Tracing the roots of difference: A blog series

“We are not makers of history. We are made by history.”

Martin Luther King, Jr.

In addressing questions about equity, analysts often present results that differ significantly by race or gender or sexual orientation.  But however dramatic the differences – even for life-and-death indicators like life expectancy and infant mortality – they rarely explore the contexts in which disparities occur.

The contexts, of course, are broad; and they differ, at least somewhat, for every group.  Events that occurred decades or even centuries ago (such as the horrors of slavery – experienced by both African American and Native American populations – or the forcible removal of Indigenous children from their families for assimilation to white European culture) can be crucially relevant to health, wealth, and overall wellbeing among people today. Just as the effects of traumatic experiences can pass from generation to generation, the effects of historically racist policies (unfair lending and hiring practices, restrictive real estate covenants, unequal access to GI Bill benefits, unequal access to quality education) have impaired the ability of multiple generations to acquire wealth and build a buffer against hard times.

This is the first in a series of EQUITY BLOGS that looks at the root causes – historical and contemporary – of longstanding disparities in the health and wellbeing of King County residents. The blogs will investigate the notion, supported by many public health leaders, that “health is a function of social inequality.” They will also describe biological mechanisms that have been proposed to mediate the close relationship between social inequality and health outcomes.

Over the next few months, blogs will explore the following topics:

  • Discrimination: An equal opportunity experience? Results of the national Discrimination in America survey.
  • Historical trauma: What is it? Why is it important now? The lasting effects of major, sanctioned oppressions that deny or ignore a group’s humanity.
  • Intersectionality in action. Effects of trauma can be compounded by intersecting identities. Illustrated with recent data from King County communities.
  • Economic policy maintains the hierarchy. How policy has been shaped to preserve power, with enduring impacts.
  • Housing policies and practices in King County. How past and present housing policies influence opportunities for residents of King County.
  • Unequal education. A look at differences in educational opportunity and the differential benefits of education.
  • Unequal justice under the law. How do we explain growing disparities in our justice system? What are we doing about it?
  • Where is environmental justice? Introducing a mapping tool to see where demography intersects with pollution and how that relates to health in King County.
  • The R word: Racism. What does it mean? Why are we so hesitant to use it? A look at changing norms and attitudes.
  • The high cost of “making it.” The stresses of having to be 10 times as good to succeed, often in a hostile environment, are reflected in a host of health outcomes.
  • Birth outcome disparities, part II. Biological explanations of persistent disparities in infant and maternal mortality. “We carry our histories in our bodies. How would we not?” (Nancy Krieger)
  • Disparities tool debuts on Communities Count. Introduction to an interactive tool that highlights disparities – and patterns of disparities – across a range of indicators.
  • Equity sources. An organized, evolving list of curated sources – national and regional – related to the above blog topics will be available on the Data Resources page.

In addition to helping us understand disparities in local data, blogs in the series are meant to show how tightly our history weaves itself into our lives and our children’s futures. In looking at trauma, we acknowledge the rich variability of responses within and across groups and generations, from strength and resilience to ongoing harm embedded in policy and culture. Our goal is not to exacerbate existing divisions, but to reaffirm the shared values, identified by King County residents, that guide the work of Communities Count.  Whenever possible, the blogs focus on the lives of King County residents, calling out local heroes as well as promising regional programs and practices.

Links

Data sources about King County communities include …

  • Communities Count offers interactive charts and maps on indicators across the following topics: education, family & community support, food, health, housing & transportation, income, population, and public safety.
  • Community Health Indicators: For 168 health and determinants-of-health indicators offers interactive charts and maps showing trends and demographics; data for King County regions, cities, and some neighborhoods.
  • City Health Profiles provides demographic and health data for 26 cities / geographic areas in King County.

 

Is inequality a choice?

Yes, according to New York Times columnist Nicholas Kristof, who writes, “… while we broadly lament inequality, we treat it as some natural disaster imposed upon us. That’s absurd. The roots of inequality are complex and, to some extent, reflect global forces, but they also reflect our policy choices.” Kristof cites a recent report that 2014 Wall Street bonuses were about twice “the total annual earnings of all Americans working full time at the federal minimum wage” (see 3/23/2015 Communities Count blog).

