replies to Rakesh, Wojtek, Charles, Chris Anarchism /Marxism debates (fwd)

Rakesh Bhandari bhandari at phoenix.Princeton.EDU
Wed Aug 25 15:33:34 PDT 1999

> No, they don't. Vicente Navarro has argued that the racial gaps in
> health indicators are actually capturing "class" differences, which
> begs the question of why race should be an influence on class in the
> first place.


Navarro's argument is more nuanced (to work from memory). first he notes that while blacks die from heart disease at a higher rate than whites; then he notes that the differential between blue collar and white collar workers is even greater. He suggests that much of the 'race' differential can then be accounted for by black over-representation in the blue collar working class (something that is confirmed by Eric Olin Wright's research on class structure). He does not deny that within the blue collar working class blacks are more at risk to die from heart disease. He argues therefore for the importance of classification by race and class but underlines that differentials are often not reported or even kept by class! Which has the effect of impressing white blue collar workers that they have more in common with upper class whites rather than fellow blacks in the blue collar working class.

There was a study published in the New England Journal
> of Medicine in the early 1990s showing that even after controlling
> for income - yeah, I know that's a highly imperfect proxy for class -
> black health indicators were worse than white. One can only speculate
> on why, but it must have something to do with the fact that the
> hidden injuries of race supplement those of class.

Some do not take racial differentials as proof of the existence of racism (even through the indirect effect of a greater probability of being consigned to an at risk group, e.g., blue collar worker). We know how some would explain IQ differences; others would explain health differentials in terms of the unhealthier diet embodied in black culture; some would invoke the greater promiscuity of minority cultures to explain racial differentials in STD's; greater minority incidence of any health problem be accounted by unspecified cultural differenes, undocumented patient preferences against invasive techniques, lack of information about the need for care--instead of racism. Such responses were filed in the New England Journal of Medicine.

The debate about the cause of racial inequality (genes vs. culture or lifestyle vs. racism vs. racism confounded or interacting with poverty) can go on endlessly because of the apparent inability to solve the problem through the accepted scientific methods. Even when one factor gets ruled out--such as genetic differences to account for differentials in birth weight--there seems to be little progress in assigning partial coefficients to the other variables or even ranking them in terms of importance.

And because no one "knows" what causes inequality, there is every chance, as Raj Bhopal has warned, that ignorance becomes an excuse to do nothing to attentuate those health inequalitie.s

Let's also not forget the insidious implication of racial statistics either. For example, why do papers regularly report figures such as crack use by race ("crack is a black problem")? Crack use does not depend on race specific and in particular biological factors. Though greater among blacks and hispanics, crack use can actually be best understood by examining very specific geographically organized social networks within which it takes place--as Mindy Fullilove has been arguing for years.

Yours, Rakesh

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