Study: Racial inequality in health the result of social policy

UNSPLASH

A report from Duke University researchers found racial inequality in health is more connected to social policy than multigenerational trauma of enslavement.

Persistent racial inequality in health is the result of United States social policy rather than slavery’s effects, according to a paper published by Duke University researchers.      

                                              
The paper “How Epigenetic Inheritance Fails to Explain the Black-white Health Gap” examines the hypothesis that trauma inflicted on the enslaved sparked genetic changes that have been passed down through generations. That argument, which is labeled Post-Traumatic Slavery Syndrome or Post-Traumatic Slavery Disorder, suggests inherited changes at the genetic level negatively affect contemporary Black Americans’ health.

“Blaming the inherited trauma of slavery for modern health disparities is inaccurate, imprecise and irresponsible,” said paper co-author William Darity Jr., a Duke public policy professor and director of the school’s Samuel DuBois Cook Center on Social Equity. “All that Black Americans have ‘inherited’ is a perpetual resource disadvantage in a society that refuses to enact policies to correct the condition.”

The paper was published in the February issue of Social Science & Medicine.

Statistics confirm a gulf in health between Black Americans and their white peers. Life expectancy is four years less for Black people, and that gap expanded during the COVID-19 pandemic. Black infant mortality is twice as high, and Black mothers are three times as likely as white moms to die of pregnancy-related causes.

The consensus among researchers is the gaps are caused by historical and ongoing systemic racial disparities and at least in part a racial wealth gap. The 2022 Survey of Consumer Finances, collected by the Federal Reserve, found that the average white household had more than $1 million more in wealth than the average Black household –in addition to disparities in access to land, housing, better-paying employment, quality education, adequate sanitation, nutrition and medical care.

The transgenerational slavery trauma argument has gained traction in recent decades as proponents suggest trauma inflicted upon the enslaved have been transmitted across generations, resulting in poorer mental and physical health.

“It is romantic to say that the trauma stemming from these atrocities is in our genes,” said Darity, a professor of African and African American studies and economics scholar of reparations in the U.S. “But this framing is dangerous since makes these problems seem more intractable than they are, when they can, in fact, be addressed by changing the material conditions Black Americans experience today.”

The paper’s authors contend there is no direct evidence for the transgenerational trauma hypothesis in that there is no data spanning five-plus generations to the period of U.S. slavery. Also, as free and enslaved Black Americans experienced racialized trauma, there’s no valid control group to isolate the effects of enslavement’s trauma.

The authors reviewed studies often cited in indirect support of the transgenerational trauma hypothesis. The authors note, intergenerational genetic transmission has been shown in laboratory animals but not humans. Studies on humans analyzed the effects of Holocaust-induced trauma in following generations, or the effects of grandparental food consumption on the health of their grandchildren. The authors found “no evidence of a pathway five or more generations, the minimum to attribute modern-day outcomes to slavery-era trauma.”

Given the persistence of racial bias in the U.S., the researchers found the transgenerational trauma argument unnecessary since it doesn’t explain anything other than “ongoing exposure to a day-to-day trauma-inducing environment.”

As discussions of reparations grow, Darity argues only precise arguments can help identify the proper causes of disparity and identify solutions.

“There are many good arguments for pursuing Black reparations, or similar policies to promote racial equity,” he said, “but this is not one of them.”

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