The discourse around DEI (diversity, equity and inclusion) and reparations has permeated various platforms, including news outlets and social media. Unfortunately, it has been used by certain political factions to incite division and secure votes.
These programs are crucial in dismantling systemic racial barriers that affect educational access and outcomes for historically marginalized communities. Contrary to what some politicians suggest, DEI and reparations are not complex issues. The public simply lacks a comprehensive understanding of the cumulative effects of systemic inequities in our nation.
There is a wealth of scholarly research spanning four decades that explores systemic racism, poverty, and their long-term effects on the health and overall wellbeing of Black and brown communities. Health and social service organizations across America agree that systemic racism is a primary factor influencing health outcomes and public health indicators among at-risk communities. Yet, these facts are often omitted from public debates and media discussions.
This column aims to highlight key arguments and emphasize the need for public policy to address these challenges. Here are key points.
Proximity
The concept of proximity is often the most neglected aspect when discussing DEI and reparations. The historical timeline from the era of slavery, through Jim Crow laws, redlining, the existence of sundown towns, to the assassination of George Floyd, is startlingly brief. To illustrate, Thomas Jefferson and Harriet Tubman shared overlapping lifetimes, and Ronald Reagan was a toddler at the time of Tubman’s passing.
Although sundown towns were outlawed with the Civil Rights Act, the eradication of their practices was protracted. The landmark Brown v. Board of Education ruling occurred in 1954, but it wasn’t until 2016 that we witnessed the desegregation of the nation’s last segregated school district.
Despite the Fair Housing Act rendering redlining illegal, echoes of the practice persist in white suburban neighborhoods, now disguised through elevated property taxes — a cunning circumvention of the law. In the South, bureaucratic barriers designed to hinder the voting rights of Black and brown communities remained entrenched until recent times. Moreover, a number of “red” states continue to employ aggressive gerrymandering of electoral maps, a tactic aimed at diluting the voting power of these same communities.
Epigenetic and somatic effects
These effects are the manifestation of intergenerational trauma, which carries serious consequences for both physical and mental health outcomes.
The constant state of hyperarousal, hypervigilance of the brain (also known as the allostatic load) when constantly exposed to both systemic and openly expressed racism, predetermines our bodies to a series of illnesses and conditions. One example is how this impacts brain development during pregnancy. Studies have effectively linked all the risk factors of public health to the trauma of structural and interpersonal racism. This is why the CDC, along with most public health organizations, have been calling systemic racism a public health emergency.
Black maternal and infant mortality rates are one of the most shameful racial disparities we have in our country, with Kansas showing the worst rates in the nation. This is a perfect example of how a combination of all the systemic inequities that are prevalent in our state directly impacts these extended health outcomes.
In the area of mental health, we have extensive research linking the prevalence of diagnosis with psychotic features with the constant exposure to racism. This happens with both microaggressions and open expressions of racism.
A recent study published by the Alzheimer’s Association establishes that racism is a primary determinant for the development of Alzheimer’s in the Black and the Hispanic community.
We can also see today how health care services, assessments and treatments are still plagued by eugenics. An example of this is how the algorithm for renal globular filtration rates used for Black people is based on nonscientific data rooted on eugenics. This has kept Black people from getting a referral to see a specialist on time. This is why Black people end up needing dialysis at a rate much higher than other groups.
In a recent study, almost half of physicians still see the Black body as more resilient to pain. This impacts pain management services, where doctors prescribe lower or higher dosages to Black clients. We see similar issues in disciplines such as dermatology and pneumatology. One example is that we still see different spirometry scales used during pulmonary function tests.
Wealth accumulation
Sixty percent of wealth in the United States is inherited, and that mostly comes from activities related to slavery, illegal land grabs, settler colonialism and the genocide of the native population. To add insult to injury, this wealth is exempt from capital gain taxes up to $10 million dollars per year.
