Suppose I were to tell you that in Durham County neighborhoods with the following characteristics — a lower percentage of white individuals, “lower economic and racial spatial advantage,” “higher area deprivation,” “higher reported violent crimes, evictions, poverty, unemployment, uninsurance, and child care center density, as well as lower election participation, income, and education” — that there is also a higher incidence of three chronic diseases. What would you conclude?
Would you, for example, draw the conclusion that the low availability of childcare was a cause of disease? Or would you perhaps draw the opposite conclusion that the incidence of disease reduces the demand for childcare — or are the two perhaps unrelated?
How about election participation? Would you think that perhaps sick people are less likely to vote, or would you think that a disinclination to vote predisposes people to disease?
And how about low income and less education? Do they produce ill health or are they a product of ill-health?
What about violent crime? Is it a cause of ill health? Is it caused by ill health or is it perhaps caused by something else? And would you wonder just what is meant by “racially and spatially disadvantaged”?
A correlation can reflect causes in both directions, or in neither. If A is correlated with B, that could mean that A causes B, B causes A, or both are caused by C. The article I am describing never attains this level of analysis.
Let me simplify it for you. Just put all these disparities into a basket labeled “structural racism.” Then the conclusion is clear: structural racism causes (okay, “is associated with”) disease.
No need to look at individual differences, individual biology, individual habits, indeed anything individual at all. An individual in this scenario has the free will and agency of a billiard ball. Structural racism rules.
All nonsense of course, but unfortunately, this article is not a parody. Nineteen investigators (well supported by the National Institute on Minority Health and Health Disparities) specializing in something called health equity research, have just done a bunch of correlations, reported those that are significant, and then added a “racism” label to the mix. The work does nothing whatsoever to uncover the causes of disease.
The idea of health equity is endorsed by government health agencies, such as NIH and the CDC, not to mention WHO. It exists because it raises a political flag that might as well say “disparities demand recompense.” But it is not science, which is what NIH and the CDC are supposed to be about.
Indeed this study, and the NIMHHD that funded it, is the very opposite. Science is supposed to make things clearer, to help us understand causes. This study obscures rather than clarifies. It finds correlations, lumps them together and invents an alarming label that diverts attention away from the real causes of disease.
Unfortunately, “antiracist” nonsense is a now called “medical science,” even in Durham, the one-time “City of Medicine.”