The Black Caucus has warned President Obama that he better express his “unwavering support” for progressive health care reform in his upcoming speech. According to Politico’s report, the letter from CBC chair Barbara Lee stated
[W]e are deeply concerned about the current discussions surrounding health care reform and the possibility that current components of the bill – such as a robust public option and myriad health disparity elimination provisions – may be stricken in order to lower its cost to about $500 billion.
As far as I can tell, “health disparity elimination” means simply spending money on minority programs. As we have seen, “disparities” are usually attributed to “barriers” or “root causes” that are never identified, and that seems to be true of health disparities as well. I took a quick look to see if there was any consensus on the nature of the “barriers” or “root causes” that produced “health disparities” and found a number of explanations similar to the following from The Health Trust (“Let’s make Silicon Valley the healthiest region in America”):
Racial and Ethnic Health Disparities
Although health disparities have been documented in many populations and communities (i.e., gender, age, ethnicity and race, education, income, social class, disability, geographic location, or sexual orientation), The Health Trust has chosen to focus particularly on reducing racial and ethnic health disparities. Without dismissing the importance of addressing the social, economic and institutional factors that trigger health disparities in all population groups, The Health Trust recognizes that because of the intersection of race and class in the US, people of color are disproportionately impacted by the multiple root causes of health disparities….
Root Causes of Health Disparities
An important feature of health disparities as it is defined in the context of health equity and social justice is that these differences in health that certain populations experience are due to factors beyond individual control. The root causes of health disparities are systemic, institutionalized, and many decades or even centuries in the making. The relationships among the root causes of health disparities are multi-directional and cyclical, exacerbating one another and calling for intervention at every level.
Well, I’m glad we’ve cleared that up.
Why is “The Black Caucus” relevant? Am I to assume membership simply means any Legislators that have attained, or been appointed, the status of Negro?
Is “The Black Caucus” subject to “special considerations”, expectations of higher standards, or any “exceptional consequences” for proved criminal behavior, than any other legislator?
Does this “special” group of folks not see the potential pitfalls for an alleged “Black Caucus” constituency in ANY legislation deep fried in “health disparity elimination provisions”?
It is so frustrating that words like health disparity don’t really get at this notion that there are root causes of illness that go way beyond simply “good/bad genes” and personal behavior.
While it is true that the proposed legislation will include funds for prevention, too frequently these prevention programs don’t address things like racism, ‘red lining,’ urban design, chronic stress, or education. I sincerely hope that we get to a place where we move beyond programs for “poor neighborhoods” and begin thinking about health in a more holistic way.
By the way, have you seen the series “Unnatural Causes?” It paints a pretty damning image of health inequity in America. I think PBS will re-broadcast parts of it sometime soon.