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Racism and Health: Henrietta Lacks Revisited
Posted by: | CommentsThe life of Henrietta Lacks is the subject of a new book, The Immortal Life of Henrietta Lacks by Rebecca Skloot. Ms. Lacks is a notable historical figure for her unwitting “donation” of her cells to scientific study. David Strohecker wrote about Ms. Lacks’ here back in October, around the 50th anniversary of her death from cervical cancer. Dwight Garner gives Skloot’s new book a rave review in The New York Times (hat tip: Jessica in Austin), and here’s a longish clip from that review:
“The woman who provides this book its title, Henrietta Lacks, was a poor and largely illiterate Virginia tobacco farmer, the great-great-granddaughter of slaves. Born in 1920, she died from an aggressive cervical cancer at 31, leaving behind five children. No obituaries of Mrs. Lacks appeared in newspapers. She was buried in an unmarked grave.
To scientists, however, Henrietta Lacks almost immediately became known simply as HeLa (pronounced hee-lah), from the first two letters of her first and last names. Cells from Mrs. Lacks’s cancerous cervix, taken without her knowledge, were the first to grow in culture, becoming “immortal” and changing the face of modern medicine. There are, Ms. Skloot writes, ‘trillions more of her cells growing in laboratories now than there ever were in her body.’ Laid end to end, the world’s HeLa cells would today wrap around the earth three times.
Because HeLa cells reproduced with what the author calls a ‘mythological intensity,’ they could be used in test after test. ‘They helped with some of the most important advances in medicine: the polio vaccine, chemotherapy, cloning, gene mapping, in vitro fertilization,’ Ms. Skloot writes. HeLa cells were used to learn how nuclear bombs affect humans, and to study herpes, leukemia, Parkinson’s disease and AIDS. They were sent up in the first space missions, to see what becomes of human cells in zero gravity.
Bought and sold and shipped around the world for decades, HeLa cells are famous to science students everywhere. But little has been known, until now, about the unwitting donor of these cells. Mrs. Lacks’s own family did not know that her cells had become famous (and that people had grown wealthy from marketing them) until more than two decades after her death, after scientists had begun to take blood from her surviving family members, without their informed consent, in order to better study HeLa.
Ms. Skloot tells the story of Mrs. Lacks’s life, from those tobacco fields in small-town Clover, Va., to the ‘colored’ ward of Johns Hopkins Hospital in Baltimore in the 1950s, where she was treated for her cancer, and where her cells were harvested. She follows the members of Mrs. Lacks’s family to East Baltimore, where many of them live today, still struggling with her complicated legacy. As one of Mrs. Lacks’s sons says: ‘She’s the most important person in the world, and her family living in poverty. If our mother so important to science, why can’t we get health insurance?‘
…
Ms. Skloot writes with particular sensitivity and grace about the history of race and medicine in America. Black oral history, she points out, is full of stories about ‘night doctors,’ men who could pluck black patients off the streets to experiment on their bodies. There was some truth behind those tales.”
While I’m glad that Ms. Lacks’ story is getting the attention it deserves in this new book, it would be mistake to regard this compelling narrative as an anomaly in U.S. history. Rather, the experience of Ms. Lacks and her descendants is in many ways an archetypal story about racism and health in the U.S., as Harriet Washington documents in her thoroughly researched book Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present.
We are allowing Poor Children to be Unjustly over Medicated? Duh!
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On the front page of the New York Times last Saturday (December 14, 2009), Duff Wilson reported on a federally funded team of researchers from the Universities of Rutgers and Columbia who revealed that children covered under Medicaid are prescribed antipsychotic medications at a rate four times that of children who are covered under their parent’s insurance. In fact the article reported that
Medicaid children are more likely to receive the drugs for less severe conditions than their middle-class counterparts, the data shows.
The article goes further to ask whether these tactics of medicating children are simply a cost-effective technique to control the problems of poor children rather than using techniques and strategies created for children within a higher socioeconomic bracket. This is very important, for it validates what my research and book, released June 2009 and titled: White Prescriptions?: Black Males and the Dangerous Social Potential of Ritalin and Other Psychotropic Drugs critically discusses.
