Monday, September 21, 2009

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.


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

* * *

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

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

-- Glenn Beck

On the July 23rd 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...



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.


  1. Hope you don't mind...

    This is an excerpt from a piece I wrote a month or so ago:

    One of the ironies in this intertwining of messages is that the two groups of people Obama was talking about in reference to the (Skip Gates racial profiling) controversy — blacks and Latinos — will be the biggest losers if real health care overhaul doesn’t happen.

    African Americans and Hispanics account for nearly half of the 50 million Americans who don’t have health insurance, according to a report by the Commonwealth Fund, a New York-based advocacy group.

    Ten years ago the UCLA Center for Health Policy Research found that the higher uninsured rates for ethnic minorities are due in large part to their lower rates of job-based insurance, which covers 73 percent of whites, but only 43 percent of Latinos, 51 percent of Native Americans and indigenous Alaskans, 53 percent of African Americans and 64 percent of Asian Americans and Pacific Islanders.

    The recession has only made matters worse, especially for middle class America. The sputtering economy is dragging down millions of Americans, but a recent study finds that Hispanic and African American families are the hardest-hit with four in five such households struggling to stay in the middle class.

    More specifically, between 2000 and 2006 there was a sharp increase in the number of families in which at least one member lacked health insurance: from 26 percent to 39 percent for Hispanics, and from 18 percent to 30 percent for African Americans.

    Click to read the rest:

  2. PBE: I remember seeing that when you first posted it. It actually inspred the lit review I've shared here. Excellent work. funny thing is that, aside from your piece, I don't see much about this in the MSM.

  3. Ed,
    I strongly agree with your observation.  Hence, run for a senate seat, I'll campaign for U!  love ya   Keep the brain food flowing

  4. There are well known risk for certain ethnic groups in terms of diseases in this country. Hypertension is just one disease we know that has significantly higher risk than in the population at large...and the risk of complications from this disease is strikingly higher for blacks. Native American Indians have a higher risk for diabetes. The risk of certain diseases has little to do with personal choices rather is a result of genetics. For the press to make such huge jumps in assumptions and accusations about health in any minority without solid facts is professional negligence,
    Disparities in healthcare exists in many subgroups in this country. It's a subject that is multilayered~ access to healthcare, cultural beliefs about treatment , financial considerations,clinician bias ,the way our healthcare system reimburses all play a part in how people and diseases are treated. Sadly, we don't have a level playing field when it comes to taking care of the health of all Americans.
    The solution to address these disparities? There has to be zero tolerance adopted in clinical practice guidelines for ALL healthcare facilities for all patients regardless of race or socioeconomic status. ALL Americans should have the benefit of choices that are of the most up to date treatment and prevention guidelines.

  5. SweetP: As I know you're professional in the field, I REALLY appreciate your iunput. I realize, as I'm sure all right-thinking Americans do, thja the amswers won't be easyu or readily available. what has saddened me is the level of dialog this issue has taken. It's just so counter-productive. I like to think that MOST americans aren't this dense and when I reach out to you and people such as yourself, I am somewhat encouraged.

    BTW: did you have problems posting? Did the system not allow yuou to post a longer response? I'm asking because one of my fiends has had problems posting longer responses.

  6. LOL @Janet> I don't think I would be a successful candidate -- I've been a baaaaad boy. I would, however, like to write white papers or maybe work for a think tank and try to influence public policy. thanks for reading!

  7. No problems when I posted here yesterday...some difficulties today that seem to have resolved.
    I think some of our current negative dialog in this country surrounding healthcare stems from people clinging to political ideals instead of allowing ourselves to look at healthcare solutions from a humanitarian perspective. Most Americans can find compassion for starving children in 3rd world countries yet have no idea that we have children right in our own back yards that are homeless and without adequate food,shelter and immunizations. When you look at the individuals that make up the statistics of people without healthcare insurance in our country there are millions of stories to tell....elderly going without medications due to finances, families who become bankrupt due to medical bills, homeless citizens who find themselves without access to basic medical care or mental health support, ethnic groups who aren't offered state of the art medical care due to limitations of reimbursement or provider biases. From an humanitarian perspective how can we choose to say one group is more deserving of  health care services and another less deserving?
    Our country is at a cross roads with our healthcare system. The political alliances that people fervently cling to  are just a method for finding solutions albeit via different methods. I have great hope that this opening chapter of healthcare reform will open the doors to solutions that span across the political spectrum and allow the focus to be about the health and welfare of Americans. It's a hard road to navigate but a country that bestows so much to people in need in other countries can certainly focus our effort on the citizens America. 


What say you?


[un]Common Sense