In light of these findings, it is time that public officials, beginning with mayors and governors and all the way up to the president, declare racism and the health disparities associated with it a public health emergency. Officials must act now to save more Black lives, and this action must include putting their money where their mouths are.
The data from the Yale study contradicts in the sharpest way the myths and lies promoted by right-wing conservatives that African Americans have gained traction and advantage since Barack Obama was elected president in 2008. To the contrary, the study finds that after initial progress during the early years of the study, from 1999 to 2011, the racial gap in the mortality rate had gotten much wider.
Clyde Yancy, a Northwestern University cardiologist who was one of the authors of the Yale-led study, said excess deaths among African Americans over the study period — disparities that worsened over the first year of the COVID-19 pandemic — were not the result of genetics but reflected the adverse effects of America’s history of racism and discrimination, effects showing up in housing, education and other areas.
This means “all those deaths were preventable,” Sandra Elizabeth Ford, a former special assistant to President Biden for public health and science, said in a phone interview. “It is not enough to have good health care. We need affordable housing and good jobs that aren’t overly stressful. In this country, we have yet to marry the health-care system with the social service system. Until we do this, we are going to continue to have disparities that lead to deaths.”
Public officials at all levels of government should heed the advice of medical experts and work to link their governments’ social services to their health-care systems. This of necessity will entail being more intentional about investments in housing and job training and ensuring that those investments have public health components. As occurs so often, bureaucrats work in silos and fail to collaborate as they should. With so many Black lives at stake, we can ill afford to continue the old patterns of working in isolation.
Both Yancy and Ford point out that education is a key social determinant of health. I asked Ford exactly what that means. She said that without proper education one “might have a problem finding a job that offers health-care benefits.” Low literacy rates, often associated with inadequate education, “could result in individuals having difficulty reading about or understanding health-care issues,” she added. Improvements in education could be achieved if public officials and educators work closely together (and if state legislatures don’t distract them with a range of culture issues unrelated to education and public health).
The work that school systems and local governments must undertake in partnership should begin prior to kindergarten. According to the Yale study, health disparities begin to surface at the pre-school age, especially following the first year of birth. “We need targeted strategies aimed at early childhood health and preventing heart disease and cancer, some of the main drivers of these disparities, to build a more equitable future,” said César Caraballo, lead author of the study.
There is sufficient funding available at the national level to strengthen local efforts in education and maternal health. Funding from the National Institutes of Health, for example, supports initiatives like the Center for Black Maternal Health and Reproductive Justice at Tufts University. The National Institute on Minority Health and Health Disparities funds Morehouse School of Medicine’s Center of Excellence on Health Disparities in Atlanta. When centers like these link up with activities of trustworthy community health centers, they prove to be highly effective.
Finally, I want to return to an earlier point: the need for public officials to adequately fund initiatives that can address preventable deaths like those documented in the Yale study. Aside from the human tragedy of lives cut short, those 1.63 million deaths cost society billions of dollars in loss of human capital, labor, creativity, tax revenue and other quantifiable contributions to our economy.
For over a century, Americans have debated whether to pay reparations to African Americans for past and present abuses. Here is an opportunity to resolve this debate once and for all. Starting with a sincere apology, public officials at all levels of government should establish what might be termed a reconciliation trust fund aimed at eliminating preventable deaths of Black Americans.
Such a fund must address racism in education, jobs, housing and other social determinants of health, in particular targeting research to lower the death rates of all Americans from cancer and heart disease. Among other things, these funds would support programs that provide health and medical services to prevent premature deaths of Black mothers and babies. Improvements in these areas should contribute to longer and healthier lives for all Americans, especially Black Americans.
For a decade now, African Americans and their allies have tried to rally the nation around the slogan “Black Lives Matter.” Now that Yale has published this landmark study, society should act to prove that Black lives indeed do matter.
Governing's opinion columns reflect the views of their authors and not necessarily those of Governing's editors or management.
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