Within my book I looked at the Medicaid system in Illinois and Florida. More specifically I investigated a specific list of psychotropic medications as it related to Black males juxtaposed against the number of all other groups covered under the state systems. The data revealed that Black males were disproportionately medicated than all other groups prescribed these strong medications. A system of social control is in operation as it relates to children, specifically males of color within the U.S. The U.S. and the government have a history of diagnosing and medically treating marginalized children.
For example, on December 30, 1969, John D. Ehrichman, Domestic Affairs Advisor of then President Richard M. Nixon sent a request to the Secretary of Health, Education, and Welfare. The president wanted the Secretary’s opinion as to the advisability of setting up pilot projects embodying some of [the] approaches presented by Arnold A. Hutschnecker, M.D., in his 1,600 page memo which advised the government to conduct nation-wide testing on all children six to eight years old. Such children would be put in special camps, and attend counseling sessions and day care centers that specialized in correcting their violent, delinquent tendencies. his national testing approach would attempt to detect and treat children who possessed homicidal and other violent tendencies.
Hutschnecker, who was at the time engaged in psychotherapy, hoped his proposal for nation-wide testing would allow those children identified as having problems to be subjected to corrective treatment. This line of thought and focus on these children continues today with the federal government, in combination with pharmaceutical companies, is continuously trying to prove the safety of and advocating the use of antipsychotic and other behavioral stimulant drugs in the behavior treatment plans for school age children. For example, in the 1990s, the National Institute of Mental Health (NIMH) attempted to explain the occurrences of violence within the inner cities. Their basis was founded on the possible biological and genetic defects in Black Americans. They proposed to do numerous studies that would have involved intrusive measures such as spinal taps, brain studies, and blood tests. Strong opponents halted the initiative, which resulted in the later resignation of Fred Goodwin, former head of the NIMH. It has been reported [at opensecrets.org] that the total electoral contributions donated by pharmaceutical companies to state and federal electives in 1990 were $3,273,367. In 2006, the donations had blown through the roof to $19,598,807. In 2006, out of the 435 members of the U.S. House of Representatives, 388 received a total of $9,481,486. Out of the 100 Senators, 92 received a total of $4,592,729 in pharmaceutical contributions. In 2006, Senator Clinton was number fourteen on the top twenty list of senators who received contributions ($124,855). Within this period, the top six contributors were Pfizer, Inc. ($1,743,839), Amgen Inc. ($1,150,925), GlaxoSmithKline ($1,108,101), Johnson & Johnson ($747,215), Abbott Laboratories ($675,896), and Eli Lilly & Co. ($540,921). During the 2008 presidential primaries the top six were Amgen Inc. ($686,500), Pfizer, Inc. ($648,971), GlaxoSmithKline ($520,716), Johnson & Johnson ($480,921), Roche Group ($370,227), and Abbott Laboratories ($366,800). These are the makers of the behavioral stimulants like Paxil, Zyban, Wellbutrin XL, Cleocine Phosphate, Zoloft and etc. These contributions have had an undoubted effect on elected officials.
For example, in 2005, President George W. Bush launched an initiative for a nationwide mental health screening of all children K-12th grade. Due to the New Freedom Commission on Mental Health (NFC), which was an Executive Order issued on April 29, 2002, his primary goal to create an integrated system of care that established identification, screening, and finally responding to metal health problems early within child welfare, public schools, criminal, and juvenile justice systems was enabled. Simply put, every child in the U.S. would be screened for mental health issues and forced prescribed care treatments. As of 2005, these measures have already been implemented in the states of Alaska; Arizona; Arkansas; California; Colorado; Connecticut; Delaware; Florida; Georgia; Hawaii; Idaho; Illinois; Indiana; Kansas; Kentucky; Louisiana; Maryland; Massachusetts; Michigan; Montana; Nebraska; New Hampshire; New Jersey; New Mexico; New York; North Carolina; North Dakota; Ohio; Oklahoma; South Carolina; Tennessee; Texas; Utah; Virginia; Washington; West Virginia; Wisconsin; and Wyoming.
This is an issue that should not be ignored but further investigated due to the lack of scholarship on the issue of medicating children. This also an issue that calls for scholars who are not afraid to look further than SES (socioeconomic status), but both race and gender.
