Racial and ethnic disparities are pervasive, and especially distressing in the case of African Americans. On a host of indicators (health, wealth, test scores, college attendance, civic participation, and Internet access, to name a few) African Americans regularly come up short. While nearly everyone acknowledges vast improvement, especially for the middle class, stubborn gaps and barriers remain, all the more frustrating given today’s turbocharged economy, the near-disappearance of legal discrimination, and continuing effort by a large network of activists and professionals within and beyond government. But remaining disparities are likely reducible only through an uncertain blend of educational and economic advancement and a thoughtful political strategy. Above all, it will take time.
One must expect some disparities since precise equality of social outcomes remains a chimera. The raw material necessary to thrive in a heavily information-based economy that rewards entrepreneurship, advanced training, and access to capital and supportive social networks cannot be equally distributed, even among Euro-American groups. And since African Americans are overrepresented among the low-income segment of the population, we should naturally perceive a racially tinged inequality.
Chatter: Necessary But Insufficient
Before any problem is successfully addressed it must be recognized and deemed worth confronting. One might think that initiating and sustaining a public discourse on racial disparities would be the easy part but it is actually a formidable challenge. The most obvious aspect is the sheer number of disparities between whites and nonwhites that one can plausibly highlight. As implied above, the list of problems can paralyze by its very length.
Moreover, even facing up to (much less attacking) some problems can prompt discomfort. Daniel Patrick Moynihan learned this in the mid-1960s when he raised the issue of black family structure. And many have probably forgotten how much harder it was a generation ago to engage in an honest discussion of such matters as teen pregnancy or the gap in cognitive skills between black and white children. More recently, black churches have shied away from confronting the horrific toll that the HIV-AIDS epidemic has been taking on black America since the 1980s. Even though most new infections and a large majority of pediatric AIDS cases crop up among African Americans (with AIDS remaining the leading cause of death among black 25- to 44- year-olds of both sexes), squeamishness about its modes of transmission has always impeded discussion. The Washington Blade, a gay weekly newspaper in the nation’s capital, observed recently that “new infections among black gay and bisexual men are largely responsible for driving the AIDS epidemic” among African Americans. That stark fact has, at least until recently, chilled involvement by the clergy.
The Conundrum of Health
But getting everyone talking is just the beginning. Leadership requires followers, and for many social problems an elite-driven discourse, no matter how intense, is of little use unless it connects effectively with the capacities and incentives facing ordinary people. That, surely, is the core challenge posed by the spotlight that journalists, foundations, and policymakers now regularly shine on disparities in health status between minority populations and other Americans. In a February 1998 radio address President Clinton declared that “no matter what the reason, racial and ethnic disparities in health are unacceptable in a country that values equality and equal opportunity for all.” Although eschewing a rhetorical flourish that would instantly have recalled failed efforts against poverty and cancer, Clinton nevertheless can be said to have launched a “war” (undeclared and low-key, to be sure) on a handful of health disparities identified by the Department of Health and Human Services pursuant to the presidential initiative on race.
But reducing such conditions as HIV infection, infant mortality, hypertension, and diabetes among African Americans to the rates at which whites are afflicted will require more than presidential attention and government funding. Perhaps millions of persons must be regularly monitored and sustain at least modest changes in habit and lifestyle, with some adhering zealously to daily drug regimens. These changes must occur among people facing associated and sometimes culturally sanctioned conditions (such as tobacco addiction, excess weight, unwholesome diets, and inadequate health care access) to which they are long habituated. Lives that are disorganized, stressful, or sedentary may resist even determined intervention. A recent case, recounted in the Washington Post, of Ohio Medicaid recipients who continued using hospital emergency rooms despite being provided a health maintenance option is suggestive. Moreover, recent evidence indicates that some physicians may treat their black patients differently from their white ones. Such provider behavior, if genuinely pervasive, may resist change as well.
