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

2. Outline Exploitation Economics, Education, Environment, Health Care, Criminal Justice System International Perspective Solutions

3. 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.”

4. Colonial Exploitation Sir Jeffrey Amherst (French and Indian Wars - smallpox): –“You would do well to try to inoculate the Indians, by means of blankets, … to extirpate this execrable race”

5. Colonial Exploitation Winston Churchill (speaking in favor of RAF’s “experimental” bombing of Iraqis in 1920s, which killed 9,000 people with 97 tons of bombs): “I am strongly in favor of using poisoned gas against uncivilized tribes to spread a lively terror…against recalcitrant Arabs as an experiment”

6. 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.”

7. Historical and Contemporary Exploitation Slavery Apartheid Civil Rights Movements (U.S. and international)

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

9. 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 –59% in 2010 (69% for Hispanic families)

10. Racial Disparities: Economic Recession, housing crisis has hit black and Latino families harder than white families –7.5% on Blacks live in substandard housing (vs. 2.8 % of Whites) Minorities face higher levels of unemployment

11. 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

12. Recession Has Worsened Racial Wealth Gap

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

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

16. Hudson River, 2009

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

18. Functional Apartheid Undocumented immigrants pay taxes: –State and local income, property, and excise taxes; employer’s share of SS, Medicare, and unemployment taxes BUT, they are not eligible for many public services: –Medicaid, SNAP, SS, Medicare, unemployment benefits, temporary cash assistance

19. 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

21. Benefits of Education For every $1 spent on early childhood education, up to $17 are saved from increased school achievement, improved health, reduced crime, and reduced reliance on public assistance Income increases 11% for every year of education

22. Benefits of Education College graduates live 5 years longer than high school dropouts Eliminating educational inequities would have saved 8X as many lives as medical advances from 1996-2002

23. Environmental Racism Polluting factories/waste dumps/incinerators more common in lower SES neighborhoods “Cancer Belt” (Baton Rouge to New Orleans) Poor, African-Americans, and Hispanics more commonly exposed to lead, other toxins

24. 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

25. Racial Disparities in Health Care Coverage Percent uninsured: –Whites = 12% –Asians = 17% –African-Americans = 21% –Hispanics = 32% –Undocumented immigrants = 100% (emergency care exception) CA Proposition 189

26. Racial Disparities: Health Care Higher maternal and infant mortality Higher death rates for most diseases Shorter life expectancies for African-Americans –Not for Hispanic Americans (healthy immigrant effect and Hispanic paradox may be relevant, but largely due to decreased tobacco use) Fewer diagnostic tests / therapeutic procedures / pain medications

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

29. 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

30. 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

31. 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

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

33. 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

34. 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

35. 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

36. 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

37. 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

39. 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

40. 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

41. 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

42. 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

43. 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

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

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

46. 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

47. 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

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

49. 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.”

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

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

52. Solutions Single payer health care –Canadian blacks are as healthy as Canadian whites Improve status of women / access to reproductive health care Overhaul immigration policy Changes in law enforcement and sentencing

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

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

55. 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

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

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

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