Ignoring Systemic Racism: The House and Senate “Health Care” Bills
Posted by: | CommentsLaw Professor, Vernellia Randall, author of Dying While Black, has sent out a commentary (see link here) on the major weaknesses in the Senate bill 3590 and House Bill 3960 (health care reform bills) that have not gotten any significant media attention. She points out how they do not deal with structural and individual discrimination in medical care:
Racial discrimination in medical treatment is a significant problem. For instance, Blacks of similar income, education and severity of illness as Whites get different health care treatment. . . . For example, studies have shown that as compared to Blacks:
• Whites are 22% more likely to be hospitalized for ischemic heart disease;
• Whites are 57% more likely to undergo coronary-artery bypass surgery;
• Whites are 49% more likely to undergo coronary angioplasty;
• Whites are 25% more likely to have a mammography;
• Whites are 57% more likely to undergo hip-fracture repair.. . . . The ultimate health care reform bill must provide for an adequate legal structure that has the potential to eliminate racial discrimination in medical treatment. . . . To be effective the Senate bill must:
- Must specifically prohibit both intentional and disparate impact discrimination. In Alexander v. Sandoval, the Supreme Court reaffirmed its longstanding position that Title VI addresses only intentional discrimination. This is disastrous since most discrimination in health care is not intentional. Most physicians, hospitals and other providers, don’t set out to purposefully discriminate. Rather, they adopt policies and practices or they rely on stereotypes and bias to make decision and the net effect (the disparate impact) is to discriminate based on race.
- Must authorize individuals to sue on both the law and the implementing regulations. This effect discrimination (also called disparate impact) is prohibited by law through implementing regulation. Unfortunately, in Alexander v. Sandoval, the Supreme court held that an individual cannot sue (that is does not have a private right of action) on effect discrimination that only an agency can enforce the regulation. Thus, a person who knows that he or she has been discriminated against based on effect, can only file a complaint with the Department of Health and Human Services and hope they follow through. The result has been that litigation based on racial discrimination in medical treatment is non-existent even though it is clear that it exists. The private right of action on implementing regulations must be clearly articulated in the law.- Must assure that all health care providers are responsible for non-discrimination. Title VI does not cover physician and other health care providers who do not take any federal financial assistance. They have been exempted by regulations which have provided that a payments to beneficiary for “contract of insurance”, such as Medicare B, are not federal financial assistance. Since some physicians do not take any other federal financial assistance, such as Medicaid, essentially these physicians and other providers are exempt from anti-discrimination law. This must be corrected – no provider should be allowed to discriminate without impunity. It is unfortunate that the Senate in its efforts to reform health care and make it more accessible and improve quality has failed to effectively address racial discrimination in medical treatment. This is unacceptable – you can’t improve the quality of health for all Americans and ignore racial discrimination in medical treatment.
You can see her full comments and sign a petition here. Also contact your senators and representatives about these serious omissions.
World AIDS Day: Black Women, Racism and HIV/AIDS
Posted by: | CommentsToday is World AIDS Day, when people around the globe stop to reflect on those lost to the HIV/AIDS epidemic, which is almost in its third decade. While many people may associate the disease with white, gay men because they were one of the groups initially infected and affected by HIV and among the most political vocal about it, the fact is the epidemic has changed. Within the U.S., if you examine the epidemic across racial and ethnic groups, you will see that HIV/AIDS is not a disease that exclusively, or even primarily, affects whites. Blacks and Latinos are increasingly affected by the disease, as this graph based on 2007 CDC statistics illustrates:
The changing nature of the epidemic is even more striking when you include gender.Today, black women are the group with the highest rates of new HIV/AIDS infections. According to CDC:
- African American women account for a majority of new AIDS cases (66% in 2006); white women and Latina women account for 17% and 16% of new AIDS cases, respectively.
- African American women account for the largest share of new HIV infections among women (61% in 2006), an incidence rate nearly 15 times the rate among white women. (For more detailed look at statistics about the epidemic’s impact on African Americans, see: “Black Americans and HIV/AIDS” compiled by the Kaiser Family Foundation, opens PDF.)