The GINI coefficient, which measures wealth inequality, is at .48 in the United States. This is the highest GINI score in the developed world. This means that we are drowning in wealth inequality. Best practice in public health is to declare a public health emergency once the GINI rate reaches .26. But we have been above .40 for decades and we have completely ignored best practices. No public policies have been enacted to address this challenge.
Since the ’60s, wealth accumulation has remained almost stagnant for the Black community. Meanwhile, in the white community it has continued to soar dramatically. In dollars this translates to $2 trillion in the Black community and $140 trillion in the white community. Decades of redlining and discriminatory practices in access to programs like the G.I. Bill also contributed.
Structural disparities
When we look at the history of how our cities and institutions were designed, we can identify the significant role played by racism. When The Highway Act of 1956 was implemented, it caused displacement of Black and brown communities. They were expropriated and forcefully relocated to undesirable areas of cities close to contaminated sites, with air pollution, and enclosed by railroad crossings.
After schools were mandated to desegregate, we saw what is now known as white flight. White people created suburban school districts and gated communities to decrease their interactions with Black and brown people. They raised their property taxes and created covenant communities to keep future buyers or renters white.
The Russel Sage Foundation conducted a study of the first 10 years of the new millennium. It showed how racism was a primary determinant for job applications and mortgage approvals. Black clients were denied mortgage applications even when they showed similar credit scores and incomes to their white counterparts.
Environmental disparities
Black and brown communities were forced to occupy spaces with a higher incidence of brownfields, lead contamination, and air pollution. These risk factors have accumulated and caused irreparable damage to members of these communities.
Permanence of racism
It is important to understand that racism is a sociological phenomenon that is ingrained and sustained through the cultural hegemony of white supremacy. In Western society, this is known as an ideological superstructure. All the automatic reactions to human interaction are programmed and informed by this superstructure.
In less than a fraction of a second, our brains react to the stimuli of otherness, and make interpretations and prescriptions about how reality ought or should be. This is what social scientists mean when we say that racism is ingrained or inherent to our western culture.
Education
The creation of racially segregated suburban districts caused a massive exodus of property taxes from urban school districts. This has caused massive disparities in funding, resources, and extended educational outcomes for Black and brown communities.
The pedagogical frameworks used in public school curricula still reflect cultural hegemony. That means only the epistemology and ontology of whiteness is included. This is evident in standardized test results, which are later used to define access to post-secondary education.
In public health studies, we have reached the same conclusion every single time: Structure beats personal agency every day of the week. National health organizations have been calling on local health departments to declare these systemic disparities a public health emergency. But county commissioners and state legislators have chosen to ignore science, and all the accumulated body of scholarly work and research of the last 40 years, because of the serious political implications of accepting these truths.
We need DEI in the workplace, in higher education and at every level of society.
This is the only way to protect historically marginalized and oppressed communities from the systemic prevalence of white supremacy and other ideologies inherent to our culture. Without these programs, racial disparities will continue to rise, and our public health rankings will continue to drop. A new study published by the Health Forward Foundation shows how anti-DEI laws are destructive to our state’s economy, and to our ability to compete and attract new businesses.
In the case of reparations, they can be implemented in many ways. Not only through liquid payments, but also through the allocation of land, tax exemptions, scholarships, lower mortgage interests and higher wages.
Reparations can also happen through changes in pedagogical frameworks, intervention models in healthcare, epistemological changes to standardized testing, mental health assessments and psych evaluation tools. But the biggest obstacle to reparations is the lack of education about these systemic inequities and their history.
As the demographics of our state continue to change into a more diverse myriad of peoples and cultures, we need to increase our cultural competencies. We need to increase our understanding about how the prevalence of systemic racism and other forms of discrimination negatively impacts our public health indicators. Leading with truth while centering equity is the only path to reconciliation and to achieve our public health goals as a state.
Samuel Paunetto is the acting safety and wellness manager at the International Rescue Committee, and an adjunct professor at the School of Social Work at Wichita State University. Through its opinion section, Kansas Reflector works to amplify the voices of people who are affected by public policies or excluded from public debate. Find information, including how to submit your own commentary, here.