Public Health in the New Millennium.Bias

New Millennium Bias

Bias. While we must acknowledge that racism, sexism, and other forms of bias play a role in who winds up poor in this country, we need a new analysis of intermediate as well as long-term effects. When we focus exclusively on skin color, ethnicity, or gender, we miss information that could help make our remedial policies less divisive and more comprehensive. There are more poor whites than poor blacks in America, but the proportion of blacks who are poor is much higher than the proportion of whites who are poor; the obvious explanation for this disparity is racism. Martin Luther King, Jr., taught that racism not only keeps African Americans socially excluded, but also contributes to the social exclusion of poor whites by keeping them from joining their political interests with the political interests of African Americans. We need more of this universalist way of thinking in our policy discourse and development. For example, we now know that, because of social exclusion, African Americans in general have not accumulated and transmitted wealth intergener-ationally to the degree that most other groups of Americans have. The rise in social status in subsequent generations seen in other ethnic groups in the US has thus been slower for African Americans.

This is a useful sociological finding because it implies that remedies are available through specific political solutions, and because it leads to a more inclusive understanding of poverty. Social exclusion is the result of multi-generational poverty. This is not a denial of racism; indeed, racism is the reason why African Americans disproportionately live in poverty. It is instead an acknowledgement that racism results in politically and economically remedial problems whose solution is in everyone’s interest. It makes sense to find common ground when we address bias. By the same token, however, we must see that different groups often do have different problems and that, even if a problem does not affect the majority, it is still worthy of our concern, our resources, and our commitment.

The Human Genome Project offers a useful analogy. If the mapping of the human genome shows that we are 99.9% the same, the focus for researchers will still be on the way in which we are 0.1% different, or why those who appear to be 100% the same have different conditions or outcomes. Why do only some of us get breast cancer or diabetes? Why do some of us appear predisposed to chemical addiction, mental illness, or health-risky behaviors? Why are certain populations prone to coronary diseases? How much of what is called genetic is the interaction of behavior or the environment and the human body? So with social exclusion: we must address how and why gender, ancestry and ethnicity, socioeconomic status, disability, sexual orientation, and rural living affect health outcomes, but we must equally look at the interaction of institutions, law, policies, and programs on groups of people. While research and analysis is essential, we cannot simply wait for the results of our investigations. The “social machinery” of which Winslow spoke is a human creation, not a force of nature, and therefore is subject to our intervention. We must demand the courage and leadership from ourselves as well as from elected leaders to create the means for all Americans to enjoy health, happiness, and prosperity. Our predecessors began this process. Now it is our turn.

Category: Health

Tags: health care, health-risky, medical care, Public Health

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