Racism and Racial Inequality in Health: Re-Thinking Health Care Reform as Social Justice

I’m gearing up for teaching this fall in an Urban Public Health program; part of what I like about the field is that it requires a very practical application of what can seem like abstractions in the field of sociology.  So, to talk about racism and racial inequality in public health means to talk about how these affect people’s bodies, health and illness.  Most eloquent on this subject recently is Marion Wright Edelman who has written about the impact of racial inequality on the health of children, she writes:

Right now, we live in a nation where children of color experience significant health disparities that begin before birth and follow them throughout their lives. Black infants are more than twice as likely as white infants to die before their first birthday and have higher infant mortality rates than children in 62 nations including Barbados, Malaysia and Thailand. One in every seven babies born to black mothers is born at low birthweight, a core risk factor for infant mortality and childhood developmental disorders. The rate of black infants born at low birthweight in the United States is worse than the rate of low birthweight in more than 100 nations including Algeria, Botswana and Panama.

Not surprisingly, black and Latino children also have higher incidences of childhood illnesses than white children. For example, one out of eight black children has asthma — one of the most common illnesses in children — compared to one in 12 white children. One out of every four black two-year-olds and one out of every five Latino two-year-olds is not fully immunized, although we know that every dollar spent vaccinating children against measles, mumps and rubella saves $16 in future costs. More than 30 percent of black children and about 40 percent of Latino children report not receiving dental care. Minority children are more likely to be living in poverty. However, racial disparities aren’t just about socio-economic status, although more than three-quarters of uninsured black children have a working parent, and more than half have a parent who works full-time throughout the year.

Edelman, a long-time defender of children’s rights, emphasizes “It doesn’t have to be this way,” and urges for reform on health care which would help address these persistent inequalities. Yet, even as much of the national public debate right now is focused on “health care reform” and that discussion has been derailed by racism.


Some anti-health care protesters, like the one in this photo (from here), cast their objections to health care reform in rather explicitly racist terms.  As Maggie Mahar writes, the health care reform effort has reignited what she refers to as the “Culture Wars,” a familiar story in the American political landscape. When viewed in terms of Edelman’s point about the impact of racial inequality on children’s health, these kinds of battle lines seem even more cruel.

I want to suggest that we re-frame the current health care reform debate in terms of social justice.   In my view, supporting universal health care for everyone in the U.S. is an important step toward re-dressing the persistent racial inequality that is endemic in our society.


  1. Dave Paul

    I want people to start talking about how the ONLY people protesting this health care reform are WHITE people. Primarily white males. I think that says a lot about the state of our nation and how (little) we provide for our people (of all backgrounds).

  2. Dave Paul

    I agree entirely with your view Jessie. This is my rationale for supporting health care reform as well. It is indecent how we let such large swaths of our population live in misery, racial neglect, and outright oppression. The public debate has always centered around white, middle class people. I am ready for our nation to begin making changes towards a more humane and respectful policy with regards to peoples’ health. We need to protect the lives of all Americans equally, if not giving those from disadvantaged communities a leg-up in health care because of the extra burden they face everyday living against the grain of white privilege and institutional racism.

  3. Seattle in Texas

    Those guys are a bunch of nuts. And on a side note but related, Rush Limbaugh’s offensive comparison with the Democratic Party and Nazi Germany, etc.( http://mediamatters.org/blog/200908070035 ) ridiculous, of which the National Jewish Democratic Council is currently petitioning to get Rush taken completely off the air…good luck. They (the right) have been convoluting socialism with Hitler’s conception of socialism, which was far more in line with the history of this in this nation on up to this very day, where only the higher level SES primarily white people have had virtually free access to health care, retirement, education, etc., and only high level politicians (historically white and white majority today) live truly socialist lifestyles, putting capitalism aside. A genuine socialist society doesn’t exclude people or groups in those ways institutionally, as did Nazi Germany and the U.S. has always done. Former Yugoslavia is a prime example of what a socialist society looks like without governmental abuse…though, the people WERE the government…soooo.