During the first decade of the epidemic, most social science research focused on changing individual behavior (e.g., wearing condoms, using clean needles) as the primary intervention strategy to prevent HIV infection, these efforts often failed in the face of complex settings of social inequality. For example, telling a woman that her partner should wear a condom becomes a risky proposition if she is economically dependent on that man for survival and he sees the request to wear a condom as an affront of some kind. Thus, researchers and community activists interested in stopping the spread of the disease began to look at the dynamics of sexuality within a broader social and cultural factors.
Just as an increasing amount of research demonstrates that mothers who experience racism are more likely to have low-birth-weight babies, the experience of racism and sexism are part of the social and cultural factors affecting HIV/AIDS rates among African American women. One way to measure this combined racism and sexism, is to look at what national leaders have to say about the HIV/AIDS epidemic among black women. In 2004, when journalist and vice-presidential debate moderator Gwen Ifill raised this important issue in the form of a question to then-candidates John Edwards and Dick Cheney, neither one could stammer out a coherent answer. It was clear that the alarming rates of HIV/AIDS among black women were simply not a concern for powerful political leaders (who also happened to be white men).
Some of the most exciting research that attempts to address this inequality is the pioneering intervention studies conducted by Gina Wingood and Ralph DiClemente of Emory University who, drawing on Connell’s gender and power theory, began to think differently about HIV prevention for young, black women. Wingood and DiClemente developed an intervention study for African American adolescent girls that used workshops that emphasized ethnic and gender pride along with the usual HIV-prevention information. Basically, the researchers included a consciousness-raising group about race and gender along with the usual health education information. These positive messages about racial and gender pride are important for enabling and empowering young, black women who encounter a layered burden of racism, sexism and often, poverty.
However, not all black women who are HIV-infected are poor, as several activists remind us. Marvelyn Brown, for example, diagnosed at age 19 with HIV/AIDS has become an outspoken proponent and visible spokesperson for HIV-prevention among young, black women. The author of Naked Truth: Young, Beautiful and (HIV) Positive, Brown has won several awards for her activism. Rae Lewis-Thornton, diagnosed at age 23, was featured on the cover of Essence magazine in 1994 and described as, “I’m young, I’m educated, I’m drug-free, and I’m dying of AIDS.” It’s been fifteen years and, fortunately, Lewis-Thornton is still very much alive and an tireless activist. Yet, she struggles with the legacy of her diagnosis (powerful video interview with Lewis-Thornton here). And, young black women who are allies, are harnessing the power of new media to raise awareness about HIV/AIDS, such as Karyn and Luvvie of the Red Pump Project.
The growing epidemic among black women in the U.S. reflects a global trend. The World Health Organization’s estimate (via AIDS.org) is that there are over three million women with HIV in the world, most of them in Africa. In fact, one in 50 women in sub-Saharan Africa is infected with HIV. AIDS is the leading cause of death for women ages 20-40 in major
cities in the Americas, Western Europe, and Africa. The fact that this disease is shape-shifting into one what disproportionately affects black women both here in the U.S. and globally raises important questions about whether or not we will, collectively, be able to put aside our racism (and sexism) to address this epidemic.
As you go to a service, attend a vigil, or just hold a good thought or observe a moment of silence on this World AIDS Day, reflect also on the ways that racism shapes the epidemic and who we lose because of it. If you care about racial and gender equality, you need to start paying attention to HIV/AIDS. IF you’re concerned about HIV/AIDS, you need to start learning about racism and sexism.
For more on the public health crisis affecting black women, you can watch this video (approximately 27 minutes) which features a discussion with C. Virginia Fields, President of National Black Leadership Commission on AIDS, Monica Sweeney, MD, Assistant Commissioner for the Bureau of HIV/AIDS Prevention and Control of the NYC Department of Health and Mental Hygiene, and Marvelyn Brown.
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Discrimination Takes a Toll on Mental Health
Posted by: | CommentsA new study by sociologist Verna Keith, professor at Florida State University, finds that discrimination takes a toll on the mental health of African American women (h/t @mtrobinson via Twitter).
