Inequitable Choices?

The Chronicle of Higher Education publishes a newsletter, Race on Campus, devoted to discussing “What national conversations about racial equity and inclusion mean for you and your institution. This week’s issue features a conversation with Fatima Stanford, director of diversity for the Nutrition Obesity Research Center at Harvard, co-author of a recent article in the New England Journal of Medicine, about “the emerging inequity in who is vaccinated for Covid-19.” This “inequity,” the Chronicle states, is the “racial disparity” of “eligible Black and Latino residents …  getting the vaccines at lower rates than other residents are.”

The first sentence of the NEJM article, however, states that “concerns have emerged regarding whether Black communities will choose to be vaccinated” [emphasis added], citing a NAACP survey reporting that “only 14% of Black survey respondents trusted the vaccines’ safety and only 18% said they would definitely get vaccinated.”

Most recent discussion of “equity” produced by our recent “racial reckoning” treats inequity and disparity as synonyms. On this view every disparity is inequitable because it is produced by systemic discrimination. And yet there is good reason to doubt whether it makes sense to say that disparities resulting from choice are inequitable.

In effect responding to that doubt, the NEJM article argues that those results are inequitable because the choice eligible blacks and Hispanics make to eschew the vaccinations is itself the result of racism — and not only historic racism (the Tuskegee experiment, etc.), but the ongoing, current “everyday racism that Black communities face. Every day, Black Americans have their pain denied, their conditions misdiagnosed, and necessary treatment withheld by physicians.”

Really? I am familiar with data showing health disparities, or at least differences, between blacks and whites, but is it really true that every day blacks “have their pain denied, their conditions misdiagnosed, and necessary treatment withheld by physicians” on the basis of race, that blacks suffer “daily subtle mental assaults” undermining their trust in the health system? Is the current practice of American medicine really so pervasively racist?

Fortunately, according to the NEJM authors, there is a clear, equity-suggested path out of this racist morass. “Framing the conversation about distrust in Covid vaccines in terms of everyday racism rather than historical atrocities,” they write, “may increase underserved communities’ willingness to be vaccinated.” The solution suggested by this “framing” is not surprising; it is the equity-suggested solution to ever disparity problem: hire more blacks:

… we need Black physicians and investigators at the forefront of vaccine-rollout efforts…. we need more public health messaging coming directly from Black health leaders…. Black scientists sharing their stories is paramount because they can more directly relate and speak to their communities’ needs.

The requirement of Title VII of the 1964 Civil Rights Act that employees be hired without regard to race seems as antiquated to today’s equity warriors, and just about as evil, as the Fugitive Slave Acts.




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