Over 90,000 Blacks die each year that would not die if Blacks had
the same death rate as whites. Blacks still suffer from the
generational effect of a slave health deficit. Blacks lag behind on
nearly every health indicator, including life expectancy, death
rates, infant mortality, low birth weight rates and disease rates.
Blacks are sicker than Whites. Blacks have shorter lives - Blacks
are quite literally dying from being black! This black health
deficit is directly traceable to the slave health deficit. The
slave health deficit that was established during slavery was not
relieved during the reconstruction period (1865-1870), Jim Crow Era
(1870-1965), the Affirmative Action Era (1965-1980) or the Racial
entrenchment era (1980 to present). Also, established at the time
was a health care deficit that continues to exist. Repairing the
health of Blacks will require a multi-facet long term legal and
financial commitment. Dying While Black produces the "smoking gun"
connection between white privilege, racism, slavery and Black
health outcomes. DWB combines careful documentation of the past and
a plethora of data with deft, compelling storytelling. The result
is a nuanced, forward looking narrative that not only provides
evidence of what's wrong and why, but offers a concrete proposal
for what can be done to make a difference. Chapter 1,
"Introduction," provides and overview to the problem to be
addressed in this book. Chapter 2, "From Slave Health Deficit to
Black Health Inequities," traces the health status deficit of
Blacks from slavery through Jim Crow to the twenty-first century.
Chapter 3, "Racist Health Care," addresses the racial inequity in
the health care system This inequitiesexist in access to health
care and the quality of treatment received. Racial inequity is
manifested in racial barriers to hospitals, to nursing homes, and
to physicians and other providers. Finally, shortage of Black
health professionals affects both access to health care and input
into the health care system Chapter 4, "Targeting the Black
Community" addresses the targeting the Black community by the
tobacco industry and the inadequacy of the national tobacco
settlement. Chapter 5, "Impact of Managed Care on Blacks" addresses
the rationing goal of managed health care organization and its
impact on Blacks. Managed care organizations (MCOs) complicate the
problem of racially disparate health care because they increase the
incentives for providers and facilities to engage in
discrimination. Chapter 6, "Slavery, Segregation and Racism:
Trusting the Health Care System: It Ain't Always Easy to Trust the
Health Care System, discusses the significant distrust towards the
health care system in the Black community. This distrust is not
just paranoia but is built on a history of abuses that includes
experimentation, the Sickle Cell Screening Initiative, family
planning/involuntary sterilization, and the complicity of the
medical system in justifying racism and discrimination. Chapter 7,
"Health Care in the U.S. as a Violation of International Human
Rights" discusses how the combination of racial inequity in health
status, institutional racism in health care and inadequate legal
protection points to serious human rights violations under the
International Convention on the Elimination of All Forms of Racial
Discrimination "(CERD or Convention). Chapter 8, "Reparations:
Repairing Black Health,"discusses the legitimacy of the demand for
reparations, but restructures the call from a compensation request
to an equity request. The Slave Health deficit will be removed only
if the United States makes the same a significant and sustained
commitment that it made to landing on the moon. The burden of a
slave health deficit has been a continuous burden and will only be
relieved lifted with a well coordinated aggressive and
comprehensive reparations and legal program.
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