Keith’s research study, published in the journal Sex Roles, used data from the National Survey of American Life: Coping with Stress in the 21st Century to analyze the relationship between perceived discrimination and depressive symptoms among 2,300 African American adult women. They also looked at whether personal efficacy — the belief that one can control important circumstances affecting one’s life — explained the intensity of the women’s psychological response to discrimination, and whether experiences of discrimination differed by skin complexion while controlling for intervening variables such as age and education. In general, African American women who viewed themselves as being able to exercise some control over their life circumstances reported fewer depressive symptoms.
Keith’s findings also suggest that African American women who were subjected to higher levels of unfair treatment experienced more depressive symptoms, in part, because day-to-day discrimination undermined their overall confidence in their ability to manage life challenges, leaving them feeling powerless and depressed.
These new findings confirm what we point out again and again on this blog: racial discrimination persists, it is pervasive, and it has a detrimental effect on the health and life chances of people of color.
~ Verna Keith will be moving to Texas A&M University in January 2010 to head the Racial and Ethnic Studies Institute.
H1N1 and Racism
Posted by: | CommentsH1N1, also known as the “swine flu,” is becoming the latest front in the battleground of racial politics (h/t to reader Residente Visitante). There are two distinct angles to this story.
In the first, there is the disproportionate impact this epidemic is having on people of color in the U.S. A recent NYDaily News story notes that city and federal health officials have been virtually silent about the outsize impact the pandemic appears to be having on blacks and Hispanics. Although the Centers for Disease Control report made a passing mention in their analysis which revealed that of the first H1N1-related deaths among U.S. children, 33% (12 of 36) were among Hispanics. All told, half of the H1N1 children’s deaths between April and August were among African-Americans and Hispanics.
Perhaps quite predictably for those who are familiar with the illogic of white-framed thinking, this fact about racial disparities in health gets quickly, easily and widely misunderstood by those wishing to promote racism. Thus, enter the talking heads of the right-wing for the second angle.
Talk radio hosts Michael Savage and Neal Boortz, radio and Fox TV personality Glenn Beck, and columnist Michelle Malkin are spreading lies about the H1N1 virus through their various public media outlets, as Bonnie Fuller (admittedly, an unlikely source) points out in a recent piece at the Huffington Post. Here are just a few of the examples Fuller cites:
“Illegal aliens are bringing in a deadly new flue strain. Make no mistake about it,” blares Michael Savage.
“I’ve blogged for years about the spread of contagious diseases from around the world into the US as a result of uncontrolled immigration,” writes Michelle Malkin.
“What happens if there’s a rash of deaths in Mexico… and if you’re a family in Mexico and people are dying and Americans are not, why wouldn’t you flood this border?” announces Glenn Beck.
What these kinds of comments reveal, in addition to rank racism, is a complete lack of understanding about racial disparities in health. The facts are these: H1N1 is not being spread by immigrants to native-born U.S. citizens. Early in the epidemic, some U.S. college students traveled to Mexico, got sick, and came back to the U.S. and they spread the disease. Why aren’t Savage, Malkin and Beck blaming college students for the spread of this disease? Furthermore, the fact that Blacks and Latinos are dying at higher rates than whites from H1N1 is a consequence of institutionalized racism, not the cause of the epidemic. Once again, hate-mongers with network contracts rather than robes and hoods, find a way to inject racism into the national discourse.
Racism as Medical Malpractice: Henrietta Lacks’ Cells
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(Source: Wikipedia)
Interesting article over at RaceWire (racewire.org) about the unbeknown and unrequited contributions of Henrietta Lacks to the field of science. In 1951, exactly 58 years ago yesterday, Mrs. Lacks died of cervical cancer. Just 3 years later, cells from her body were cultured at Johns Hopkins into the “HeLa cells” now used as the standard vaccination for the polio virus. The kicker? The cells from Lacks’ body were used without her consent, without her knowledge, and without any reparations to the Lacks family. As stated,
While the cells were commercialized early on, and have recently been used to create a whole new lucrative industry of gene mapping the family of Mrs Lacks has (of course) never been offered any part of the wealth. They have only been asked to contribute yet more cell and blood samples, ‘for the good of science.
And it was not until 2001 that Johns Hopkins scheduled an event to honor Lacks’ contribution and to thank her family. Unfortunately, the event never happened.
