Kai Wright is writer in New York City, and can be reached at KaiWright.com. A longer version of this article appears in the May/June issue of Mother Jones magazine.
My father came a long way to arrive at his deathbed at the age of 57. Reaping the early benefits of the civil rights movement, he earned a medical degree from the nation’s most prestigious black university, and, only 15 years ago, ranked among Indianapolis’ premier physicians. His income soaring, he bought a suburban home for his family and a Datson 280Z for himself. But Type 2 diabetes took his right leg by his mid-40s, chipped away at his sight and eventually all but immobilized him, finally sparking the kidney failure that landed him in the hospital for the last time.
Since the civil rights movement, African-Americans have improved their lot in life by almost every measure: income, school dropout rate, access to middle class occupations. But in that same period, black America has made no progress on what may be the most important measure of all: living to see old age. Black and white death rates from heart disease were equal in 1950; by 2002 blacks died 30 percent more often. Blacks had a 10 percent lower cancer death rate than whites in 1950; now it’s 25 percent higher. And the infant mortality gap doubled between 1950 and 2002
Progressive convention says the problem lies in poverty—too many black people uninsured, too few with access to routine care. But what no one can figure out is why the health gap is getting worse even as socio-economic conditions are improving. As you move up the economic ladder, black health drastically improves, but the disparities between blacks and whites do not. How does a successful, educated and well-insured man like my father die before the age of 60 at the hands of a disease that is totally preventable?
My father was one of 3.2 million African-Americans who have diabetes today, which is 80 percent higher than the disease’s prevalence among whites. The diabetes mortality rate is 20 percent higher for black men than white men, and 40 percent higher for black women. Opinions on why some people get the disease and others don’t generally fall into two camps: genes versus lifestyle. Here’s where the debate turns political. If genes are decisive, then no one is to blame for the racial imbalance in Americans’ health. If it’s lifestyle that divides the sick from the well, then the problem is a matter of personal choice.
But there’s a third way to look at the disparity, one that is both more complex and more disturbing. According to this theory, my father died of the side effects of racism. The reason for the gap, a growing number of researchers say, is that the vaunted black middle class simply ain’t all it’s cracked up to be. Black strivers have a much harder time turning their paychecks into the status, opportunity and security that white yuppies take for granted.
Middle-income black families worked the equivalent of 12 more weeks in 2000 than did whites with matching incomes, leaving them little time to take care of themselves. My father worked long hours to get that house and car, and it meant meals on the run, gobbling fries from salty sacks snatched up at drive-through windows. In the midst of all that learning and achieving, he never got around to the walks in the park or turns on the treadmill that will keep you alive despite diabetes or heart disease. While the white middle class has grown healthier in recent decades, the tenuousness of black middle-class life has left many stumbling through a vicious circle.
Furthermore, African-Americans are more likely to be supporting parents who have faced early retirement due to disabling conditions. For whites, the story is quite different: parents and grandparents often help with home loans, college tuition and child care. So as both black and white families gained net worth during the booming 1990s, the gap between them grew as well. At the century’s close, the typical black family possessed 10 cents of wealth for every dollar held by its white counterpart.
Like my father, black America has been spent the years since the civil rights movement fighting outward battles—for education, jobs, equal rights. But both individually and communally, we’ve failed to pay attention to the biggest battle of all: living to see old age. We’ve taken health and wellness for granted, and now it’s coming back to haunt us.
Despite all of the material success my father achieved in life, he died deeply in debt—by the time he got hold of his dream, he could no longer stay healthy enough to keep it. Black America cannot afford to make the same mistakes.
It’s time we truly engaged the national health care debate. From access to health insurance to the environmental health of our neighborhoods, from the wellness of our communities to our own individual choices, we must learn now that health is politics. If we do not, for too many of us, there’ll be no tomorrow to improve upon.
