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A Glance at Systematic Racism, Path Dependence and Health Equity

Posted by Mackenzie Slade on July 02, 2015 at 11:18 AM

I never understood the saying ignorance is bliss. Ignorance is not bliss, ignorance is… ignorance. An example of ignorance would be to say that there is no racism in the United States of America. Maybe there is less racism than 400 years ago when white Americans were slave owners or even during segregation, but racism is certainly alive and thriving today, because it has become systematic. 

Our entire history is shaped by path dependence. This is the concept that explains how decisions made in previous circumstances that may no longer be relevant today, have shaped and limited our current system. Path dependence hold especially true for policy.  An example could be the Jim Crow laws of 1876. Though mandated segregation is no longer enforced in our current system, the policies that enforced mandated segregation before the civil rights movement certainly affected our current system. This path dependence of inequality in previous policies created a flawed and inadvertently racist system that is based off the previous ideology that black Americans are inferior, and I am going to break it down for you.

Between the years of 1934 and 1962 the federal government backed $120 billion dollars in home loans… on the contingency that you were white, and living in a neighbor with other white people. Like all white people.  You were not eligible to receive a government-backed loan if you even lived in the nearby area of black people. This process is called redlining and not only did this exclude black Americans from receiving any government- backed loans for housing, but it also segregated America into the system we have today.

Without being eligible for housing loans, black Americans were forced into lower socio-economic urban centers which are commonly referred to as “ghettos.” These urban centers had lower property taxes than white America due to their location. Property taxes are the sole funding for schools, which by no coincidence allowed white Americans in nicer areas to receive a better education than black Americans.

lede_art_house2.jpgWith better education comes better job opportunities, and with better job opportunities comes wealth, inheritance and a higher quality of living.  This gave white American’s an advantage towards, well… everything and anything. White Americans were booming with the economy, while black Americans were resorting to grueling manual labor accepting low wages for work. So after centennials of slavery and oppression, black Americans were allotted into a flawed and racist system that gave them zero equity for the past.

The system that I keep referring to is the societal system that for many means no social mobilization. For many, this means that your area code determines your future. Now for someone like me who has lived in middle class suburbia my entire life, this ain’t so bad. My quality of life is great. But guess what, my middle class suburbia qualified for federal housing loans leaving me with a great education and opportunities, so that’s why my zip code determining my future wouldn’t be the worst thing. For those who are born and raised in low socio-economic urban centers because their ancestors had committed the crime of uhh not being white, that is just fundamental injustice.

Now this is not to say that this holds true to every single person. There are outliers on all sides and there are certainly a lot of white people who may be in living in poverty or in urban centers- the only difference is that the white people aren’t in poverty because at one point in life, their race was seen as inferior.

Do you see what I mean by path dependence of policies shaping injustice in our current system? If that break down didn’t do it justice, I suggest you watch this video of a young and charismatic woman named Laci Green lay out a timeline of racist policies that led us into modern day America.

The only thing Laci Green did not address in her video is health equity. My brother always makes fun of me because I can turn any conversation into one about healthcare… which is exactly what I am about to do.

A lot of people seem to be confused on the difference between equality and equity. Equality ensures equal treatment of all people. Equity is the advantages that are given to people to make up for past inequality. An example of equity for systematic racism would be Affirmative Action. This is the policy usually used for employment or education purposes to give people who were historically excluded, like black people or women, an advantage for admissions.

Taking a look back at when I talked about redlining and the disadvantages people had for job opportunities, there was an important piece of information I left out- access to healthcare. It doesn’t take a genius to figure out that less income means less healthcare. With black Americans working low wages, it is safe to say they were using what little income they had on things other than healthcare. As for white people who had more means, they had access to healthcare and the reason why is a little more complex than “because they made more money.” It was because their jobs offered it.

During World War II, millions of American men were sent off to fight for our country overseas. This created a huge shortage in our labor force. Employers became desperate for employees, and the working class of America knew this, and used it to their advantage. They started demanding higher wages for work because they knew they were needed. The employers however, didn’t want to pay higher wages and for the most part simply couldn’t afford to. So President Roosevelt responded to this battle with the Stabilization Act of 1942. This act allowed employers to circumvent raising wages for their employees by offering them benefits, such as healthcare. And just like that, an entire white working class was just given the opportunity to insure their health. As for the black Americans who were still working low wage, hard labor jobs, they were not. And the cherry on top is that they weren’t even allowed to vote to change this policy.

So historically, black Americans became less wealthy and less healthy than white Americans. And that system that I keep repeating myself on shows that to this day. More than 17% of black Americans are uninsured, compared to the 12% of white Americans. That 5% is a lot bigger of a gap than it appears. In South Carolina, 57% of the uninsured population is black. How we restore health equity in this case is by expanding Medicaid, the social program of health insurance by the federal government given to people with low income.  But our state of South Carolina chose not to expand Medicaid, leaving little equity to those who deserve it. But this post isn’t a stance on Medicaid expansion. It is not a stance on what policies need to take places in order to ensure equality and avoid future equity and it is not me presuming to know what it is like to be black. This post is to merely shed light on how racism had been embedded into our infrastructure for just about everything, and how it has to be addressed in order to pursue change. 

calls-removal-confederate-flag-outside-20150623-182429-946.jpgWe took our first step in addressing the blatant racism that we see every day by discussing the idea of taking down the Confederate flag. New Morning Foundation and the South Carolina Coalition for Healthy Families stands firm in its belief that if the flag is a symbol of oppression and inferiority to one group of people, than it is a threat to equality and justice for all. We believe that the flag should absolutely come down, but we also need to remember to not be blinded by one symbol of inequality. Taking down the flag doesn’t mean nearly as much as creating policies that expand opportunities and equity for suppressed people such as expanding Medicaid. In order for our country to thrive it is imperative that we recognize our faults in path dependence and take all actions necessary to rid the flawed system that still suppresses so many.


Join us at the "Take the Flag Down. SC Unity Festival" on July 4 on the South Carolina State House grounds. 

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