The Public Health Catastrophe of White Supremacy.

White supremacy comes in many forms in the United States. We recently saw an emesis of it in Charlottesville, ending in a terror attack that killed one and injured 19 others. Other associated acts of terror injured many more, as self-proclaimed Nazis rampaged against peaceful protesters, and police largely looked on and let it happen. It was horrifying, appalling, and deeply disappointing.

But it was not shocking. White Christianist terror has been part of the United States’ story for centuries. As some forms of it became socially unacceptable – like the KKK – it was driven underground, only to resurface in forms like Timothy McVeigh, George McGovern, and the NRA. The mass incarceration of black non-violent offenders – a new slavery quietly persisting today.

Our president, Donald Trump, has now openly embraced the rising violent tide of white supremacists, saying many of them are “very fine people”. While he did specifically condemn the driver of the car, he embrace the reason that these neo-Nazis were assembled, and defended their motives and character. He equilibrated the violent white supremacists and the peaceful protesters there to confront them.

There is a terrifying and rising tide of white Christianist terrorism in the United States, but that is only the tip of the iceberg when looking at how white supremacy harms us all. White supremacy has more insidious tendrils which infiltrate systems and laws and culture in ways that cause terrible economic and health damage to all of us. Primarily and egregiously to the minorities that are oppressed, but with negative effects on the privileged as well.

It starts with historical injustice and inherited wealth. Few non-white families in America have much of that. And it doesn’t take much. It doesn’t even have to be wealth in terms of dollars inherited when relatives pass away. Inherited wealth includes parents being able to help pay for college, or school supplies. For health insurance to the age of 26. Whites have much more access to these kinds of wealth. Which result, at the level of public health, in an ability to participate in the economy in greater proportions.

Lack of inherited wealth results in ghettoization of minorities into areas with substandard housing, schools, and services. This results in poorer education, less access to health coverage and care. We see exactly how serious it is in cases like Flint, Michigan, now years without lead-free water. And that isn’t isolated to Flint. Dozens, perhaps hundreds, of poorer communities have lead-contaminated water. Flint is famous because it was a cover-up.

The effects of white supremacy do not stop there though. Biased behavior – which everyone exhibits – conspires to diminish opportunity and outcome both for minorities once again. Minor scrapes with the law – common for persons of all races – result in warnings and small fines at much higher rates for whites than for other races. Black men especially are incarcerated for minor offenses at extremely high rates. Wealth again is a factor – the ability to hire one’s own lawyer is a major factor in the severity of punishment for minor crimes.

Once a person has been incarcerated, it becomes incredibly difficult for them to find housing, employment, or access to social services. And poverty claims another generation when those people can’t provide good educations and health care and housing for their families. The cycle continues.

Even those minorities who escape all that face greater obstacles in terms of biased hiring and promotion. Stereotypes of racial labor create barriers to entry in many types of industry. Hiring managers often worry that a candidate may be the “beneficiary of affirmative action” and thus unqualified. When in fact, affirmative action helps prevent the hiring of unqualified whites over qualified minorities.

These biases – which are often small and clandestine – are difficult to prove in any individual case, but have profound effects to the public at large. Lower wages, fewer leadership positions. Resultingly, the problem of inherited wealth perpetuates. Less access to high quality educations, more debt, less health coverage.

Each step is relatively small by itself. They combine to create a system which promotes whites and represses minorities. Minorities have worse health outcomes in nearly every measurable category. Because they have less coverage, less ability to attend preventive care, and because doctors are less likely to provide them with high quality care – there’s bias in the doctor’s office too. Worse treatment, and worse access to treatment.

The pernicious effects of this system result in shorter lives and worse quality of life. Not for any intrinsic reason. It is a function of wealth, access, and bias.

And it harms everyone. It is easy for white people to ignore these problems – our privilege lets us. But we do so not only at great cost to our own moral condition, but also at great harm to our own lives. Systematically oppressing some 39% of the population (the 2016 estimate from the US Census Bureau is that 61.3% of the population is non-Hispanic white) has profound consequences on many things.

We sacrifice equal participation of almost 40% of our innovators. Of our inventors. Of our professors. Our leaders. Our artists. Talent, drive, intellect, ambition – these things are not based on a person’s “race”. What we call “race” is not supported by genetics in any meaningful way. It is a way of looking at people that pigeonholes them into various boxes far more closely associated with economics than with genetics.

The United States is much like a large swimming pool, one we all wade in. We have selected a large group of people based on their skin color, fired all their swimming teachers, and pushed them into the deep end. And then we blame them for drowning.