For the last few years, we’ve heard a growing and loud glut of racists spouting ridiculous theories about white replacement theory—how minorities are turning what they believe is a white nation into something browner and stealing the privileges white folks, even well-meaning ones, repeatedly deny they have. While it is true that demographics in this country are shifting (higher birth rates in minority and immigrant groups and increased immigration from non-white countries have projected the United States to be a majority-minority country by 2060), the reality is much more nuanced.
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Demographics aside, since 1999, Black Americans have suffered 1.63 million excess deaths compared to white Americans. It’s an issue that was exposed during the early days of the COVID pandemic, and one experts gathered at the STAT Summit in Boston earlier this month to discuss: the crisis of Black deaths in the United States and interventions that can help advance health equity.
“If we continue to have a maternal health crisis, if we continue to have an infant mortality crisis… we’re going to potentially see a situation or circumstance where Black people can be extinct in the future,” said panelist Monica McLemore, a professor and interim associate dean for equity, diversity, and inclusion at the University of Washington School of Nursing.
OK, extinction might be a stretch, but the numbers don’t lie. Black women are two to three times more likely to die from pregnancy-related complications compared to their white counterparts, and this disparity increases with age. We have a higher cancer burden and face greater obstacles to cancer prevention, detection, treatment, and survival. In fact, Black folks have the highest death rate and shortest survival of any racial or ethnic group for most cancers in this country.
What are the drivers of these disparate outcomes? You guessed it: According to the STAT Summit panelists, structural racism and discrimination rooted in our health system. And an essential step toward tackling the problem is acknowledging these racial biases exist.
“It’s like you have to be a white supremacist to be a racist,” said panelist Harlen Krumholz, a cardiologist and Yale professor of medicine. “No. We’re all racist.”
Dismantling structural racism and advancing health equity also requires addressing the social determinants of health that continue to disproportionately harm Black Americans, such as poverty, segregation and environmental degradation. Important interventions include paid family leave, doctors who look like us and legislation that fights health disparities.
There also have to be people willing to do the difficult work of making sure inequities don’t wipe out us out.
“As long as I’m around and a whole lot of other people are, we’re not going to allow that,” McLemore said.
Kendra Lee is a writer based outside Washington, D.C.
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