Suppose I were to tell you that in a North Carolina county, neighborhoods with a “lower percentage of White individuals … lower economic and racial spatial advantage, and higher area deprivation” and “higher reported violent crimes, evictions, poverty, unemployment, uninsurance, and child care center density, as well as lower election participation, income, and education,” are areas that also had a higher incidence of three chronic diseases. What would you conclude?
Would you, for example, infer that the low availability of childcare was a cause of disease? Or would you perhaps draw the opposite conclusion that the incidence of disease reduces the demand for childcare—or are the two correlated but unrelated?[1] How about election participation? Would you think that perhaps sick people are less likely to vote, or would you think that a disinclination to vote predisposes people to disease? And how about low income and education? Do they produce ill-health or are they a product of ill-health? What about violent crime? Is it a cause of ill-health? Is it caused by ill-health or is it perhaps caused by something else? And would you wonder just what is meant by “racially and spatially disadvantaged”—and why three diseases and not one?
Let me simplify it for you.
Just put all these disease disparities into a basket labeled structural racism. Then, hey presto! The conclusion is obvious: structural racism causes—or “is associated with”—disease.
No need to look at individual differences, individual biology, individual habits, indeed anything individual at all. An individual in this scenario has the free will and agency of a billiard ball. Structural racism rules.
All nonsense, of course, but unfortunately, this article is not a parody. Nineteen investigators—well supported by the ill-begotten National Institute on Minority Health and Health Disparities (NIMHHD)—specializing in something called health equity research, have just run some Bayesian models reported results that are “significant,” and then added a “racism” label to the mix.[2] The work does nothing whatsoever to uncover the causes of disease.
The idea of health equity is endorsed by all U.S. government health agencies, such as the National Institutes of Health (NIH) and the Centers for Disease Control and Prevention (CDC), and the World Health Organization.
It exists because it raises a political flag that might as well say “disparities demand recompense.” But it is not science, which is what the NIH and CDC are supposed to be about. Indeed, this study, and the NIMHHD that funded it, is the very opposite.
Science is supposed to make things clearer and help us understand causes. This study—and many, many others like it—obscures rather than clarifies. It finds correlations, lumps them together, and invents an alarming label that diverts attention away from the real causes of disease.
It is political, not scientific.
Unfortunately, this “antiracist” nonsense is a now called “medical science,” even in Durham, NC, the one-time “City of Medicine.”
[1] A correlation can reflect causes in both directions or in neither: if A is correlated with B that could mean that A causes B, B causes A, or both are caused by C. The article I am discussing never attempts this level of analysis.
[2] Established by the passage of the Minority Health and Health Disparities Research and Education Act of 2000.
Photo by Jared Gould — Adobe — Text to Image
Leave a Reply