A good portion of racial inequality in health is due to the associated economic
inequality. But not all of it. Some of it is due to everyday experiences of
racism, plain and simple. For a nice summary of research evidence, see:
http://www.rwjf.org/reports/grr/026422.htm (based on the longitudinal studies
of David Williams, now at Harvard's School of Public Health).

I haven't read "The Trouble with Diversity" yet, but my understanding is that
the author is saying the focus on diversity and racial identity distracts from
broader structural issues. It leads people to worry about things like the
number of black managers or CEOs rather than how the current economic system
allows some people to make billions while others literally starve. So, programs
like diversity training can only do so much. In the absence of broader
structural changes, they may even make things worse.

Having said that, it's worth emphasizing that reducing income inequality and
poverty is unlikely to suddenly eliminate all forms of racism. For example, if
my sources are correct, perhaps the biggest social problem in Scandinavian
countries today is discrimination against non-white immigrants. Accepting and
embracing different cultures is one thing Canada does better (although we still
have a long way to go in accommodating Aboriginal rights & needs).

Jeff




--
Jeff Denis
PhD Student
Department of Sociology
Harvard University

"The principle of organizing our society for the benefit of all the people and
not for a privileged few - that is still here and that is a principle to which
we adhere." - Tommy C. Douglas



Quoting Terry Schleder <[log in to unmask]>:

> Dennis,
> I appreciate your knowledge, wisdom and analyses and I want to understand
> more about this critique. I live and work in public health the US, and have
> never worked outside the country (sadly).  I am part of local efforts in NM,
> the poorest state in the US, to address racial health disparities or
> inequalities in health access/outcomes because I see evidence that a focus
> on income or class is insufficient in dealing with institutionalized racism
> in our healthcare and other politically informed structures.
>
> For example, even within our privately insured classes we see inequalities
> by race in treatment, outcomes and access measures.  So, one theory I gather
> from this is that "equalizing" the health access systems by income (private
> insurance as a proxy since poor folks do not have it here, and the US
> doesn't measure "class") still produces racism in aggregated pop. health
> outcomes.
>
> Our focus on racial health disparities is therefore a strategy to increase
> access to healthcare systems in a more equitable manner, but it is not the
> end-goal of the movement for universal access, as I see it.  Are you and
> this author saying that we should not be concerned with persistent racial
> inequalities because an economic levelling will normalize them?  If so, that
> sounds intriguing (coming from you) to me but also worrisome given our
> country's history with the institutionalization of racism and with the high
> present-day rates of poverty and disease within racial minority communities.
>
> Your thoughts are appreciated!
>
> Thanks for all you do.
>
> Terry
>
> Terry Schleder, MPH
> Community Health Consulting Services
> 402 Girard SE
> ABQ, NM 87106
> 505.401.1328
>
> "The opposite of war isn't peace; it's creation."
>                            - Mark Cohen, Rent
> On 2/16/07, Dennis Raphael <[log in to unmask]> wrote:
> >
> > I finished this book and recommend it highly.  His analysis of America's
> > obsession with race and neglect of inequality is consistent with my sense
> > that focus on racial and ethnic "disparities" in health serves to
> > depoliticize the issue of class inequalities and the skering of public
> > policy priorities towards the interests of the wealthy.
> >
> > The problem by this dominant discourse is outlined as being not that there
> > are a lot of poor people but that the rate for non-whites is greater than
> > that for whites, not that poverty levels are strikingly high in the USA.
> >
> > dr
> >
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