In an article published by The Atlantic, Olga Khazan chronicles a powerful account of Being Black in America. She tells the story of Kiarra, a young African American woman from Baltimore who faces the insurmountable obstacles of a social structure that is hostile to people of color. Growing up in poverty, Kiarra’s adverse childhood experiences (and other stressful life events) resulted in severe health problems that affect her quality of life. Sadly, even though she lives in close proximity to some of the world’s most advanced medical facilities and personnel, she struggles to access the care and treatments she desperately needs. This is not how Christians respond to health inequalities.
These social conditions are at the heart of the disparity between people of color and white Americans.
The COVID-19 pandemic has afforded us a shocking glimpse into the depth and breadth of these disparities. The Centers for Disease Control and Prevention reports that, while no one is exempt from the scourge of this deadly disease, Hispanics, Blacks, Native Americans, and other minority groups are disproportionately affected by it compared to whites. Moreover, while infection and death rates have narrowed among Blacks and Hispanics, health inequities and disparities persist for non-white individuals.
According to the World Health Organization, these discrepancies are rooted in fundamental social structural inequalities, which seem to be connected to racial discrimination, economic contraction, and other forms of prejudice. Together these elements coalesce to form an underlying matrix of social inequality that diminishes the quality of life for the most vulnerable members of our society and produces fallow ground where access to healthcare resources is restricted or denied for those in need.
Race, Health, and Discrimination
Researchers describe discrimination as a dominant group wielding its power to restrict access to resources and other social structures for minority groups, thus creating an environment delimited by glaring systemic disparities. People of color are on the receiving end of these long-standing discriminatory practices. Moreover, researchers have discovered links between discrimination and health-related issues such as increased blood pressure, heart problems, lower childbirth weight, anxiety, depression and other mental health problems, respiratory and dental issues, uncontrolled pain, and other chronic health problems.
Though it may seem hard to fathom, the prevalence of psychosocial stressors like poverty and oppression contribute to the increased production and release of stress hormones (i.e., cortisol and epinephrine), increasing the likelihood of health problems. Likewise, redlining issues such as subpar educational systems, low wages, food insecurity, inadequate housing, and lack of proper health insurance converge contribute to adverse health outcomes for people of color.
Historically, people of color live in marginalized communities with inadequate healthcare facilities, hindering access to life-saving treatments, medications, and state-of-the-art medical technologies. As a result, they are disproportionately affected by life-threatening conditions (i.e., stroke, cancer, kidney disease, hypertension, diabetes) compared to white Americans.
Another alarming form of this structural disparity is the high maternal mortality rate among Black women. The data shows that Black women are three-to-four times more likely to die during childbirth than white women in the United States. More significantly, researchers explain that over half of maternal deaths among Black women occur during the postpartum period. Clearly, social determinant factors such as poverty, education, and geography are connected to this disparity. However, research suggests that racial discrimination is a primary cause of these adverse outcomes.
- “Racial Inequities Persist in Health Care Despite Expanded Insurance” — Roni Caryn Rabin analyzes health and race disparities in the wake of improved access afforded by the Affordable Care Act.
- “Health and Race Disparities in America Have Deep Roots: A Brief Timeline” — Tammy Joyner and Jasmi S. Lee provide a historical timeline of racial disparities in healthcare in America.
- “Health Disparities in the Black Community: Past and Present” — On this episode of Origin of Everything, PBS outlines health disparities for Black communities in America.
- “Addressing Racism & Reconciliation” — Pastor Scott Sund from Bethany Community Church shares ideas on a Christian priority of racial justice and reconciliation.
- “Professor N.T. Wright on Racism, Reconciliation, and the Church” — N.T. Wright speaks about the Christian vocation of displaying the ethics of the Kingdom of Heaven.
Race, Health, and God’s Telos
In a recent webinar with the Synod of the Covenant of the Presbyterian Church, my colleagues Drew and Greg addressed the complicated history of science and race. Sadly, ideas such as racial superiority, eugenics, and race as a biological construct have been used to justify countless instances of discrimination and oppression. In fact, our social scaffolding seems—at least in part—to be held in place by racial discrimination. But Drew and Greg reminded us that God created one race, the human race, and any attempt to reinterpret that fact is an attempt to subvert God’s order.
In the gospel of Matthew, Jesus explains that God’s telos must be understood in terms of a Christian engagement that includes making provisions for the needs of the most vulnerable members of society. As Brenda Salter McNeil suggests in her book The Heart of Racial Justice, our Christian responsibility must be grounded in an active faith that seeks to redress this world’s broken systems, eradicate all instances of disadvantage, and destroy all racial discrimination as acts of participation in God’s Kingdom. This is how Christians respond to health inequalities.
What do I mean by an active faith? Wesleyan theologian Theodore Runyon proposes that our love for God impels us to love our neighbor in ways that uphold human rights, care for the poor, and seek to create a better social environment (Matthew 22: 37-40). He says our faith demands that our religious engagement be “a public observance, a celebration of the common story and common values regarded as bestowing identity upon a people” who are the ultimate object of God’s love (John 3:16).
In Matthew 25, Jesus explains that faith demands concerted acts of love directed to “the least of these,” our brethren. Feeding the hungry, clothing the naked, advocating for prison reform, and fighting for equitable and accessible healthcare systems are biblical injunctions and not partisan issues for Christians. These are central elements of God’s telos, tangible expression of the good news, and God’s way of removing this intersection of disadvantage to give way to the actualization of his proleptic kingdom.
In Nobis Regnant Iesus,