By Robert A. Hummer, author of Population Health in America
Over the last couple of weeks, President Trump has intensified his long-standing racist behavior with repugnant tweets aimed at Congressional Representatives Ilhan Omar, Alexandra Ocasio-Cortez, Ayanna Pressley, Rashida Tlaib, and Elijah Cummings. Such hostile expressions, directed in these latest episodes toward five of our country’s minority lawmakers, has led me to question what long-term damages to health are occurring—both to our country as a whole and to the subgroups and populations whom Trump has focused his hate. Based on a large body of research on racism and health in the United States, the consequences will be real and will not be good.
I’ve been working on issues of population health in the United States for over 30 years and recently published Population Health in America, co-authored with Erin Hamilton. We devoted one chapter of the book to issues of race and health in the US, although admittedly this particular area of study is deserving of much more research. Focusing on health disparities between African Americans and Whites in the US, it is clear that both groups experience much more favorable population health—longer lives and healthier lives—than they did a century ago. That’s the good news. On the flip side, African Americans still live, on average, about four years less than Whites. We note that a four-year life expectancy difference between groups equates with an airplane full of African Americans crashing and dying every day. Where is the outrage? Where are the policy debates? Beyond the life expectancy disparity, we also discuss that African Americans continue to experience much earlier bouts of most diseases and disabilities than Whites, meaning that African American lives are not only shorter, but sicker as well.
The reasons for racial disparities in longevity and health are quite well documented by social and health researchers. The key explanation is racism—both at the personal level and, especially, as it operates in institutions such as the educational system, the labor market, the real estate market, the criminal justice system, through (lack of) government representation among minority groups, through inheritance laws that maintain our extraordinary level of wealth inequality, and more. Such institutional racism, experienced day in and day out by African Americans, creates stresses on the body and results in (many) fewer resources for African Americans and other minority groups to deal with those stresses as they express themselves across the course of life. Our country’s structure of institutional racism continues to result in much poorer population health among African Americans than Whites and creates additional suffering for African American lives in very human ways.
If we overlay the blatant forms of racism exhibited by the President on top of the already well-documented racial health disparities and explanations noted above, what will our disparities look like 5, 10, or 20 years from now? Perhaps even more concerning, what if through Trump’s lead and through a complicit set of followers, the incredibly hard-fought advances toward equality made by African Americans and their allies since the Civil Rights Movement are partially or fully worn away? What will be the future of racial disparities in population health as the era of racist leadership at the highest level continues to unfold and create its ugly legacy?