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The CDC Says Racism Is A Public Health Threat. Here's What It Means

STEVE INSKEEP, HOST:

What does it mean to rank racism as a threat to public health? The head of the Centers for Disease Control and Prevention just did that. Dr. Rochelle Walensky points to the disproportionate effects of coronavirus. She says they come after generations of discrimination that do affect people's health. So let's consider that reading of history and what it means for public health policy today. Dr. Camara Phyllis Jones is with us this morning. She is an epidemiologist and studies race and health at the Morehouse School of Medicine and Emory University. Dr. Jones, welcome to the program.

CAMARA PHYLLIS JONES: Good morning, Steve.

INSKEEP: I just want to acknowledge this is obviously not a new idea to some people who've studied this for decades. But I'm imagining it is rather new or seems jarring to some people, the idea that racism affects not just your attitudes or your job opportunities but your health. What in general is the idea that racism affects public health?

JONES: Well, basically, first of all, there are differences in health outcomes by so-called race across the country that have been documented for decades and centuries. The question is, why do we see these differences? And we know enough now to know that they are not based in our genes because there is no genetic difference between humans, you know, that would cause so-called racist or racial subspeciation...

INSKEEP: Right.

JONES: ...That what we see as race is not something that's deeply in our genes in terms of health. It's not in our cultures. It is affected by social class. But there is - it doesn't just so happen that Black people and Indigenous people and Latinx people and Pacific Islander people and others are overrepresented in poverty. So when you try to figure out why are we seeing these health disparities by race, you need to figure out, what does this race thing capture? And you need to get to root causes. Race is the social interpretation of how we look in this society, where opportunity is differentially structured by this so-called race. And even the basic value that we assign to different people differs by race. It's because of racism as a root cause of these health disparities.

INSKEEP: You just pointed to one way that this would work when you said poverty. If you discriminate against a group of people, if it's harder for them over generations to build up wealth and get ahead, they are also often less healthy. You don't eat as well. You're not able to live as well. You just don't have the same kinds of opportunities. So that's the historic trend. Did the pandemic just make this all more obvious for us?

JONES: Yes (laughter) yes, it did. Well, it's because - we knew at the beginning of the pandemic that all humans were equally susceptible, I would say, to the COVID-19, that none of us was immune.

INSKEEP: Yeah.

JONES: So if opportunity were equally distributed, if exposure risk was equally distributed, there would be no way that we could slice and dice the population to see differences in who was getting infected or who was dying. So it just showed that opportunity is not equally distributed by race in this country. It showed that exposure to risk is not equally distributed, that people of color are more likely to get infected with COVID-19 because we've been more exposed in the front line jobs, more exposed in crowded housing and the like and less protected. And then once infected, people of color are more likely to die because we're more burdened by chronic diseases that come from living in poor neighborhoods, disinvested neighborhoods with environmental hazards and no good food and no green space and the like, with less access to health care. So what COVID-19 did was just expose, again, racism as a root cause, the same way that Hurricane Katrina exposed - the poisoning in the Flint water supply. There have been many times that we could open our eyes and see that opportunity is not equally distributed in the society by race.

INSKEEP: So...

JONES: But what happens is we open our eyes and then we close them again.

INSKEEP: So a couple of years ago, we had an interview on this program with Kamala Harris, then a presidential candidate, now the vice president of the United States. And I asked her about reparations, and she began talking about this public health problem is something that could be addressed. You can't give payments to people who were enslaved generations ago and are now dead. But you have these generational effects that have continued with discrimination today, including public health effects, and that requires some kind of intervention, she said then. So if you're thinking about public policy, what form could that intervention take?

JONES: Massive investments in communities of color so that we improve housing, clean up the environment, improve the schools, so we have excellent public schools for all of our kids, that we start investing again in wealth building. It's not - as I say, these differences that we see between communities of color and white communities didn't just so happen. There were real historical injustices, like the taking of the land from American Indians or the enslavement of Africans and using our unpaid labor for centuries to build this country that have never been addressed. In this country, we don't even pay much attention to history. We are so ahistorical. We act like the present was disconnected from the past and as if the current distribution...

INSKEEP: And it's not, of course.

JONES: It's not - and as if the current distribution...

INSKEEP: Now, let me just - if I could just - I've just got a few seconds left, and I'm so sorry I cut you off.

JONES: Oh, I'm sorry.

INSKEEP: We could go on forever on this discussion. But I'd like to know, as you observe the Biden administration, do you see them just making a statement about this or laying the groundwork for serious, different policies about it?

JONES: I am very heartened that we - first, you have to make this statement. First, you have to name racism because if you never name it, in our widespread culture of racism denial, then you're complicit with the denial. So you have to name a thing, but that's - you then have to move to action. I think, yes, the Biden administration has made the first step and is moving toward action. Yes.

INSKEEP: Dr. Jones, it's a pleasure talking with you. Thanks so much.

JONES: Thank you.

INSKEEP: Dr. Camara Phyllis Jones is at Morehouse and Emory University. Transcript provided by NPR, Copyright NPR.