By Kareem Abdul-Jabbar
WebMD Magazine Special Series: Social Justice
Photo by John Russo
My life is at risk. Not just because I’m 73 with the usual annoying aches and pains that accompany age, but because I’m tall and I’m Black. At 7 feet, 2 inches, I’m statistically more prone to blood clots, lower back and hip problems, higher risk of cancer, especially prostate cancer, atrial fibrillation (a heart rhythm disorder), and a shorter life span in general. Being Black means I’m more likely to suffer from diabetes, heart problems, obesity, cancer, and a shorter life in general. Yup, tall people and Black people have shorter life expectancies. So far, in keeping with these statistical risks, I’ve had prostate cancer, leukemia, and heart bypass surgery.
I’ve been fortunate because my celebrity has brought me enough financial security to receive excellent medical attention. No one wants an NBA legend dying on their watch. Imagine the Yelp reviews. I’m also lucky that one of my sons is an orthopedic surgeon and another is a hospital administrator. Dad gets to nag them for medical advice whenever he wants. But while I’m grateful for my advantages, I’m acutely aware that many others in the Black community do not have the same options and that it is my responsibility to join with those fighting to change that. Because Black lives are at risk. Serious risk.
"Because Black lives are at risk. Serious risk."
Not just from the diabetes, heart problems, obesity, and cancer that we as a group are prone to, but from a wide spectrum of health threats built into the foundation of American society as solidly as steel girders holding up a bridge. Most people know this is true, though some will deny it because they fear removing those rusty girders will cause the whole bridge to collapse. The truth is that those girders are already malignant with rust and will eventually collapse if we don’t address the underlying rot of systemic racism. San Francisco’s Golden Gate Bridge has 200 ironworkers, electricians, and painters who daily maintain the bridge’s integrity. If we want America to maintain its cultural integrity, we need to fix its structural flaws—and we need to do so on a daily basis.
“The backlash in which white people proclaimed All Lives Matter clearly had no understanding of the issue. Blacks weren’t saying that Black lives mattered more, they were emphasizing that, the way the system works now, Black Lives Matter … Less.”
There are a lot of groups addressing these rusty fissures, including the National Association for the Advancement of Colored People (NAACP), the American Civil Liberties Union (ACLU), National Urban League, Southern Christian Leadership Conference (SCLC), and others. People who may not be familiar with the wonderful work of those organizations at least know about Black Lives Matter (BLM), which is less a traditional organization and more a movement of loosely affiliated activists across the country united by the credo that is their name. The backlash in which white people proclaimed All Lives Matter clearly had no understanding of the issue. Blacks weren’t saying that Black lives mattered more, they were emphasizing that, the way the system works now, Black Lives Matter … Less.
BLM started organizing in 2013 to protest police violence. But by 2020, after a series of police killings of unarmed Blacks that culminated with the suffocation of George Floyd, BLM had grown into the largest protest movement in the history of the United States. Between May 24 and August 22, there were more than 10,600 demonstrations. An estimated 15 million to 26 million people in the U.S. participated in protests following Floyd’s death. A June 2020 Pew Research Center poll showed that, although the majority of American public opinion was negative toward Black Lives Matter in 2018, a majority now supported them. Seems like progress.
An estimated 15 million to 26 million people in the U.S. participated in protests following Floyd’s death.
But police brutality is merely the most dramatic and violent attack on the lives of African Americans. It’s a TV camera-ready symbol of their status in America as negligible and disposable. Unruly children to be punished for their impertinence, regardless of how justified their outcry. However, the more insidious and damaging threat to the health, lives, and economic well-being of Black Americans is a health care system that ignores the fact that, though they are most in need of medical services, they actually receive the lowest level. As Dayna Bowen Matthew, author of Just Medicine: A Cure for Racial Inequality in American Health Care, states in a Brookings Institution article: “What we politely call a ‘health disparity’ is killing people of color daily. It is causing people of color to live sicker and die quicker, because of the color of their skin.”
The COVID-19 pandemic has highlighted just how malignant the system is. The virus has hit the African American community at a much higher and more devastating rate than it has the white community. At the same time, they receive a lower standard of care. The death rate for Blacks is 3.6 times higher than for whites. But in predominantly Black counties, the infection rate is three times higher and the death rate is six times higher than in predominantly white counties. Other marginalized people of color are also suffering: nationally, hospitalization rates are five times higher for Native Americans and African Americans and four times higher for Latinx. A Centers for Disease Control and Prevention (CDC) report released August 14, 2020, concluded that in 79 hot spot counties in the U.S. that had information about race, 96.2% showed racial disparity in COVID-19 cases.
“However, the more insidious and damaging threat to the health, lives, and economic well-being of Black Americans is a health care system that ignores the fact that, though they are most in need of medical services, they actually receive the lowest level.”
Why are Blacks in general more vulnerable to relentless pandemics? One reason is underlying health conditions. But that can be misleading, because the causes of some of those conditions are the poverty created by systemic racism that results in subpar education compared with whites. Having lesser education, and less financial resources, means less opportunity to compete for higher education, which means less opportunity for better paying jobs. Even those who manage to claw their way through these substantial obstacles and enter the job market with higher degrees face hiring discrimination based on race. The Harvard Business Review stated that an examination of 21 studies concluded that, due to racial stereotyping and unconscious biases, “hiring discrimination against Blacks hasn’t declined in 25 years.” The result is that African Americans are not only twice as likely to be unemployed, but even when employed they earn almost 25% less. To counter this, Black job applicants have taken to “whitening” their names and omitting ethnic information in order to get job interviews. Sadly, this has been effective. In a study published by Harvard Business School, 25% of Blacks using a whitened name on an application received a callback, compared to 10% who didn’t.
