The mean life expectancy in the United States is 82.4 years, but in Harris County this can vary by about 20 years between ZIP codes. Average folks in Kashmere Gardens (77026) generally don’t see their seventieth birthday. In Sunnyside the most senior residents average about sixty-six years old. White people in Clear Lake (75407) can expect to live until at least ninety. Only about 6 % of the residents there are Black. The chronic stress of living in a predominantly Black neighborhood in Houston is a significant contributor to these statistics. Segregation influences one’s health.
Racism is clearly correlated with the increase in inflammatory diseases like gastrointestinal disorders and asthma. The stress hormones associated with discrimination are elevated in Blacks and result in premature aging. The poor air quality, the limited availability of affordable fresh food, and the inability to escape racial violence, all seep into the community and increase the susceptibility to illness. Black citizens in every neighborhood suffer historically worse medical outcomes than any other groups other than Native Americans, from maternal mortality to heart disease and cancer.
The term “weathering” is how Arline Geronimus, a public health researcher at the University of Michigan describes this phenomenon. She compares the Black body to a rock that is constantly being worn down by a hostile environment and weakened by the stress and pressure of existing in a prejudiced culture. Strategies challenging education, shelter, income, and jobs all impact one’s physical and mental well-being. Entrenched racism within those social structures and institutions disrupts the health of all Black Americans.
The National Academy of Medicine knows and deplores that “racial and ethnic minorities receive lower-quality health care than white people, even when insurance status, income, age, and severity of conditions are comparable.”
The Academy Award winning actress and philanthropist Angelina Jolie knows this first-hand. She is the mother of six children who were born across the globe. In an article, she wrote for the American Journal of Nursing and discusses the fact that, “I have seen my children of color be misdiagnosed, at times in ways that endangered their health.” Her critique included the fact that medical professionals have overlooked and disregarded the circumstances that race and ethnicity present, and how medical and nursing schools assumed white skin to be the model to study.
Serena Williams is another example of this travesty. None of her wealth or celebrity status could protect her from the life-threatening crisis she suffered after the birth of her first baby.
Dr. Michael LeNoir, a physician based in Oakland, California endorsed these concerns. “Just being Black makes you tired. We’re the only population that probably does not benefit health-wise from increasing your socioeconomic status.”
The reasons for this disparity are many, including self-sabotage. Blacks are less inclined to be vaccinated for preventable diseases such as the flu or COVID. Still, the nonprofit, nonpartisan Commonwealth Fund has ranked Texas as the most difficult state in the nation to access health care; it also distinguished us as among the costliest for uninsured patients, which nearly a quarter of us are. The state’s legislature has defiantly snubbed the expansion of Medicaid despite the unmistakable financial rewards it would return.
Many Blacks do not have a personal physician, and when they do, the unconscious bias of white doctors as well as those of other ethnicities sometimes cause them to judge minority patients unsympathetically and indicate in their notes that they doubt the severity of their patients’ conditions. Black pain is frequently undertreated because some providers believe that Black people tolerate pain more easily than white people.
Although the scarcity of Black primary care doctors is a reality, most studies recognize that the life expectancy and over all well-being of Black citizens are improved in counties with increased numbers of Black physicians. This may be because Black patients are more likely to follow medical recommendations after visiting Black doctors, especially those with hypertension and heart diseases, but it is also likely that improved communication and trust is the result of the commonalities the doctor and patient share.
“Weathering” is a reality for Blacks living in a discriminatory society. It is up to each of us to protect and boost ourselves and each from as many storms as we can.