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Julianne Malveaux

Health Disparities: A Function of Assets, Access and Attitudes

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(NNPA) Last week, I attended a “think tank” conversation with leaders of the Rodham Institute, a newly- established center at George Washington University is dedicated to reducing health disparities in Washington, D.C. This is an important effort because Washington is such a divided city. East of the Anacostia River – Wards 7 and 8 – are the poorest areas in the district, with some of the most challenging problems. They have an obesity rate of more than 40 percent, which is more than the national average, and more than the extremely poor state of Mississippi. There are food deserts east of the river, where it is easier to get potato chips than an apple or banana. While there are rudimentary hospitals and health centers, most referrals to a specialist will likely require a Ward 7 or 8 resident to take an expensive taxi ride across the river. This city is rife with health disparities.

Washington isn’t the only city with these issues. Whether you are in San Francisco, Baltimore, New York, Chicago, Atlanta, or Dallas, there are areas that can be described as predominately Black and predominately poor. To be sure, there are well-off people in these predominately Black areas. They live there by choice, and have the resources and luxury of mobility that gives them access to some of the best hospitals in the city. But the poor don’t, and when health centers consolidate or close, they experience additional barriers to health care.

Health disparities are a function of assets, access and attitudes. Those with greater assets have more access to healthy food, better health care, and more information. Those without assets do not, and often make a decision to forego medical treatment in favor of food. Some of these folks can’t or don’t know to go to cost-savings stores which as Costco (which now has a store in the District of Columbia), where bulk healthy food is readily available. Some, stuck in habit, prefer greasy food to baked options. Many do not make the connection between eating choices and heart disease. Assets and access are linked.

And there is the issue of attitudes. Too many physicians don’t take poor (and African American) patients seriously. The Institutes of Medicine released a study in 2002 that showed that African American and Latino men were less likely than others to get painkillers for a broken bone. A subsequent study showed that African American children were likely to get differential treatment in emergency rooms. Too many poor people use emergency rooms for primary health care because they lack health insurance or access to good health care.

The attitude gap is also internal. Too many poor (and Black) people don’t take good care of themselves, which explains some health disparities. Frequent exercise and good eating habits go a long way toward healthy living, as do regular checkups. Some folks don’t know how to do the right thing. Some folks don’t have access to the right thing. And some people just won’t do the right thing.

One of the ways the attitude gap could be bridged is by admitting more African Americans to medical school. However, one of the speakers at the Rodham Institute conference indicated that not one African American man was admitted to this year’s class at Howard University’s medical school! If historically Black Howard University won’t admit African American men, who will?

Former Secretary of State Hilary Rodham Clinton closed out the conference, graciously laying out her vision for the institute and answering questions. She said that health disparities are a function of inequality, and that’s the point that sticks. Too often we look at the results of inequality without looking at the causes. Health disparities, the achievement gap, unemployment differentials are all a function of inequality. Dealing with these gaps on a piecemeal basis doesn’t get us close to finding solutions.

How do we close the income and wealth gaps that are at the root of so many other gaps? In the current conservative environment, talk of income or wealth transfers is just that – talk. Conversations about reparations are even more meaningless in this environment, especially when the entire Congressional Black Caucus won’t sign the Conyers bill on simply studying the impact of slavery on contemporary American life.

The Rodham Institute has laudable goals, a wonderful founding director in Dr. Jehan El-Bayoumi (full disclosure – my doctor), and a great community focus. In working to eliminate health disparities, perhaps this group will get us a bit closer to closing economic disparities as well.

Julianne Malveaux is a Washington, D.C.-based economist and writer. She is President Emerita of Bennett College for Women in Greensboro, N.C.

Is 'Big Brother' Racially Biased?

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(NNPA) When George Orwell wrote the novel 1984, he envisioned a character, real or imagined “Big Brother” who was a know-all, see-all, omnipotent and elusive presence that intruded into lives because he could. Those who knew about “him” were told that they did not exist, but in many ways, Big Brother may not have existed, either. The omnipotence had taken on a life of its own.