This reminds me of the countless Black men exploited by white scientists in the infamous Tuskegee Syphilis Study of 1932 . This study, arguably the most despicable and atrocious example of state racism, eventually led to the 1979 Belmont Report, which is now standard operating procedure for scientific research with human subjects. However, the fact that the study continued under various supervisors until it was leaked to the press in 1970 bears testament to the enduring (white) logic of science and racism. In both Lacks’ case and the Tuskegee study, Black bodies were seen as expendable commodities by white researchers, who took advantage of their subjects and in the case of the Tuskegee study, ultimately killed them, their families and spouses.
As we have often argued on this blog before, American wealth and privilege has been born out of the sacrifices and injustices of people of color, particularly those of African Americans. It is striking how many Black Americans suffer from health inequality today despite their contributions to the very medical procedures and vaccines we now take for granted.
Why does the field of science proclaim objectivity in the face of such incontrovertible racism? Can we really tease out our sociocultural biases and prejudices when conducting scientific research?
Racial Disparities in Health Take a Financial, Moral Toll
Posted by: | CommentsA new study by Thomas A. LaVeist (Professor in Health Policy and director of the Hopkins Center for Health Disparities Solutions at the Johns Hopkins Bloomberg School of Public Health) and Darrell J. Gaskin (professor of health economics in the Department of African American Studies at the University of Maryland) conducted for the Joint Center for Political and Economic Studies, a Washington-based think tank, found that:
between 2003 and 2006, 30.6 percent of medical care expenditures for African-Americans, Asians and Hispanics were excess costs that were the result of inequities in the health of these groups. Between 2003 and 2006, the combined direct and indirect cost of health disparities in the United States was $1.24 trillion (in 2008 inflation-adjusted dollars). This is more than the gross domestic product of India and equates to $309.3 billion annually lost to the economy.
This staggering financial toll is accompanied by a moral toll that is even more devastating. As LaVeist and Gaskin note:
The large number of premature deaths among American racial and ethnic minority groups represents a substantial loss of human potential, a loss of talent and productivity that might otherwise have contributed to the betterment of society. By imposing a substantial burden on the economy, health disparities visit suffering on the entire society, not just the minorities who live sicker and die younger.
That, to my mind, is the central tragedy of racism – the loss of humanity, of human potential. And, lest this spark another round of ‘it’s in the genes’ LaVeist and Gaskin go on to note:
There are some who believe that health disparities are due solely to genetic differences among racial groups or irresponsible behaviors among those who suffer higher rates of illness and death. However, this is not true. Health disparities are rooted in environmental and societal factors associated with poverty and discrimination. As the Robert Wood Johnson Foundation put it, health disparities have “more to do with your ZIP code than your genetic code.”
For all the people on this blog and in the wider public discourse who lament that we need to “do something” about ending racism and racial inequality, I would like to suggest that we do this: end racial disparities in health and see if that doesn’t go a long way toward eliminating other dimensions of inequality.
A Look at Latina Teen Pregnancies: Intersections of Race, Gender, and Class
Posted by: | CommentsSilvia Henriquez has an interesting article on today’s Huffington Post entitled “Policies to Curb Latina Teen Pregnancies Have the Reverse Effect.” In the piece, Henriquez argues that the policy efforts designed to curb Latina teen pregnancies are too narrow and shortsighted—they focus on birth control and marriage rather than on big picture issues like immigration, poverty, and inequality. What’s most important about Henriquez’s article is that she skillfully highlights the ways intersecting factors of race, gender, and class overlap to shape these high rates of teen pregnancy. Henriquez begins by offering some important context in which to situate the debate. She writes:
“Latina teens give birth at a rate more than twice that of white teens. Latinos have a much lower high school and college graduate rate compared to white teens.”
This background information gives insight into the environment facing pregnant Latina teens. Other sociological research has shown that when women give birth at young ages they are less likely to finish school, less likely to land well paying, stable jobs, and thus more likely to be poor. When the fathers are in comparable situations (like the lower high school and college graduation rates Henriquez describes), this only compounds young women’s likelihood of raising children in poverty. And given that institutional and employer-based racial discrimination still runs rampant, Latino/as are likely to face higher jobless and underemployment rates than whites, further exacerbating the chances of remaining poor. (Deirdre Royster’s book “Race and the Invisible Hand” is one such example of insidious racial discrimination in low skilled labor markets, though there are many others.) Henriquez continues on to say that:
“Myths — rather than realities — have too often guided the public discourse about Latinas and pregnancy. Latina teens don’t have sex more often than their white counterparts and most desire a college education. In addition, despite the demonization of immigrants in recent health care debates, most Latina teen moms are not immigrants.”
