Correspondence from Chicago

by Sophie Johnson

When CNN broke a story earlier this month that showed reports of black heart disease patients dying at a much higher rate than equally sick white patients, there shouldn’t have been any surprise. The story—on racial inequalities in the American healthcare system—is an old one, and the reasons behind it are manifold and debatable. Why is this happening?

That question, of course, gets right at the heart (no pun intended) of race issues in America today. It cannot be answered by individual patients, nor can it be answered by medical institutions alone. To find the answer to that question, we must look at the living conditions of the typical African-American in the U.S.: from his diet, to his job, to the place he lives.

The study concluded that among those with serious coronary disease, black patients had a 36 percent survival rate and white patients a 46 percent survival rate after being tracked for nine years. Researchers reflected on the possibility that racial discrimination by doctors may have played a role, but they said that that sort of allegation was difficult to prove.

Not too difficult, in my opinion.

Researchers need only look a few years back, in fact, when the Duke University Medical Center conducted a similar study, which examined 1,392 white patients and 242 African-American patients who suffered from heart disease and had been diagnosed between 1998 and 2001. At the time of diagnosis, both groups had similar symptoms, but somehow only 60 percent of the African-Americans received either a bypass operation or angioplasty, while 72 percent of white patients had received such procedures. Furthermore, a poll conducted six months after the study began found that the African-American group reported worse symptoms and quality of life than the white group.

Because race is a social construction and should not, on its own, produce physical differences in peoples’ health, we must conclude that racism was at play in both these studies. A 12 percent difference in the amount of major surgeries recommended to white patients versus black patients is too large a difference to overlook. It is impossible to argue that the recent findings concerning discrepancies between the physical conditions of black and white heart disease patients has nothing to do unfair medical treatment based on race. In other words: doctors can say what they want, but the fact is that African-American patients receive unequal treatment in our healthcare system.

But can doctors really be blamed? I am skeptical that doctors make a conscious decision to be racist in their medicinal practices. More likely, our prejudices are so deeply ingrained in our beings that we don’t even realize we’re exercising them.

Mary Mitchell, a columnist for the Chicago Sun-Times, likes to cover race issues in her bi-weekly column. She recently published a controversial article detailing the reasons that black men need to get married.

“I kept getting phone calls from white women who said, ‘My boyfriend won’t marry me either! Why do you have to make this about race?’ These people don’t realize that we read about white issues every day. There is only one column that covers African-Americans, and I’m writing it. I’m not going to apologize for covering race, because race is a real issue,” Mitchell said while speaking to our class.

It is true that many whites—especially liberal, middle-class whites—are ready to dismiss the whole race issue and move on. Herein lies the very problem. Without recognizing the severe institutionalization of racism that has happened since the Civil Rights Movement in this country, we ignore one of the biggest cover-ups in history, which is happening right under our noses. Too often, as these medical studies show, it becomes an issue of life and death.

Unfortunately, racism is so institutionalized that we cannot stop with medical organizations while talking about medicinal racial disparities. According to research done by Wayne State University in 2001, the age-adjusted death rate for cancer was 25.4 percent higher for African-Americans than for white Americans, the infant mortality rate among African-Americans was more than twice the rate for white Americans and the diabetes age-adjusted death rate for African-Americans was more than twice that for white Americans. And that’s not just because doctors are racist.

To understand why these gaps are so great, we must look at the living conditions of African-Americans versus whites. Why, for example, is the leading cause of death among African-Americans heart disease? The median income for African-American citizens, of course, is much lower than it is for white Americans. Therefore, African-Americans (like other minority groups) are often forced into economically underprivileged neighborhoods, where resources are scarce if not completely unavailable.

For example, in the Englewood neighborhood in Chicago, more than 97 percent of the residents are African-American, according to the 2000 Census report. Forty-three percent of those living in Englewood are living below the poverty line. As a result, there is a relative surfeit of fresh fruits and vegetables, and residents of the neighborhood are forced to eat foods high in deadly trans fats and cholesterol. Those employed with minimum wage jobs typically work at least 10 hours a day, and don’t have the luxury to exercise for the sake of exercising. This kind of diet and lifestyle, of course, leads to heightened blood pressures, diabetes, obesity and heart disease.

Even if doctors in the United States practiced perfect racial equality (which I might argue is impossible in today’s society), many African-American citizens don’t have the money to afford the healthcare they need. This has as much to do with medical institutions as it does with unequal treatment across the board: in job opportunities, resource availability and adequate welfare systems.

The point is that racism has become so much a part of the American soil that it’s no surprise its crops are growing everywhere.

The best thing we can do at this point is educate. If the typical American can see the way the strings of racism connect—can see the ultimate result of the current system—more can be done to strengthen equality and bring justice to all.

The problem is that the truth in terms of race relations is under-reported in this day and age. People are dying because racism is an institution in this country.

The American public needs to know that.


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