    But this article reminded me of how discrimination is carried out in other ways with relation to the health care industry also. Even when it becomes the case that all people do have access/coverage to healthcare of various sorts, people as in today, will still suffer various levels of discrimination based on the type of health care coverage they have, the information they are given based on the color of their skin, and so on. Research has shown that doctors tend to give white patients more time and information based on their conditions than Black patients–and the type of healthcare coverage has also played a role. The long racist history of physicians consulting their patients at varying degrees (even if unconscious and not intentional) impacts recovery rates and preventive behaviors between the groups—resulting in better outcomes for whites than people of color, also playing a key role in the impacting the longevity of life spans between groups. Not to mention even further, the pharmacists. They can even be helpful or not with relation to filling prescriptions and providing further advice, which reminds me of an older brief post on a different blog a few years back, but a good one (these are only three cases that reported then…there were likely plenty more who didn’t complain and went elsewhere): http://www.blah3.com/article.php?story=20060415041434892 .

    So, while ensuring all people have access to healthcare or are insured, this nation will still have such a long way to go in terms of ensuring all people have equal quality healthcare also. That’s a whole different can of worms….

  4. JDF

    Thanks for posting that link, Dave Paul. I’m a big Maddow fan and watch her show pretty regularly and this interview was terrific; it probably went over time and I can imagine her whispering “let it go” to the producer.

  5. MOM@Jesse

    I am glad you posted this, but I would like to know where you received your statistics about the black and Latino babies…I know that if you don’t have the money in this country then your children are able to receive Medicaid for shots, or access to clinics that would help your children receive shots etc.. I don’t feel it’s the lack of health care out there for children, I feel, it could be the lack of education of the parents for not getting their children proper medical treatment…I don’t say this to be mean, but I know white young parents that do not get the proper medical attention because of their lack of understanding, regarding, how to raise their child..In fact, I know of a white female right now that has to take a parenting classes, so she would have a better understanding about how or what impact she has on her children by the choices she makes about health and the emotional welfare of her children..There are so many young children having children. In other words, how can we expect children to really know what to do with taking care of their child when they are a child themselves..Maybe the problem is not the lack of help that they could receive, but the lack of understanding of what is out there to help them receive better treatment for their children.
    I have and know a lot of people on medicare right now, and people of all color and race will be affected by the changes to the medicare reform that everybody is worried about…The problem that many of these people face is that the medicare coverage will be cut down if you have a terminal illness period..In other words, if you have a terminal illness and are receiveing treatment, but the treatment is doing nothing to fix the problem, but rather, just maintain your problem; then medicare will cut down on the number of treatments that you will receive. There are a lot of people in nursing homes that do not have a good quality of life.. Most of the people sit in wheelchairs all day, and do nothing; some of them don’t know where they are, and the majority of them are bed ridden..Now, I am not suggesting that we should let them die, but I do think that every person in this country should be required to have a living will because many of those people I just mentioned above, probaby, would not want to live in those conditions. .However, there are a lot of co-harent people that are not able to move, but their minds are working especially, after a “stroke”, so again, althogh they cannot communicate verbally they are still able to reason mentally…Those are the people that will be affected by this health care reform because there is nothing that could be done for them, other then maintain or extend their life…I feel it’s wrong for the government to tell those people that they are cutting down on the treatments because their is nothing more that could be done for them as far as
    I’ve been watching the news, and I have to tell you that people of all races are upset about this reform not just “white middle class” men…However, what bothers me that “we” as the people have the “right” according to our constitution to question “our” government about laws that will effect “all” of us…I am glad that there are people out there that have questions about the reform concerning health care that will effect every one of us, our our children, and our grandchildren…”We” the people not “we” the government…This is very important for “all” of us to understand…This is what I’ve seen, thus far, however, I do know that the government has a 1000 page document showing all the changes that are going to be made concerning health care..Thanks Mom:)


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