Racism Kills: Health Disparities, the Stressors of Race, & Public Policy

Arline Geronimus

Alternet recently posted an article entitled, “The Hidden Toll of Race,” which discusses the pioneering work of Arline Geronimus, a University of Michigan professor, researcher, and activist , who has studied health disparities between white Americans and Black Americans, with a focus on urban working poor, womyn, and teenage pregnancy.

Geronimus’ work is fascinating and has over her 30-year career faced considerable resistance. Geronimus’ hypothesis, and what her research shows, is that the underlying cause of health disparities among Americans of color and white Americans, is racism. Geronomis points out that public health research has long shown, that stress impacts one’s health. Researches have found that stress increases the production of cortisol, and that production over a long period of time (covering times of high stress) can trigger hormonal reactions that put individuals at risk for hypertension, diabetes, and other serious health issues.

Geronimus draws a powerful and controversial (perhaps to some) conclusion, that because the stress of racism builds over time, that Black womyn who have children during their teenage years, may actually be having children when it is healthier for both mother and child, and that it is the social stigma and lack of support that makes being a teenage parent so difficult.  Geronimus cites data that backs up her thesis, including evidence that Black womyn’s fertility and overall health declines after age 25. Moreover, Geronimus points out that racism causes significant health risks – risks and results that can’t be blamed on Black culture, eating, exercise habits, or genetics. Instead, the health impact is the result of oppression, which suggests that all subjugated populations would show similar health disparities.

It’s a tricky article, and an even more complex thesis. The article is well-written and gives much to think about because it challenges the idea that racism is benign or that we are anywhere near living in a post-racial society. Yet, I can understand why Geronimus’ work could be perceived as threatening, offensive or difficult. For one, it could be perceived as suggesting that Black people,, as Zora Neale Hurston once derisively wrote,  are all “tragically colored,” instead of “busy sharpening [their] oyster knives,” as Hurston herself was busy doing. In other words, suggesting that all Black people do is lament being Black in a society that oppresses Black people, or Black people haven’t created defenses or responses to racism that serve them and protect them from the impact of racism, or that Black people even think or experience racism much.  Lastly, and perhaps most uncomfortable is the role that biology plays in Geronimus’ work. Folks of color are used to biology and eugenics being used to assert that we are less than or somehow defective. And though I feel that’s a real concern to be mindful of when approaching Geronimus’ work, I think that the nuance and opportunity for critical thinking and dialogue posed by her work, is worth review. And it’s an opportunity to turn the biological binary and argument on its head – there’s nothing wrong with Black people, we are not and never have been biologically inferior, but systems of oppression are inhumane, because they impact us all at the very level that makes us all human; our biology. What a powerful paradigm shift in thinking about why social injustice is wrong, dangerous, and bad for us as a society. Not only that, but it certainly creates a quandary for social conservatives and those who say they value life.  If we value life, and we know and understand the impact of our actions, would social conservatives and society be willing to make different decisions. It really requires us to answer the question, whether we as a society intend to value the lives of all people on the planet, or do some people have rights to health, unimpacted biology, prosperity, wealth, and others simply do not. With clear evidence of the impact of racism, would we still create, live in, and reify racism in society?

I think many within communities of color have known this for some time: that racism, and more specifically, the stress of racism, the daily racism that makes life not only more difficult, but that also can prevent one from getting and having what one needs in life (like adequate medical care) all contributes to the health of Black Americans. Certainly, nearly every person of color, who is honest with themselves, can cite personal experience in which the experience of racism (not receiving an earned promotion, being ignored or followed in a store, flippant comments made by co-workers) hasn’t impact them – made them sad, anxious, or angry. Or that witnessing the disparity between how whites and non-whites plays out doesn’t cause a certain level of despair. The article reminds me of a harsh joke (read social commentary) from Dave Chappelle. In the joke, “How Old is Fifteen Really?” featured in Chappelle’s For What It’s Worth, performance live in San Francisco, Chappelle highlights America’s lack of empathy when it comes to how we think of and treats 15-year olds, depending on whether they are Black or white. He cites Elizabeth Smart, a7-year old girl, a 15-year old in Florida convicted and sentenced to life in prison, and R. Kelley.

Please note the clip has explicit language, and a what may be construed as an offensive argument to some. 

Geronimus, like Chappelle, also discusses this cognitive dissonance, of treating Black and white people in fundamentally different ways, albeit in far less controversial terms and without blaming the victim. What both Geronimus and Chappelle are saying, however, is that America does not respond with empathy to people across race in the same way. It does not protect children in the same way. And more often than not, people of color are blamed for their lives or for being hurt or harmed, in ways we never think about holding white Americans accountable. What’s more, our society is constructed at a psychological level, to stunt empathy, so that many non-people of color, or people with money, are completely unaware of the very real stressors of people of color and the poor. This in turn shapes our public policy.

Geronimus points out that given the health struggles, particularly of Black womyn, that having a child before the 20s is not necessarily an unwise decision for the health of either the mother or the baby, and that it is our public policy, and attendant cultural lenses, beliefs, and societal preferences that demonize Black teenage pregnancy. On the one hand, we live in a society in which some individuals spend hundreds of thousands of dollars to conceive, and yet chastise womyn who conceive naturally, but at a time society feels is inappropriate – in the case of Black womyn, too young, in the case of white womyn too old (past 40). Dorothy Roberts explored the legal and public policy implications of this in her book Killing the Black Body, which examines the way that government attempts to regulate Black female sexuality and reproduction, by codifying racist ideologies and laws, many remaining from U.S. slave society, into modern-day lawKilling the Black Body: Race, Reproduction, and the Meaning of Liberty

 I always knew racism was deep, I didn’t realize how much research was being done on how racism impacts health. Though I know organizations such as the Black Women’s Health Imperative, have been organizing and working with Black womyn around health for some time. This recent article brings both a sense of relief – in seeing the issue discussed, and deep sadness.

But I also wonder: would Geronimus get press if she weren’t a white womyn? I think that practitioners, particularly health practitioners of color have long known about this, perhaps through anecdotes,  but known about it nonetheless. Why is it that the voices of people of color, identifying the need or wound of the community are ignored? Why is community knowledge, whether knowledge of womyn, people of color, differently abled people, LGBT people ever considered valuable information. We write tomes on the ideas, motives, thinking and psychology of Nixon to Madoff, but somehow a whole community speaking, seems only to create a sense of apathy and silence.

I am glad that Geronimus is doing the work that she is doing – and hope that she can, in doing the work, also highlight practitioners of color who have been doing similar work. 

Key phrase for this week: paradigm shifts are needed.


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