1. Overview of Economic, Health, and Human Rights Issues of Racial and Ethnic Minorities Martin Donohoe

2. Colonial Exploitation Christopher Columbus’ log entry upon meeting the Arawaks of the Bahamas: “They…brought us…many…things…They willingly traded everything they owned…They do not bear arms…They would make fine servants…With fifty men we could subjugate them all and make them do whatever we want.”

3. Colonial Exploitation Cecil Rhodes (Rhodesia, Rhodes Scholarship, DeBeers Mining Company): “We must find new lands from which we can easily obtain raw materials and at the same time exploit the cheap slave labour that is available from the natives of the colonies. The colonies would also provide a dumping ground for the surplus goods produced in our factories.”

4. Exploitation leads to: Maldistribution of wealth and resources Environmental degradation Wars

5. Racial Disparities: Economic Median income of black U.S. families as a percent of white U.S. families: –60% in in 1968 –62% in 2002 –63% for Hispanic families in 2002 Minorities face higher levels of unemployment

6. Poverty and Hunger U.S.: 14.3% of residents and 20% of children live in poverty –Rates of poverty in Blacks and Hispanics = almost 3X Whites Poverty associated with worse physical and mental health

7. Recession Has Worsened Racial Wealth Gap

8. Income Inequality Lower life expectancy Higher rates of infant and child mortality Short height Poor self-reported health AIDS Depression Mental Illness Obesity

9. Voltaire “The comfort of the rich rests upon an abundance of the poor”

10. Hudson River, 2009

11. Functional Apartheid Segregated communities Stress consequent to ongoing racism and poverty Undocumented immigrants face constant threat of deportation, disruption of family and social relationships

12. Educational Apartheid High levels of de facto school segregation by race and SES Gross discrepancies in per-pupil spending and teacher salaries Achievement and graduation gaps growing

14. Environmental Racism –Waste dumps/incinerators more common in lower SES neighborhoods –“Cancer Belt” (Baton Rogue to New Orleans) –Poor, African-Americans, and Hispanics more commonly exposed to lead, other toxins

15. Pesticides EPA: U.S. farm workers suffer up to 300,000 pesticide-related acute illnesses and injuries per year –25 million cases/yr worldwide NAS: Pesticides in food could cause up to 1 million cancers in the current generation of Americans WHO: 1,000,000 people killed by pesticides over the last 6 years

16. Racial Disparities in Health Care Coverage Percent uninsured: –Whites = 12% –Asians = 17% –African-Americans = 21% –Hispanics = 32% –Undocumented immigrants = 0% (emergency care exception) CA Proposition 189

17. Racial Disparities: Health Care Higher maternal and infant mortality Higher death rates for most diseases Shorter life expectancies Less health insurance Fewer diagnostic tests / therapeutic procedures

19. Health Disparities Among Latinos Higher rates of: –Overweight and obesity –Certain cancers –Stroke –Diabetes –Asthma/COPD –Chronic liver disease/cirrhosis –HIV/AIDS –Homicide

20. Racial Disparities in Health Care: African-Americans Equalizing the mortality rates of whites and African-Americans would have averted 686,202 deaths between 1991 and 2000 –Whereas medical advances averted 176,633 deaths AJPH 2004;94:2078-2081

21. Social Factors Responsible for Illness and Death Deaths in 2000 attributable to: –Low education: 245,000 –Racial segregation: 176,000 –Low social support: 162,000 –Individual-level poverty: 133,000 –Income inequality: 119,000 (population-attributable mortality – 5.1%) –Area-level poverty: 39,000 (population-attributable mortality – 1.7%) –AJPH 2011;101:1456-1465

22. Diseases Responsible for Illness and Death Deaths in 2000 attributable to: –AMI – 193,000 –CVD – 168,000 –Lung CA – 156,000 –AJPH 2011;101:1456-1465

