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 Abstract

Excerpted From: Aurora J. Grutman, The Racial Wealth Gap Is a Racial Health Gap, 110 Kentucky Law Journal 723 (2021-2022) (83 Footnotes) (Full Document)

 

AuroraGrutmanBenjamin Franklin's Poor Richard's Alamanack, published from 1732 to 1758, was the colonial equivalent of a bestseller. Each issue featured an annual calendar, weather predictions, astronomical data, astrological predictions, poems, and witty sayings. Maxims published in the Almanack and attributed to Franklin include, “A friend in need is a friend indeed!” and “Early to bed and early to rise makes the man healthy, wealthy, and wise.” Franklin almost certainly did not originate these phrases, but he did popularize them; several of these adages remain in use over two hundred and fifty years later. This Article takes Franklin's aphoristic linking of health and wealth as a starting point for a more serious discussion of the extent to which these two factors are, in fact, related and what both have to do with race.

Part I provides a brief overview of the data on the relationship between and among income, wealth, and race in the United States. By almost any measure, the poorest families in the country tend to be Black, American Indian, or Alaska Native. Reasons for this are undoubtedly multi-faceted and complex; explanations lie in the history of slavery and the involuntary removal of indigenous people from the land they occupied, as well as racism. There are also long-standing social, political, and economic structures that contribute to race-based inequalities in the twenty-first century. Because these topics are well explored by other contributions to the symposium and elsewhere, Part I refers only briefly to recent statistics about median and mean household income, wealth, and poverty across multiple racial categories.

Extending the statistical snapshot approach deployed in Part I, Part II presents a selection of salient data about the health in the United States. Rates of smoking, adult obesity, hypertension, and life expectancy differ by race, as do rates of insurance by private carriers versus public health plans such as Medicare and Medicaid. Again, by almost any measure, Blacks, American Indians, and Alaska Natives in the United States tend to suffer from serious health conditions in greater proportions than members of any other racial group. As with race-based inequalities in income and wealth, the reasons for health disparities are long-standing and multi-faceted; explanations lie in both historic and contemporary practices. While a complete account of the causes of race-based health gaps are beyond the scope of this Article, it is possible to point to some of the same structures implicated in race-based wealth disparities that contribute to race-based health disparities as well. While the inequalities do not map precisely onto each other, this Article makes the modest claim that wealth, health, and race are correlated in the United States.

Part III therefore suggests that a complete account of the racial wealth gap in this country also requires attention to the racial health gap. Indeed, meaningful progress in lessening the wealth gap will require narrowing the health gap (and vice versa). This Article concludes with a call to expand the larger conversation about the racial wealth gap to include the racial health gap.

[. . .]

Until relatively recently, discussions about “wealth transfers” have largely focused on the transmission of assets like cash, marketable securities, and homes from one generation to another during lifetime or at death. A more expansive definition of “inheritance” includes advantages such as access to education, enrichment programs, vacations, social and business connections, and a sense of belonging. This Article seeks to broaden that conversation even further to include health as part of the “wealth transfer” that one generation makes the next. Many of the social determinants of income or wealth are also determinants of health (and vice versa). Thus discussions about inheritance, broadly understood, should include health considerations as well. It is possible to improve the social determinants of health for present and future generations. The primary way to do that is by increasing income and wealth.


Aurora J. Grutman is an independent author located in New York, New York.


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