For suggestions of ways to counter inequality, he turns to a new book, Inequality: What Can Be Done, by British economist Anthony Atkinson. Among Atkinson’s 15 steps to reduce inequality:
■ Government should be more concerned with monopolies and competition policy.
■ Trade unions should be bolstered to represent workers’ interests.
■ Government should provide public-sector jobs at minimum wage to those who want them, in areas such as meals-on-wheels, elderly care, child care and so on.•
■ In addition to a minimum wage, there should be a framework to restrain pay at the highest levels. Atkinson cites companies that have voluntarily decreed that executive pay should be capped at 65 or 75 times the average pay in the firm.
■ Personal income taxes should be made more progressive, with a maximum rate of 65 percent.
■ Every child should get a “child benefit” payment, to help keep kids out of poverty.

Finally, Kristof poses the following question about how Congress responds to inequality (more than one choice could be correct):

Congressional leadership is showing resolve to slash —
A) subsidies for private jets;
B) the carried interest tax loophole for billionaires;
C) food stamps;
D) the estate tax on couples with estates worth more than $10.9 million.

The answers: C and D — policies that “would hurt low-income children while offering a helping hand to billionaires.” Kristof asserts that “the problem isn’t inequality; the problem is us. We’re paralyzed.”

For examples of inequality in King County, see Communities Count data on health insurance, perceived safety, homicide by neighborhood poverty and race/ethnicity, and poverty trends.

Best Starts for Kids: Focus on prevention

In his annual State of the County address, King County Executive Dow Constantine introduced Best Starts for Kids, a 6-year, levy-funded project that, if approved by voters, will implement proven and promising strategies to help children reach their full potential. The long-term goal is to invert the County’s current pattern of spending more on negative outcomes (such as incarceration) than on effective strategies, early in development, to prevent those outcomes. Best Start for Kids is designed to jumpstart this inversion.

Some excerpts from this morning’s presentation:

“From 1950 to the late ‘70s, … 90 percent of American households enjoyed 70 percent of all income growth…. Yes, the rich did get richer, but as the economy grew, so did the middle class. Back then, a rising tide really did lift all boats. But … between 2009 and 2012 here in Washington state, 175 percent of all income growth has gone to just the top 1 percent…. This mocks the fundamental principle on which we were all raised: That if we work hard, we can all succeed.

“From Boeing to Costco to Microsoft to Starbucks to Amazon, King County has prospered because our people have excelled at solving problems. But income inequality puts our future prosperity at risk by denying more of our children an equal opportunity to contribute to a well-educated middle class…. The sad truth in America today is that a top predictor of a child’s success in life is the income of the household in which that child is raised. Our goal must be to break this connection between income and outcomes.”

“One of the worst outcomes for children who are victims of abuse, neglect, homelessness, or mental illness is to land in the juvenile justice system. Every child who drops out, who gets kicked out, who is locked up, marks our failure as a community to provide the love and care and support that every child needs. These kids aren’t failing us—we are failing them.

“We can and must do better, as a county that prides itself on taking its name from Dr. Martin Luther King, Jr. A full century before Dr. King, Frederick Douglass observed: ‘It is easier to build strong children than to repair broken men.’ Strong children require strong communities, and it will take all of us working together across sectors to ensure that every child has the opportunity to fulfill her potential, and to participate fully in her community.”

For full text, go to 2015 State of the County address. For background information and an infographic, go to the Best Starts for Kids webpage.

The ever-shrinking middle class

America’s middle class is on the move — but it’s not moving up. According to the Center for American Progress, only 45% of American families qualify as middle class, down from almost 57% in 1979. And research by a U.C. Berkeley economist found that during the “economic recovery” years of 2009 to 2012, the richest 1% of Americans received 95% of all income gains. In King County, economic recovery has been strikingly uneven by race: by 2013, the proportion of Black households with income below the Federal Poverty Threshold was up to 35%, significantly higher than all other race/ethnicity groups except those identifying themselves as “other race.” Communities Count presents data on wealth and income inequality in the Income section.

Income inequality shrinks the American middle class.