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by Vernellia R. Randall (Author)
Over 90,000 Blacks die each year that would not die if Blacks had the same death rate as whites. Blacks still suffer from the generational effect of a slave health deficit. Blacks lag behind on nearly every health indicator, including life expectancy, death rates, infant mortality, low birth weight rates and disease rates. Blacks are sicker than Whites. Blacks have shorter lives - Blacks are quite literally dying from being black This black health deficit is directly traceable to the slave health deficit. The slave health deficit that was established during slavery was not relieved during the reconstruction period (1865-1870), Jim Crow Era (1870-1965), the Affirmative Action Era (1965-1980) or the Racial entrenchment era (1980 to present). Also, established at the time was a health care deficit that continues to exist. Repairing the health of Blacks will require a multi-facet long term legal and financial commitment. Dying While Black produces the "smoking gun" connection between white privilege, racism, slavery and Black health outcomes. DWB combines careful documentation of the past and a plethora of data with deft, compelling storytelling. The result is a nuanced, forward looking narrative that not only provides evidence of what's wrong and why, but offers a concrete proposal for what can be done to make a difference. Chapter 1, "Introduction", provides and overview to the problem to be addressed in this book. Chapter 2, "From Slave Health Deficit to Black Health Inequities", traces the health status deficit of Blacks from slavery through Jim Crow to the twenty-first century. Chapter 3, "Racist Health Care," addresses the racial inequity in the health care system This inequities exist in access to health care and the quality of treatment received. Racial inequity is manifested in racial barriers to hospitals, to nursing homes, and to physicians and other providers. Finally, shortage of Black health professionals affects both access to health care and input into the health care system Chapter 4, "Targeting the Black Community" addresses the targeting the Black community by the tobacco industry and the inadequacy of the national tobacco settlement. Chapter 5, "Impact of Managed Care on Blacks" addresses the rationing goal of managed health care organization and its impact on Blacks. Managed care organizations (MCOs) complicate the problem of racially disparate health care because they increase the incentives for providers and facilities to engage in discrimination. Chapter 6, "Slavery, Segregation and Racism: Trusting the Health Care System: It Ain't Always Easy to Trust the Health Care System, discusses the significant distrust towards the health care system in the Black community. This distrust is not just paranoia but is built on a history of abuses that includes experimentation, the Sickle Cell Screening Initiative, family planning/involuntary sterilization, and the complicity of the medical system in justifying racism and discrimination. Chapter 7, "Health Care in the U.S. as a Violation of International Human Rights" discusses how the combination of racial inequity in health status, institutional racism in health care and inadequate legal protection points to serious human rights violations under the International Convention on the Elimination of All Forms of Racial Discrimination "(CERD or Convention). Chapter 8, "Reparations: Repairing Black Health", discusses the legitimacy of the demand for reparations, but restructures the call from a compensation request to an equity request. The Slave Health deficit will be removed only if the United States makes the same a significant and sustained commitment that it made to landing on the moon. The burden of a slave health deficit has been a continuous burden and will only be relieved lifted with a well coordinated aggressive and comprehensive reparations and legal program.
