The Doritos Factor

¡Hola! Everybody...
I simply no longer have what little patience I had to begin with... I don’t want to change your mind; I don’t care if you “agree” with facts or not; I don’t care what it is you believe in, all I care about is telling the truth.

Period.

A few people have asked that I post something along the lines of "Neoconservativism for Dummies" and I just might attempt it. LOL!

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-=[ Healthcare and Racism in the US ]=-

... minorities... eat more Doritos...

-- Glenn Beck

On the July 23^rd edition of his show on Fox News’, Glenn Beck said, in reference to Obama’s healthcare reform efforts that the “Office of Minority Health” could allow for “litigation against Doritos” since “minorities” may “eat more Doritos.” In the video clip, he offers up Latina racial conservative, Linda Chavez, as a talking head basically supporting the idea that Blacks and other people of color have lower standards of health because, well, they’re stupid and lack impulse control. They eat too many Doritos, as Glenn Beck would have it. Chavez is a prime example what Latino/as call a come mierda -- a shit eater. I will be posting more about her (and her crusade against Latino/as in general and Puerto Ricans specifically) and other conservative minorities at a later date.

For now, it would be safe to say that the prevailing opinion among many conservatives is that blacks and Latino/as suffer from low health outcomes because they choose to participate in high-risk behaviors. I think Linda “Come Mierda” Chavez and Glenn Beck, as well as the millions that watch/ listen to his show would agree with this form of reasoning.

Because it extends beyond individual attitudes and is embedded in our social structures and organizations, race is a strong determining factor in the way Americans are treated and how they fare. White Americans, whether they admit it or not, benefit as individuals and as a group from the current way the social hierarchy is set up. These benefits, running the gamut from educational, economic to political advantages encourage white Americans to invest in whiteness as if it were a form of capital (Lipsitz, 1998). The possessive investment in whiteness is like property. And as a kind of property, its value lies in the right to exclude, or deny, communities of color the opportunity to accumulate assets. Therefore, racism is a dialectic (a dance?) between accumulation on the one hand, and exclusion on the other.

What the Glenn Beck’s of our society deny (with the encouragement of their black and brown enablers) is the fact that white privilege exists and is pervasive. Though discussions of racial inequality often tend to focus almost exclusively on black and brown behavior, something as simple as shopping can be problematic for people of color. Clerks in retail stores are more frequently concerned with the color of shoppers’ skin than with their ability to pay. One clothing franchise, Cignal Clothing, for example, stamped an information form on the backs of personal checks. The form included a section marked “race,” and shoppers were classified “W” for white, “H” for Hispanic, and “07” for black (don’t ask!). After conducting an extensive qualitative study, sociologist Joe Feagin reported, “No matter how affluent and influential, a black person cannot escape the stigma of being black even while relaxing or shopping” (Feagin & Sikes, 1994).

Health care is another realm where significant disparities exist between blacks and whites -- disparities that often literally mean the difference between life and death. The wide gaps in mortality rates and access to primary care between blacks and whites have been noted in newspaper accounts and, more extensively, in the academic literature.

However, similar disparities cut across every aspect of health and health care, and few of these differences can be fully blamed on social status and genetics. For example, The National Cancer Institute (NCI) has reported that that cancer deaths are increasing much faster for blacks than for whites, sometimes by as much as twenty to hundred times as fast. Black women are more likely than white women to die of breast cancer, even though the incidence of the disease is lower among blacks (McBarnette, 1995).

According to the same NCI report, “Black men have a cancer-death rate about 44 percent higher than that for white men” (Squires, 1990). In fact, African American men between the ages of fifty and seventy are nearly three times as likely to die from prostate cancer as white men, and their prostate cancer rate is more than double that of whites.

Now, some of you are probably thinking that these disparities fall under the heading of “Fucked Up Choices Black & Brown People Make,” right?

You would be wrong.

Higher death rates for blacks diagnosed with cancer, for example, are a recent development. In the 1930s, blacks were only half as likely as whites to die of lung cancer. Since 1950, however, the rate of lung cancer deaths among black men has increased at three times the rate for white men. Increases in smoking rates are not the likely cause behind the change. Exposure to environmental toxins and carcinogens, which are disproportionately located in poor and minority communities, is one of the most important reasons for racial differences in cancer death rates (Cooper & Simmons, 1985).

Unequal access to screening, prevention, and treatment are other reasons for the health disparities. One of the chief reasons black women are more likely to die of breast cancer is that they are not diagnosed until the disease has reached an advanced stage (Yood et al., 1999). Even when access is to health care is equal, African Americans are diagnosed at a later stage and are almost twice as likely to die of breast cancer as whites. A study of operable lung cancer found that the rate of surgery for black patients was 12.7 percent lower than that for whites with the same diagnosis. This goes beyond social class or the issue of access to health care. The researchers of this study concluded that the “lower survival rate among black patients... is largely explained by the lower rate of surgical treatment among blacks” (Bach, Cramer, Warren, & Begg, 1999). Similarly, racial differences in mortality rates for cervical cancer remain significant even after controlling for age and economic status, and are more likely attributable to differences in screening and diagnosis (McBarnette, 1995).

