Why is “white” the comparitive?

Rockford Health Council hosted a community event on February 22 that should have drawn much more attention and participation than it did from the community.  The event was entitled “Health Equity:  Deepening the Dialogue”; Dr. Terry Mason, Chief Medical Officer of the Cook County Health and Hospitals System provided the keynote and offered some eye-opening statistics and information. 

Approximately 150 people from the community were in attendance, many from the fields of health care, human services, religion, government and a few business professionals – mostly people I see at other meetings.  Unfortunately there was very little participation from the community at large, even though the event had been promoted heavily through email, newspaper advertisements and direct mailings.  Dr. Mason shared the fact that health is much more than just health care.  Our individual behaviors like diet, smoking and sedentary lifestyle obviously impact our health, but social conditions also effect health: access to fresh produce and grocery stores, safe places to exercise and play, well financed schools that offer gym and fine arts programs, encounters with prejudice, social exclusion, segregation and access to health care all have an impact on our health.  Achieving health equity is something we all can, and should, have a voice in.

When looking at disparities in health care, we automatically tend to look at the disparities between black and white populations.  Most conferences and meetings I attend on racial health disparities are broken down in this manner.  Why?  It could be that black/white issues are more polarizing in general or it may be easier to compare the two and strive for “equity”.  But does it make sense to work on decreasing the disparity based on ethnicity?  Or, would it make more sense to work toward making everyone as healthy as the healthiest population? 

Take cancer of the digestive system as an example.  We are disturbed to find that more than 770,000 black men and women die from cancers of the digestive system  annually, while only 534,000 white men and women die from the same cancers.  Is the goal to lower the black death rate to be only as bad as the white death rate?  Or, should we look further into the study and learn that Asians/Pacific Islanders only experience 486,000 deaths due to digestive system cancers and strive to achieve that health standard for all?  As Dr. Mason stated, “I’d rather be as healthy as the Asian group, not as sick as the white group.  If we only look at the black and white disparity, it means that we’d need to increase the Asian and Hispanic death rate in order to achieve equity.” 

In so many of our studies and discussions we compare the inequity that exists between black and white populations – perhaps we’re missing the boat by using white, or Caucasian, as the comparative.  Why not focus on the most successful or healthiest ethnicity in whatever we’re studying and strive to achieve that success for everyone? 

Since hearing Dr. Mason, I’ve found it interesting to go back over data on wealth and income studies that are highlighting the wage gap between black and white populations, even the U.S. Census report was interesting for a moment.  It’s intriguing to add in the Asian and Pacific Islander population; when you take into account their population size, they are actually more financially prosperous and fewer numbers are living in poverty - why not use that as the comparative?

The Rockford Health Council is seeking people interested in working on one of their nine work groups that range from access to care to crime and public safety.  If you have an interest in working toward a stronger and healthier community, I’d encourage you to reach out and volunteer.