Orwell’s book was a book ahead of its time. At a different time, his book could have been dismissed as psychedelic fantasy. Today, he is just a step behind the reality in which we live. Verizon is sharing telephone records. The Department of Justice is monitoring journalists, and the IRS is playing games with those who seek nonprofit status. People pulled over for a minor traffic violation will have to submit fingerprints to find out if they have broken other laws. Big Brother is alive and well in too many layers of our lives,

Meanwhile, market researchers are segmenting populations by zip code and consumer patterns. They can tell you what percentage of Whites; African Americans or Latinos live in a certain zip code. They can tell you what you earn, what you are worth, and how many of your neighbors have criminal records. The zip code data drives marketers. Does it also drive law enforcement?

A recent study indicated that African Americans are between 2 and 6 percent more likely to be arrested for marijuana violations that Whites. I guess it is easier to arrest from a corner than from a country club! The rate of arrests for marijuana possession is 716 per 100,000 for African Americans, compared to 192 per 100,000 for Whites. The disparity is much higher in some counties.

Does this mean that African Americans are breaking more laws, or that law enforcement officers are targeting some zip codes or communities more regularly? It is a lot easier to pick up a few citizens enjoying marijuana in a park than banging down the doors of an elite country club. Yet data about marijuana usages suggests that there is little to distinguish the habits of African Americans from those of Whites. The only difference is the arrest rate.

Big Brother knows.

Big Brother has driven the kind of demographic that will tell you where you can find low-income, highly unemployed individuals, regardless of race. Big Brother can tell you who can afford lawyers and who cannot. Big Brother can drive police to investigate the least and the left out, those who are most vulnerable, while deciding to allow others to slink behind their space of class and privilege. Big Brother can play bang for buck games that make it more profitable to arrest those with few resources in the hood instead of those with home-based protection.

Data collection seems to be a race-neutral process. While data collection is an input, arrests are an output. Between input and output there is the opportunity for racial bias to show up. If White folk and Black folk take an equal toke, why are Black folk more likely to be arrested? Are zip codes driving public safety officers to one place and deterring them from another?

Differences in marijuana arrests raise real questions about the many ways that data may be used to discriminate. Instead of structural racism, intrinsic racism, and other forms of racism, we now have a data-based racism that is only logical when we ask how data is collected. Simply put, the zip code data leads people to discriminate, if only because they are being led to single out a certain population.

In other words you can be a non-racial racist. You can let the data, warped though it may be, lead you to biased conclusions. Data-based racism is as corrosive as emotion-based racism. Big Brother’s racial biases is nothing more than par for the course.

Julianne Malveaux is a Washington, D.C.-based economist and writer. She is President Emerita of Bennett College for Women in Greensboro, N.C.

Is the Recovery Stumbling or Soaring?

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(NNPA) Although the overall unemployment rate still exceeds 7 percent, and the official Black unemployment rate is greater than 13 percent, there are some who insist that there is a robust economic recovery in progress. Indeed, we were declared “post recession” in 2011, based on the definition of recovery as GDP growth for three quarters in a row. The perception of whether the recovery is stumbling or soaring depends on your own financial status. White and Asian households headed by those age 40-61 and have a two or four year degree recovered all but 2 percent of their wealth by 2012. Similarly situated African American and Hispanic households had just 58.7 percent of the wealth they had at the beginning of the recession. Wealth recovery depends on race, pre-recession portfolio (which speaks to the racial wealth gap), home value, stocks (the wealthier are more likely to hold stocks than others), savings (lower for African Americans), and debt (higher for African Americans).

Wealth accumulation is important. Even moderate amounts of wealth increase the likelihood that young people these in households are more likely to go to college, more likely to experience upward economic mobility, and more likely, in the next generation, to attain homeownership. Our nation lost more than $16 trillion in wealth during the downturn. Much of it has been recovered, but too many families, especially African American families, have yet to recover. Homeownership among African Americans, especially younger African Americans have declined.

Unemployment also has something to do with the wealth gap, because those who are unemployed frequently draw down on their home value, increase credit card debt, or use other means to simply survive. African Americans are twice as likely to be unemployed as Whites are, and there are no existing public policies to both increase employment generally, and to target employment programs to those most in need. President Obama can’t create “Black” employment programs, but targeting employment possibilities to inner city resident is an implicit target to Black America. Targeting to recent college grads that are unemployed and have significant debt would also implicitly favor African Americans (since virtually all African American students graduate with some debt, but nearly 50 percent of Whites graduate without debt).

