It’s Not Poverty, It’s Racism

70% of Covid-19 lives lost in Louisiana have been Black lives. Black people make up only 33% of the population. NPR interviewed Louisiana Senator Bill Cassidy, a Republican and a medical doctor, about the disparity. After listening this morning, I was compelled to deconstruct his avoidance of root causes and structural racism, despite his insistence on the contrary. The entire conversation can be found here.

Host David Greene jumps right in with “what is being done to help the black community in your state?” To which Cassidy responds, “there’s been a surge of ventilators, of medical equipment to all folks.”

  1. Refuse to help Black people directly, even when they are most at-risk

He continues,

But if you’re going to look at the fundamental reason, African Americans are 60% more likely to have diabetes. The virus likes to hit what is called an ACE receptor. Now, if you have diabetes, obesity, hypertension, then African Americans are going to have more of those receptors inherent in their having the diabetes, the hypertension, the obesity.

So there’s a physiologic reason which is explaining this. Now, as a physician, I would say we need to address the obesity epidemic, which disproportionately affects African Americans. That would lower the prevalence of diabetes, of hypertension. And that’s what would bring benefit.

2. Blame the victim

Greene zeroes in, “But I mean, we heard Congressman Cedric Richmond say, as well, that this is rooted in years of systemic racism. Aren’t there other forces at work here?”

Cassidy: Well, you know, that’s rhetoric, and it may be. But as a physician, I’m looking at science. And the science…

Greene: You’re saying that’s just rhetoric? I mean, there are more uninsured African Americans compared to other populations in your state. Doesn’t that play a role…

3. Ignore the 400 year history that has crafted inequity

Cassidy talks about how they’ve expanded Medicaid, and says that as a physician he has to look at the problem physiologically. Greene responds, “You are a doctor, as you said. But I mean, obviously, you’re also a member of the U.S. Senate. And if there are other issues at play here, isn’t it also your role to address them?”

Absolutely. But – absolutely. So – but I think it’s important to be analytical because we’re not going to come to a solution if we just say, oh, this must be the case. The issue at hand is, how do we decrease death rates from COVID-19? And that is by, among other things, addressing the underlying factors. And those are diabetes, hypertension and obesity, no matter your race. And if we do that, all will benefit.

4. See #1 & #2

5. Pretend that there is no immediate solution to a problem that has an immediate solution, because you don’t want to implement the solution.

There are things we could do now; legislative things. Set up testing centers in Black communities, ensure free medical care for all respiratory illnesses for the next 2 months, so that people will get checked for potential infection without the fear that care may not be covered by the new Covid allowances. Open up unused hotels and other spaces so potentially infected people won’t bring the infection home to overcrowded living spaces. At the very least, reopen enrollment for ACA, as Greene suggests. But Senator Cassidy believes that addressing a chronic condition during an immediate, present health crisis is the best way to decrease mortality.

Does he think he can reduce obesity, diabetes, and hypertension before the curve peaks? He’s not an idiot. He says this because he’s unwilling to spend money to directly help Black people dying in his state. Maybe he thinks it will cost him re-election; maybe he really thinks their health conditions are their own fault, not fueled by years and generations of systemic and violent and subtle and cultural racism, stressors proven to contribute to obesity and diabetes and hypertension.

6. Black people are just ignorant about good diets and healthy living.

And this is when I fell in love with David Greene:

Can I just ask you to step back? I mean, you’ve been, obviously, a very central player in your party when it comes to questions about the future of health care in our country. As you look at a moment like this and see African Americans dying at an alarming rate and you think about, you know, as a doctor, as you said – thinking about what conditions can be addressed, but when you think about policies, you know, you’ve been criticized before by the NAACP for policies that, in their view, don’t support minority communities.

Is this a moment where you’re willing to step back and say, let’s rethink everything and think about whether we as a country are addressing the racial disparities when it comes to health care?

Let’s rethink everything. Yes, David. Yes.

Cassidy responds per usual, “if you separate poverty out of the separate issue, then a lot of the racial – not all, but a lot of the racial disparities go away because poor people have less – have poorer health than those who are well-off. And that’s what we must address.”

Yes, that’s what we must address. He reframed the discussion from one about Black people bearing the overwhelming brunt of deaths in his state, to one of poor people having “poorer health.” Not even poorer access to health care, which is slightly more relevant: poorer health.

Sing along! 1! 2! 3! It’s the same old tunr. Even when White people in power almost admit to structural racism, it is somehow never the cause of the problem at hand. And dismantling it is never the solution.

The present inequity is the result of a racist, genocidal, xenophobic past. It is also unprecedented. We have a grand opportunity to open our eyes and Rethink Everything.

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