23. Exploitation: Post-WW II Human Subject Experimentation Tuskegee Syphilis Study Guatemalan Syphilis Experiment

24. Exploitation: Contemporary Research Imbalances Unethical research on special populations (cultural minorities, prisoners, developing world, etc.) 90% of research dollars spent on diseases affecting 10% of the world’s population Limited access of developing world to results due to scarcity of open-access publications

25. Medical Care 50% of global health care budget spent in the U.S. Per capita expenditure on health care: –U.S. = $8,160 –Typical poor African/Asian country = $5-10

26. Exploitation: The Medical Brain Drain Five times as many migrating doctors flow from developing to developed nations than in the opposite direction “Inverse care law”: –Those countries that need the most health care resources are getting the least

27. Racism in the Criminal Justice System Persons of color are more likely than whites to be: –Stopped by the police (e.g., “Driving while black”) –Abused by the police –Arrested –Denied bail –Charged with a serious crime –Convicted –Receive a harsher sentence

28. Race and Detention Rates African-Americans: 1,815/100,000 –More black men behind bars than in college –13% of black men currently have no voting privileges Latino-Americans: 609/100,000 Caucasian-Americans: 235/100,000 Asian-Americans: 99/100,000

30. Outside the U.S. Racial and cultural inequalities Poverty, famine, war Governments/corporations promoting poverty and worsening maldistribution of wealth and resources through trade agreements, internalization of profits and externalization of costs

31. The Third World Debt Crisis Each African child inherits approximately $379 in debt at birth Countries spend more each year repaying debt than on education and healthcare

32. Consequences of Debt Repayment Agreements Government spending on food, fuel and farming subsidies reduced Social service (healthcare/education) program spending cut Countries strip and sell their natural resources

33. Foreign Aid In total dollars: U.S. #1 As a % of GDP, U.S. #21 U.S. Aid: Over 1/3 military, 1/4 economic, 1/3 for food and development

34. Foreign Aid 0.9% of the total federal budget, 1.6% of the U.S. discretionary budget Americans think that 24% of the federal budget goes toward foreign aid

35. U.S. Charitable Giving Approximately $250 billion/year – 2.5% of income –2.9% at height of Great Depression

36. U.S. International Non- Cooperation/Isolationism Failure to sign or approve: –Kyoto Protocol on Climate Change –International Covenant on Economic, Social, and Cultural Rights

37. U.S. International Non- Cooperation/Isolationism Failure to sign or approve: –Convention on the Rights of the Child –Convention on the Elimination of Discrimination Against Women

38. U.S. International Non- Cooperation/Isolationism Failure to sign or approve –The Stockholm Convention on Persistent Organic Pollutants –WHO International Code of Marketing of Breast Milk Substitutes

39. U.S. International Non- Cooperation/Isolationism Failure to follow World Court Decisions Failure to recognize International Criminal Court

40. Primo Levi “A country is considered the more civilized the more the wisdom and efficiency of its laws hinder a weak man from becoming too weak or a powerful one too powerful.”

41. Solutions More equitable distribution of medical research funds and health care dollars Living wage laws –E.g., NY, LA, Chicago, and Philadelphia Education reforms

42. Solutions Creation of healthier communities Stronger environmental and occupational and safety laws/enhanced enforcement

43. Solutions Single payer health care Improve status of women / access to reproductive health care Overhaul immigration policy Changes in law enforcement and sentencing

44. Fyodor Dostoyevsky “A society should be judged not by how it treats its outstanding citizens but by how it treats its criminals”

45. Solutions Publicly financed campaigns and campaign finance reform Proportional representation Instant runoff voting/cumulative voting/range (rating) voting

46. Solutions U.S. voter turnout low (139/172 worldwide) –Wealthy vote at almost twice rate of poor –Whites > Blacks > Hispanics –Old > Young –Property owners > Renters Activism / Protesting / Whistleblowing Work in Groups

47. Günter Grass “The first job of a citizen is to keep your mouth open.”

48. Anita Roddick "If you think you are too small to have an impact, try going to bed with a mosquito in your tent"

50. Public Health and Social Justice Website http://www.publichealthandsocialjustice.org http://www.phsj.org martindonohoe@phsj.org