Median wealth among single African American women with children is just $5, according to a Pew study. Average wealth is a bit higher, at $1000. The root of this low level of wealth is a function of unequal income, but more importantly, more debt, lower savings, and lower stock ownership. Consider the life of an African American mom. She works hard, raises her children as best she can, may or may not have health insurance (the lack of which can push her into debt), and is likely to have little savings. She is all too often the sole support of her children. If she is the most stable in her family, she is frequently “hit up” for loans by parents and siblings. This, too, contributes to her difficulty to accumulate wealth.

Wealth gaps were significant even before the recession, with African Americans less likely to own homes, hold stock, or have significant savings. Not only were African Americans more likely to have debt, but also African American debt was more likely to come from high-interest credit card debt, while others had lower-interest bank debt.

Can the gap between African American wealth and that of others ever be closed? It’s unlikely, given that unequal wealth is a function of history. In other words, income is a snapshot of what is happening today, but wealth is the history of you and your family. The very wealthy pass on estates that may shape life chances for several generations. Those who were enslaved, generally, had little to leave. Often those who were thrifty enough to accumulate, found their wealth blatantly stolen by envious Whites. The destruction of Black Wall Street had nothing to do with the fact that a Black teenager allegedly jostled a White woman in an elevator, and everything to do with the thriving Black middle class in Tulsa.

The next time you hear about economic recovery ask, “Whose recovery has this been?” Some have escaped from the Great Recession unscathed. Others, especially some African Americans, Latinos, the young, and those who remain unemployed, have yet to experience economic recovery.

Julianne Malveaux is a Washington, D.C.-based economist and writer. She is President Emerita of Bennett College for Women in Greensboro, N.C.

In Jobs, we’re in a Race to the Bottom

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(NNPA) On May 21, I had the opportunity to testify before a Congressional Progressive Caucus meeting on how federal dollars drive inequality by paying contractors who pay too many of their workers too little. The hearing was driven by a study from Amy Traub and her colleagues at Demos, a New York based think tank, that issued a report exposing the many ways that federal contracting often adds to the burden of the low income, especially those who earn less than $12 an hour, or less than $25,000 a year.

If these workers have even one child, they are living at or below the poverty line. As summer looms, we know that children who are in summer programs will be better prepared when they return to school in the fall. Yet those with income limitations will find it difficult to pay fees that range from $50 to $125 a week for summer enrichment programs. This cycle of disadvantage means that low wages yield more limited opportunities for students who, but for their parental situation, might be exposed to the kind of opportunities that would make them more competitive for college admissions. Their limited wages create a cycle of disadvantage for children.

The Obama administration has supported a “Race to the Top” in education, yet job creation suggests that we are running a “Race to the Bottom.” We are underutilizing talent and expertise when we sideline so many Americans. Those over 50 who have experienced downsizing have moved into lower paying retail jobs. New college graduates have been pushed back into their parents’ homes, and into low-wage jobs because there is little else available. Too many take unpaid internships to make them more competitive for future jobs, working at night or on weekends in the retail market because these are their scant possibilities.

Some economists suggest that we are in an economic expansion, not a recession, and the 2.5 percent GDP growth last quarter might support that. Still, there has been little trickle down from the top. People take what is offered in salary because they have few choices. The federal government can help or hurt these workers, depending on how they choose to protect them with minimum wage legislation, with regulation on federal contractors, with requirements to make health care and other social protections available.

Instead, according to Demos, we have millions of workers who work full time, but are paid at low wages, thanks to federal contracting policy. If government takes the lowest bid to provide services, workers will likely earn the lowest wage. If our government specified that a living wage and benefits are part of the contract we would reduce inequality. Today, too many contracting executives earn six or seven figure salaries, while workers earn poverty-level wages.

I am especially concerned about home health care workers, and others in the hospital services industry because these are predominately Black and Brown women, taking care of our sick, infirm and elders. How can we expect these workers to offer the highest quality care, when we are not offering them the highest quality wages? These are women who bring chips of ice to the dying, who hold a hand and say a prayer to someone who needs comforting. They rub the feet and massage the heads of those who are in pain. What if the low wages they are paid becomes a stressor, not allowing them to fully focus on their work for worries about their own economic survival?

Our economy has been bifurcated between those who have good jobs and bad jobs. Good jobs have decent pay and benefits, while bad jobs have hourly pay and none of the above. Increasingly, the Great Recession has pushed former good job workers into bad jobs, and bad jobs have become the norm for too many. We may be creating a permanent underclass by offering too little to too many, using federal funds to subsidize this inequality. When full –time workers need food stamps and federally subsidized health insurance, when full-time workers cannot afford apartments, when full time workers give full effort and remain in poverty, then we have turned the American dream into a nightmare!

