic majority by the year 2050.

Disparities in Health Care

National Conference of State Legislators
January 2012

The term health disparities refers to population-specific differences in the presence of disease, health outcomes, quality of health care and access to health care services that exist across racial and ethnic groups. Disparities represent a lack of efficiency within the health care system and therefore account for unnecessary costs. According to a 2009 study by the Joint Center for Political and Economic studies, eliminating health disparities for minorities would have reduced direct medical care expenditures by $229.4 billion between 2003 and 2006.

Many factors contribute to racial, ethnic, and socioeconomic health disparities, including inadequate access to care, poor quality of care, community features (such as poverty and violence) and personal behaviors. These factors are often associated with underserved racial and ethnic minority groups, individuals who have experienced economic obstacles, those with disabilities and individuals living within medically underserved  communities.  Consequently, individuals living in both urban and rural areas may experience health disparities.

Despite ongoing efforts to reduce health disparities in the United States, racial and ethnic disparities in both health and health care persist. Even when income, health insurance and access to care are accounted for, disparities remain.  Low performance on a range of health indicators—such as infant mortality, life expectancy, prevalence of chronic disease, and insurance coverage—reveal differences between racial and ethnic minority populations and their white counterparts. For example:

Infants born to black women are 1.5 to 3 times more likely to die than those born to women of other races/ethnicities and American Indian and Alaska Native infants die from SIDS at nearly 2.5 times the rate of white infants.

Cancer is the second leading cause of death for most racial and ethnic minorities. African American men are more than twice as likely to die from prostate cancer than whites and Hispanic women are more than 1.5 times as likely to be diagnosed with cervical cancer.

African Americans, American Indians and Alaska Natives are twice as likely to have diabetes as white individuals; diabetes rates among Hispanics are 1.5 times higher than those for whites.

Health disparities are getting the attention of legislatures across the country. State policymakers are asking important questions: How are disparities in health eliminated? What is the role of state lawmakers in reducing disparities? How does my state compare to other states? What strategies decrease disparities in a cost effective way? Policymakers are responding to these questions with different kinds of legislation.

Racial and Ethnic Disparities in Health Care: Fact Sheet

Agency for Healthcare Research and Quality

The overall health of the American population has improved over the past few decades, but all Americans have not shared equally in these improvements. Among nonelderly adults, for example, 17 percent of Hispanic, and 16 percent of black Americans report they are in only fair or poor health, compared with 10 percent of white Americans.

How much do differences in the health care that people receive contribute to disparities in health? What strategies can overcome these differences in care? These are questions for health services research, and ones that researchers supported by the Agency for Healthcare Research and Quality (AHRQ, formerly the Agency for Health Care Policy and Research) have begun to address.

 

Identifying Disparities in Care

Access to Primary Care

Primary care is the underpinning of the health care system, and research studies have shown that having a usual source of care raises the chance that people receive adequate preventive care and other important health services. Data from AHRQ's Medical Expenditure Panel Survey (MEPS) reveal that:

About 30 percent of Hispanic and 20 percent of black Americans lack a usual source of health care compared with less than 16 percent of whites.

Hispanic children are nearly three times as likely as non-Hispanic white children to have no usual source of health care.

African Americans and Hispanic Americans are far more likely to rely on hospitals or clinics for their usual source of care than are white Americans (16 and 13 percent, respectively, v. 8 percent).

Diagnosis and Treatment

Race and ethnicity influence a patient's chance of receiving many specific procedures and treatments. Of nine hospital procedures investigated in one study, five were significantly less common among African American patients than among white patients; three of those five were also less common among Hispanics, and two were less common among Asian Americans. Other AHRQ-supported studies have revealed additional disparities in patient care for various conditions and care settings including:

Heart disease. African Americans are 13 percent less likely to undergo coronary angioplasty and one-third less likely to undergo bypass surgery than are whites.

Asthma. Among preschool children hospitalized for asthma, only 7 percent of black and 2 percent of Hispanic children, compared with 21 percent of white children, are prescribed routine medications to prevent future asthma-related hospitalizations.

Breast cancer. The length of time between an abnormal screening mammogram and the followup diagnostic test to determine whether a woman has breast cancer is more than twice as long in Asian American, black, and Hispanic women as in white women.

Human immunodeficiency virus (HIV) infection. African Americans with HIV infection are less likely to be on antiretroviral therapy, less likely to receive prophylaxis for Pneumocystis pneumonia, and less likely to be receiving protease inhibitors than other persons with HIV. An HIV infection data coordinating center, now under development, will allow researchers to compare contemporary data on HIV care to examine whether disparities in care among groups are being addressed and to identify any new patterns in treatment that arise.

Nursing home care. Asian American, Hispanic, and African American residents of nursing homes are all far less likely than white residents to have sensory and communication aids, such as glasses and hearing aids. A new study of nursing home care is developing measures of disparities in this care setting and their relationship to quality of care.

More: Chartbook on health care disparities

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