Racial differences in hypertension have been well documented and much has been written about its prevalence among low income African Americans. One study, however, rejected the conventional wisdom that hypertension among blacks is genetic, concluding that socioenvironmental factors like the stresses of low job status and income are the chief culprits for the different rates of hypertension (Klag, Whelton, Coresh, Grim, & Kuller, 1991).

Access to advanced diagnostic and treatment procedures for coronary heart disease and related ailments also accounts for the significant differences between blacks and whites. Once differences in age, sex, health care payer, income, and diagnoses for all admissions for circulatory disease or chest pains to Massachusetts hospitals had been controlled for, a 1985 study found that whites underwent significantly more angiography and coronary bypass grafting than blacks (Wenneker & Epstein, 1989). More recent studies confirm these results. One study found that that after controlling for differences in age, gender, severity of disease, comorbidity, geography, and availability of facilities, blacks were 60 percent less likely to have thrombolytic therapy.

However, the most glaring issue in health and race is that of racial bias. Evidence suggests that racial stereotyping and discrimination influence the medical decisions made by doctors. One study (whose findings proved controversial), asked doctors to respond to videotaped interviews with “patients” who were in actuality actors with identical medical histories and symptoms. Only the race and gender of the actors were different (Schulman et al., 1999). It turned out that doctors were significantly less likely to refer black women for aggressive treatment of cardiac symptoms than other categories of patients with the same symptoms. Doctors were also asked about their perceptions of patients’ character traits. Black male actor/ patients, whose symptoms and comments were identical to white male actor/ patients, were perceived to be less intelligent, less likely to participate in treatment decisions, and more likely to miss appointments. Doctors in the study thought that both black men and women would be less likely to benefit from invasive procedures than their white counterparts, less likely to comply with doctors’ instructions, and more likely to come from low socioeconomic backgrounds. Put simply, where actor/ patients were identical except for race, black patients were usually seen as low-income members of an inferior group.

Although I am sure most doctors would deny being racist, and probably aren’t intentionally racist, they are not immune to America’s racial history and the resulting cognitive bias. In a groundbreaking article on unconscious racism, Charles Lawrence III observed, “racism is part of our common historical experience and... culture. It arises from the assumptions we have learned to make about the world, ourselves, and others as well as from the patterns of fundamental social activities” (1987)

Discretion is inseparable from the practice of medicine, and combined with other sources of racial bias, it causes the differences in treatment and health care. This pattern of racially biased discretion is similar to patterns found in education and criminal justice.

On the other hand, maybe it’s just the fuckin’ Doritos...

Eddie

References

Bach, P. B., Cramer, L. D., Warren, J. L., & Begg, C. B. (1999). Racial differences in the treatment of early-stage lung cancer. New England Journal of Medicine, 341(16), 1198-1205.

Cooper, R., & Simmons, B. E. (1985). Cigarette smoking and ill health among black Americans. New York State Journal of Medicine, 85, 344-349.

Feagin, J. R., & Sikes, M. P. (1994). Living with racism: The black middle-class experience. Boston: Beacon Press.

Klag, M. J., Whelton, P. K., Coresh, J., Grim, C. E., & Kuller, L. H. (1991). The association of skin color with blood pressure in US blacks with low socioeconomic status. Journal of the American Medical Association, 265(5), 599-602.

Lawrence III, C. R. (1987). The id, the ego, and equal protection: Reckoning with unconscious racism. Stanford Law Review, 39(2), 317-388.

Lipsitz, G. (1998). The possessive investment in whiteness: How white people profit from identity politics. Philadelphia: Temple University Press.

McBarnette, L. S. (1995). African American women. In M. Bayne-Smith (Ed.), Race, gender and health (pp. 51-52). Thousand Oaks, CA: Sage Publications, Inc.

Schulman, K. A., Berlin, J. A., Harless, W., Kerner, J. F., Sistrunk, S., Gersh, B. J., et al. (1999). The effect of race and sex on physicians' recommendations for cardiac catheterization. New England Journal of Medicine, 340(8), 618-626.

Squires, S. (1990, January 20). Cancer death rate higher for blacks. Chicago Sun-Times p. A5.

Wenneker, M. B., & Epstein, A. M. (1989). Racial inequalities in the use of procedures for patients with ischemic heart disease in Massachusetts. Journal of the American Medical Association, 261(2), 253-257.

Yood, M. U., Johnson, C. C., Blount, A., Abrams, J., Wolman, E., McCarthy, B. D., et al. (1999). Race and differences in breast cancer survival in a managed care population. Journal of the National Cancer Institute, 91(17), 1487-1491.