The costs of inequality: Faster lives, quicker Deaths

For blacks and Hispanics, frail neighborhoods undercut education, health, and jobs — all keys to thriving.

Seventh in a series on what Harvard scholars are doing to identify and understand inequality, in seeking solutions to one of America’s most vexing problems.

Sixteen years into the new millennium, many white Americans see racial and ethnic inequalities as belonging to a bygone era of blatant discrimination and legal segregation that ended with the Civil Rights protections enacted a half century ago or more.

The popular thinking goes that the reasons African-Americans and Hispanics nationally lag behind in income and wealth, in health and education, have to do with their own “personal shortcomings,” in the words of Harvard sociologist William Julius Wilson.

Or, as David R. Williams, the Florence Sprague Norman and Laura Smart Norman Professor of Public Health and professor of African and African-American studies in Harvard’s Faculty of Arts and Sciences, characterizes this perspective, “It’s their fault because they’ve had the doors of opportunity open to them and haven’t walked through those doors.”

Public opinion has hardened so much that Harvard scholars who’ve researched racial and ethnic inequalities feel they must take it into account when asked to propose solutions to those ongoing disparities. The scholars factor in how to reframe the public conversation to make their suggestions politically acceptable.

Rather than advocate approaches that target racial or ethnic groups, these analysts instead offer broader solutions directed at disadvantaged neighborhoods or classes of people. The scholars are inclined to promote practical, place-based initiatives to bring programs and services to particular areas.

For African-Americans and other minorities, the promise of equality is always around the next bend ― along with, it generally seems, the next political roadblock.

Faster life and quicker death

Williams sees racial and ethnic inequalities as a stark matter of faster life and quicker death.

“Health inequalities are the sum total of all the other social inequalities,” Williams said. “All the other social inequalities finally end up in the area of health.”

Williams cited studies showing:

  • African-Americans contract serious diseases sooner, resulting in 96,800 deaths that would not have happened if they fell sick at the same rate as whites. Williams compared the loss of life to “a fully loaded jumbo jet, with 265 passengers and crew taking off from Boston Logan Airport and crashing today, everybody on board dying, and the same thing happens tomorrow. And the same thing happens every day next week and every day next month and every day for a year.”

  • Since 1950, the black-white gap in life expectancy has been halved from eight years to four, but it would take another 30 years for the life spans to become equal — if the average longevity of whites remains static.

  • The longer that Hispanic immigrants live in the United States, the less healthy they become. Their health status is similar to whites’ when they arrive, but over time deteriorates to a level almost as low as blacks’. Subsequent generations born in America are less healthy than their immigrant forebears.

  • Ten standard measures of health, such as blood pressure and cholesterol levels, show the bodies of African-Americans at midlife have aged 10 years faster than whites’. The premature aging, Williams said, shows “how physiologically compromised you are because of the onslaught of chronic, ongoing physical, chemical, psychosocial stressors.”

What are those stressors? Much attention has been paid to income inequality affecting all Americans, more so people of color. But for blacks and Hispanics, Wilson and Williams said, the wealth gap is wider and more significant.

A 2014 census report showed that Hispanics earn 70 cents and African-Americans earn 59 cents for every dollar whites earn. For African-Americans, the disparity is the same as it was in 1978, according to Williams.

Another report from the Census Bureau indicated that in 2013, “For every dollar of wealth that white households had, Hispanic households had seven cents, and black households had six pennies,” Williams said.

Taken together, the two sets of proportions peg the wealth gap as 10 times larger than income inequality for African-Americans and Hispanics. Possessing minimal assets causes insecurity and stress over how to cope with life’s ups and downs.

“It’s the wealth gap. That’s where the real problem is,” said Wilson, the Lewis P. and Linda L. Geyser University Professor.

Isolation in impoverished neighborhoods

One factor in the current gap was the Great Recession, in which African-Americans and Hispanics, having been disproportionately targeted for subprime loans by mortgage brokers, lost billions in wealth through home foreclosures. Another factor Wilson cited was the “growing deterioration of the conditions of poor blacks” and their isolation in impoverished neighborhoods.

Before 1970, blacks lived in mixed-income neighborhoods more often than any other racial-ethnic group, Wilson said, but now they are the least likely to do so.

“Today poor black families have fewer middle-class neighbors than they had in 1970,” Wilson said. “When you combine this growing income segregation with [residential] racial segregation, you see that low-income blacks cluster in neighborhoods that feature disadvantages among several dimensions, including joblessness and [lower] educational attainment.”

Hispanics are also concentrated in low-income urban neighborhoods. The Initiative for a Competitive Inner City(ICIC), which Harvard Business School Professor Michael E. Porter founded in 1994, has calculated that 37 percent of the nation’s inner-city residents are Hispanics and 31 percent are African-Americans.

Through the school years, both minority groups are on the short end of achievement gaps when compared with whites and Asians, and have higher dropout rates. Driving the high Hispanic dropout rate are deficiencies in bilingual education and the expectations of immigrant parents that teenagers work to help support their struggling families.

The biggest education gap for both groups is how much schooling they complete. In a knowledge economy that greatly rewards the better-educated, 50 percent of Asians and 29 percent of whites have earned a college degree, compared with 18 percent of blacks and 13 percent of Hispanics, according to the Census Bureau.

Because Williams believes that health disparities represent the cumulative impact of other inequalities, he calls for solutions that stretch traditional medical care and public health policy. His first step, though, would be universal access to insurance coverage. He favors a single-payer government system.

“Education is really one of the keys for Latinos to deal with the whole question of inequality.” — Davíd Carrasco

His next step? “Quality early childhood education for all, especially for those who are coming from low socioeconomic backgrounds who could not afford it,” Williams said. That initiative would start before birth with home visits by nurses who would counsel pregnant women on health and other matters.

From education research on achievement gaps, Ronald Ferguson has arrived at a similar conclusion. “Racial and socioeconomic and gender skill gaps are clearly apparent in the national data by the age 2. So you have to start prenatal to deal with these things,” said Ferguson, adjunct lecturer in public policy at Harvard Kennedy School (HKS) and faculty director of Harvard’s Achievement Gap Initiative.

Best practices in their homes

In 2015, Ferguson launched a local collaboration, Boston Basics, that encourages the city’s parents to adopt five best practices in their homes to “help give children equal life chances.” They are simple activities such as “talk, sing, and point” to build communications skills, and “read and discuss stories” to enhance comprehension.

As part of Boston Basics, the Boston Public Health Commission is making home visits to expectant mothers in distressed families to teach them those practices — much as Williams envisions.