These are critical points that highlight the ways Latinas are cast in what Joe Feagin insightfully describes as the white racial frame. This frame (discussed elsewhere on this blog) encompasses stereotypes, sincere fictions, and ideologies about different racial groups. However, these stereotypes, images, and beliefs are shaped by gender as well as race. Thus, women of color often are cast as hypersexual, while men of color are likely to be depicted as criminals. As such, when Henriquez writes that Latina teens do not have sex more often than white teen girls, nor are they mostly immigrants, she counters white racial framing of Latinas as hypersexual, irresponsible, and a drain on national resources. (Similar imagery and framing was present in Ronald Reagan’s depictions of “welfare queens” in the 1980s.) Henriquez then identifies some of the factors that influence Latina teens’ high birth rates:
“Compared to white teens, Latina teens have higher pregnancy rates because they use birth control much less often and reject abortion much more often. Religion and family influence are very important factors, but for sexually active Latina teens these are not the only or even most relevant obstacles to birth control usage. For many Latinas, the top barriers to birth control usage are much more mundane: transportation, lack of health insurance or cash for health services, confusing and intimidating immigration regulation for households with a combination of citizens and non-citizens, and lack of guidance about available services. When teen pregnancy prevention programs and messages ignore these obstacles, Latinas become distanced from sex education efforts.”
Here is an incredibly important point that highlights Henriquez’s central thesis that bigger issues than simple individual choice are at play for Latina teen moms. The issues she cites—transportation, lack of health insurance—are directly linked to social class. If you’re a teenager in the suburbs with your own car, it’s relatively easy to head off to your local Planned Parenthood for condoms. If you have health insurance, you can visit your doctor, tell him or her you’re planning on becoming sexually active, and get safe, confidential counseling and birth control. Switch out the car, the suburbs, and the health insurance for an impoverished neighborhood, no access to a doctor, and no money to find one, and the picture gets much bleaker.
Note also that these aren’t just class issues. For Latinas, intersections of race and gender are also factors. Henriquez astutely points out that immigration regulation can add layers of bureaucratic confusion that can make it difficult for these teen girls to access social services. This is a point that highlights that race makes a difference, and that not all racial groups are interchangeable—these issues of immigration regulation are less likely to impact poor black teens, for instance. But they are more likely to impact teen Latinas who, by virtue of their sex, face greater potential consequences of sexual activity than do Latinos. Gender, race, and class all come together to shape this issue. Henriquez continues:
“Sex education programs often tell teens that delaying parenthood until they finish high school and college will bring them some version of the American dream: a good job, economic security, family stability. The troubling reality is that for Latinas this promise comes true for only a limited few. Recent research confirms that Latina teen mothers have roughly the same socioeconomic circumstances at age 30 as those Latina teens who delay childbirth. The unfortunate reality is that access to college and the opportunities that emerge as a result is starkly different for Latina teens and white teens.”
This reiterates Henriquez’s point that broader issues than personal choice are at play here. If Latina teen mothers are in the same socioeconomic place by age 30 as those who’ve chosen to delay childbearing, then this points to major issues in our educational and economic spheres. Most studies show that more education translates into increased economic rewards. Do Latinas have the same access as women of other racial groups to access higher education and its attendant rewards? Perhaps more importantly, do women of all racial groups have the same access as white men, who despite being a numerical minority of the population remain overrepresented in the highest paid, most prestigious positions?
I agree with Henriquez that these are the structural conditions that should be the subject of focus, rather than simplistic, “one-size-fits-all” policies that fail to take into consideration the ways that intersections of race, gender, class, and other factors shape groups’ experiences differently. Latino/as are the fastest growing segment of our population, and by the middle of this century, whites will cease to be a numerical majority as the population of other racial groups continues to grow. Given our rapidly changing national demographics, we would be wise to establish policies that eliminate institutional disadvantage for all groups of color.