Another health factor caused by poverty is obesity. African Americans have the highest rate of obesity in the U.S., which contributes heavily to why Blacks are more prone to high blood pressure, strokes, diabetes, and heart disease. All of which figures into why Blacks have the highest death rates of any racial and ethnic group in America. Some of this can be attributed to genetics, but the larger cause is reduced access to healthy foods because grocery store chains are less prevalent in poorer neighborhoods, so they have to pay more money for lower quality foods. “National and regional supermarkets are typically full-service, with an extensive variety and assortment of food at competitive prices. Some even have pharmacies or minute clinics,” explained Anne Palmer, director of the Food Communities and Public Health program at the Johns Hopkins Center for a Livable Future, to CNN Business. “By bypassing Black or low-income communities, they exacerbated the problem of easy access to healthy food.” Fast foods are a cheap source of food, but a steady diet plays havoc with one’s health, especially in terms of obesity.
The problem with pulling any single thread—COVID-19, health risks, job opportunities—is that each thread is a single strand in a giant quilt that smothers the Black community. One thread leads to another, to another, to another—each forming an interlinking pattern that seems impenetrable and unassailable. A police officer crushing the windpipe of an unarmed Black man is related to not valuing Blacks, which is related to stereotypes about Blacks, which is related to how they are portrayed (or not portrayed) in media, which is related to not having educational opportunities, which is related to … and on and on.
37.7% vs. 26.9%
One of the reasons Blacks are contracting and dying from COVID-19 at higher rates is because they work at what the government has defined as essential jobs more than any other ethnic group: 37.7% Black versus 26.9% white.
It’s hard to feel valuable to a society that doesn’t value your health or life. And yet, one of the reasons Blacks are contracting and dying from COVID-19 at higher rates is because they work at what the government has defined as essential jobs more than any other ethnic group: 37.7% Black versus 26.9% white. In health care and social assistance industries, the rate is even higher. So, they’re both essential, yet disposable, like protective gloves. The mistake is to think we can fix any one aspect of racism without fixing the others. That’s like having four flat tires and only fixing one. Education, the criminal justice system, the health care industry, the job market, low-income housing—these are all rungs in a ladder that must be solid enough to lift everyone up. Ending racism, like the Golden Gate Bridge, requires daily maintenance. Studies have shown that Black students do better in school when they have at least one Black teacher, that juries are more thorough and fair when they are diverse, and that Black babies survive more often under the care of Black doctors than white, regardless of the mother’s income. More Black teachers, jurors, and doctors—that’s our daily maintenance. Athletes kneeling during the national anthem, social media banning hate posts, politicians and celebrities condemning racist speech, police not profiling based on race, companies committing to financially supporting organizations fighting racism—that’s our daily maintenance. And not just for the next few months until the public relations spotlight has dimmed, but until the country proves through legislation and public behavior that it actually believes in liberty and justice for all.
It’s one of the reasons I chose to become the UCLA Health Ambassador. I wanted to reach out to the Black community to make sure they were receiving the medical and health information that could save their lives, just as it had saved mine. The health challenges that are endemic to our community can be effectively addressed if people know they have a place to go that will help them. UCLA’s Precision Health program is a new approach to treatment that targets care based on an individual’s profile of genes, environment, and lifestyle. When I was diagnosed in 2008 with leukemia, precision medicine was used to focus on the genetic mutation driving my disease.
“It’s as if the Black community is trapped in Groundhog Day in which every day we fight racism, prove it exists, see gains, and then wake up the next day to all the same obstacles.”
It’s also why I’m so proud of my son Amir, who chose to become a surgeon in an effort to help the Black community. He knew that Black men have the lowest life expectancy of any demographic group, living an average of 4.5 years less than white men. Part of the reason is that Black people have a reasonable trust issue with the medical profession dating back to the Tuskegee Experiment in which Black men were told they were being treated for syphilis, only to find out they weren’t so the government could secretly study the progression of the disease. A recent National Bureau of Economic Research study in the Harvard Business Review showed that Black men received more effective care when they had a Black doctor as opposed to a white doctor. As a Black doctor, Amir provides medical treatment for those who might otherwise be reluctant to seek it and, according to the study, provides more effective care. He also serves as a role model for Black children who might want to seek a career in science or medicine.
But even with all of the positive efforts my son and others might be making, the sad truth is, I could have written this article 50 years ago. It’s as if the Black community is trapped in Groundhog Day in which every day we fight racism, prove it exists, see gains, and then wake up the next day to all the same obstacles. In the movie, Bill Murray escaped the cycle by becoming selfless, caring more about others’ needs than his greedy desires. That’s how America will escape this self-destructive behavior. The future of equity for Black Americans starts with physical and mental health, and as long as they are at the end of the line for services, true equity can’t happen. Black lives have to matter in every aspect of American society if they are to thrive.
More in This Series
The pandemic and the social justice movement in 2020 highlighted the structural racism in many areas, including medicine, leading some to ask, "Where are the black doctors?" We explore the issue.
Mental illness has long been cloaked in shame in the Black community. Experts talk about the misconceptions that have prevented this group of people from getting the help they need.