We cannot compete in this global economy if we cannot pay people wisely and well. Without regulation, the private sector may pay unequal wages, but there is no reason for the federal government to do the same thing.

Julianne Malveaux is a Washington, D.C.-based economist and writer. She is President Emerita of Bennett College for Women in Greensboro, N.C.

Placing Athletics Above Academics

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(NNPA) Why does sports play such a prominent role in college education? Does it crowd out the attention we pay to other aspects of college life? Why are student athletes treated like slaves or gladiators, playing to pay colleges for the fruits of their labor? Other students enjoy “school spirit” when their team wins, and universities collect revenue from advertisers when they make it to the big leagues.

Women’s sports don’t reap the same benefits that men’s sports do. Still, Spelman’s President Beverly Daniels Tatum deserves kudos for eliminating the college’s basketball program in favor of providing physical education for all of Spelman’s students. She made the important calculation that organized sports activity costs hundreds of thousands, if not millions of dollars, and just a few students benefit from the athletic training. To be sure, school spirit is elevated when Spelman students cheer against opponents; yet a burst of school spirit, however, is worth a lot less than graduating a cadre of physically aware, if not fit, young women.

At Bennett College for Women, our goal was to educate the “whole” woman – academically, intellectually, spiritually, physically, and socially. Yes, people come to college to be prepared academically, but colleges are more than four-year matriculation experiences. This is why so many colleges attempt to offer a holistic experience for students.

Unfortunately, too many schools place athletics above other aspects of student development. At Penn State University, the football team was such a moneymaking machine that the fabled coach Joe Paterno jeopardized his legacy by allegedly covering up a sex abuse scandal. At Florida Agriculture and Mechanical University (FAMU), the revered marching band found its glitter not only tarnished but also corroded by the death of one of the band members as a result of his hazing. At Duke University, lacrosse players were accused of enticing, then abusing strippers at their apartments. While the allegations were disputed, the university earned a black eye for the bad behavior of its athletes. At nearby University of North Carolina at Chapel Hill, departing Chancellor Holden Thorp spent nearly half of his time dealing with athletic scandals that included no-show classes for football players, the firing of a coach, and the possibility of academic sanctions against the university.

Basketball and football at top athletic universities (as distinguished from top academic universities) generate millions of dollars for their institutions. Athletes may be rewarded with scholarships, but with full time academic and training schedules, have to hustle for money to buy a phone, travel home, and pay for other incidentals. If a generous alumnus chooses to subsidize a student for these expenses, both the student and the school will be sanctioned.

Why not pay these athletes at least some of the money they are generating for their colleges? Or why not take college athletics down a notch, putting the millions of dollars of advertising money aside in favor of the purpose of college – education. This would probably shatter a student-pimping industry. It would also remind students that their tenure in college is about academics, not athletics.

This proposal is as likely to be implement as ice cubes are likely to survive 10 seconds in hell. Yet college leaders must grapple with the many ways that sports dollars and energy distort the educational experience. There are stadiums full of fans clapping for the last 3-pointer, or the winning touchdown, but little applause for the Phi Beta Kappa graduate, or the best poet on campus. These are societal values that have, unfortunately, penetrated the ivory tower.

My interest in this issue is the fact that many of the athletes are African Americans who often come from low- and moderate-income families. Many are student athletes who combine their athletic prowess with academic ability. Too many others have been recruited for their athletic prowess, notwithstanding athletic ability. Classes that do require little – not even attendance — do not advance the long-term interests of students.

When student-athletes get hurt, what happens to them? Some colleges will continue their scholarships, others will not. Further, the likelihood of moving from the college basketball court or gridiron to a professional one is something like 1 percent. Those who aren’t drafted and don’t make it to an athletic career often languish without even basic skills to market.

If I had my way, I’d ask that every college spend more on physical fitness than on student athletics. If I had my way, fitness would be as required a course as literature or history. Truly, if I had my way I would consider putting exploitive college athletics on the back burner.

I’m not going to have my way. On too many of our nation’s college campuses the sports mission has overshadowed the education mission. Kudos President Beverly Tatum for choosing the road less travelled.

Julianne Malveaux is a Washington, D.C.-based economist and writer. She is President Emerita of Bennett College for Women in Greensboro, N.C.

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