Moreover, neither a guaranteed right of access nor individual compliance speaks to a fundamental underlying challenge. Universal health care coverage remains a worthy social goal, but its achievement may not augur success on the disparity front. Both Britain and Canada show signs of continuing disparities in access and outcomes linked to socioeconomic status. “Wealthier is healthier” is perhaps the single most widely replicated finding in the health field.
The Paradox of Prevention
One recurring systemic difficulty is that recognizing an equity problem and mobilizing to address it tend to lag behind the creation of the processes and policies where the problem arises. Sometimes a consciously inequitable policy choice has prevailed, as when the Congress that created the Social Security program in 1935 declined to authorize benefits for farm and domestic workers, an action with greatly disproportionate adverse consequences for African Americans. When the landmark environmental legislation of the 1970s was enacted, concerns regarding what is now called “environmental justice” had occurred to few community advocates or policymakers; effective advocacy began penetrating the federal government only in the 1990s. Even more recently, the introduction of personal computers and the subsequent Internet explosion have been a great boon to society as a whole. But the implications of a “digital divide” separating minority and low-income persons from the rest of American society would have seemed too ephemeral and distant a decade ago, even though the disparity we see today was entirely predictable. How could one have planned to address it? Perhaps more important, who would have paid any attention to anyone trying to? But by last year the issue was making headlines as the target of yet another federal initiative. The paradox is that one wants ideally to prevent problems that become apparent, and tangible enough to appear worth solving, only after time has allowed them to take root sufficiently to generate concern.
Technology and Its Uses
Technology, a primary engine of economic growth and employment, is a sure vehicle for both opportunity and disparity, increasingly so in the new millennium. Every product has both a price (that may place it beyond the means of some consumers) and a profile of skills and values necessary to its effective use. Hence there must always arise disparity in benefits from technology. As with television, the telephone, and other developments, declining prices and increased ease of use should have a democratizing impact. But that effect will not be completely egalitarian, no matter how cheap or simple the product, because people (and groups) differ in skills and preferences. Cable television is accessible to nearly everyone but it’s also a safe bet that the History Channel’s audience is demographically skewed. Someone with shaky reading skills is likely less comfortable with e-mail and web browsing than another person more verbally adept. And when the Census Bureau queried Internet “non-users” in 1998 regarding their reasons for abstaining, about a quarter of white and black respondents alike replied that they simply “don’t want it.” The share of white non-users citing cost concerns was 15.6 percent while the figure for African Americans was 22 percent. This gap will probably narrow as prices decline, but it is worth remembering that even today 6 percent of American households overall (and 15 percent of African-American households) do not have telephone service.
Transracial Appeals and Nonracial Policies
If race remains America’s major piece of unfinished business, African Americans must chart new pathways toward its completion on favorable terms. During only two brief periods of American history (the years 1850?70 and the decade leading up to passage of the Voting Rights Act in 1965) have black interests commanded a compelling moral leverage over the national discourse. Such eras will not likely recur, even in a political environment of governmental budget surpluses.
Three strategic principles follow from these circumstances. First, the African-American community must become ever more engaged by, and anchored within, the private sector. There lies wealth, from which flows both an enlarged collective voice and expanded personal choice. Second, in the political realm, as many have already observed, the African-American community must frame issues of importance to it in terms that facilitate building transracial coalitions. In part that means advocating multi-interest policies that have potentially disproportionate payoffs for blacks. An example would be enhanced efforts to educate and train America’s incarcerated population; that’s one of several obvious places to target the “digital divide.” A third and related need is an African-American leadership that identifies and analyzes the racial implications of nonracial policies, from free trade to consumer protection to suburban sprawl and beyond. It is imperative that we know whether efforts to control sprawl will expand or constrict housing and employment prospects among urban blacks. In short, both realism and farsightedness must characterize the continuing struggle for African-American uplift.
Poor blacks are 47 percent less likely to say they experience stress than poor whites and those differences remain constant over the other income groups as well.