Race and Medicine: The Harm That Comes From Mistrust: Racial bias still affects many aspects of health care.

Good overview of the data and issues:

Racial discrimination has shaped so many American institutions that perhaps it should be no surprise that health care is among them. Put simply, people of color receive less care — and often worse care — than white Americans.

Reasons includes lower rates of health coverage; communication barriers; and racial stereotyping based on false beliefs.

Predictably, their health outcomes are worse than those of whites.

African-American patients tend to receive lower-quality health services, including for cancer, H.I.V., prenatal care and preventive care, vast research shows. They are also less likely to receive treatment for cardiovascular disease, and they are more likely to have unnecessary limb amputations.

As part of “The 1619 Project,” Evelynn Hammonds, a historian of science at Harvard, told Jeneen Interlandi of The New York Times: “There has never been any period in American history where the health of blacks was equal to that of whites. Disparity is built into the system.”

African-American men, in particular, have the worst health outcomes of any major demographic group. In part, research shows, this is a result of mistrust from a legacy of discrimination.

At age 45, the life expectancy of black men is more than three years less than that of non-Hispanic Caucasian men. According to a study in the Quarterly Journal of Economics, part of the historical black-white mortality difference can be attributed to a 40-year experiment by the U.S. Public Health Service that shook African-Americans’ confidence in the nation’s health system.

From 1932 to 1972, the Public Health Service tracked about 600 hundred low-income African-American men in Tuskegee, Ala., about 400 of whom had syphilis. The stated purpose was to better understand the natural course of the disease. To do so, the men were lied to about the study and provided sham treatments. Many needlessly passed the disease on to family members, suffered and died.

As one scholar put it, the Tuskegee study “revealed more about the pathology of racism than it did about the pathology of syphilis.” In fact, the natural course of syphilis was already largely understood.

The study was publicized in 1972 and immediately halted. To this day, it is frequently cited as a driver of documented distrust in the health system by African-Americans. That distrust has helped compromise many public health efforts — including those to slow the spread of H.I.V., contain tuberculosis outbreaks and broadenprovision of preventive care.

According to work by the economists Marcella Alsan and Marianne Wanamaker, black men are less likely than white men to seek health care and more likely to die at younger ages. Their analysis suggests that one-third of the black-white gap in male life expectancy in the immediate aftermath of the study could be attributed to the legacy of distrust connected to the Tuskegee study.

Their study relies on interpreting observational data, not a randomized trial, so there is room for skepticism about the specific findings and interpretation. Nevertheless, the findings are consistent with lots of other work that reveals African-Americans’ distrust of the health system, their receipt of less care, and their worse health outcomes.

The Tuskegee study is far from the only unjust treatment of nonwhite groups in health care. Thousands of nonwhite women have been sterilized without consent. For instance, between the 1930s and 1970s, one-third of Puerto Rican women of childbearing age were sterilized, many under coercion.

Likewise, in the 1960s and 1970s, thousands of Native American women were sterilized without consent, and a California eugenics law forced or coerced thousands of sterilizations of women (and men) of Mexican descent in the 20th century. (Thirty-two other states have had such laws, which were applied disproportionatelyto people of color.)

For decades, sickle cell disease, which mostly affects African-Americans, received less attention than other diseases, raisingquestions about the role of race in how medical research priorities are established.

A ‘Rare Case Where Racial Biases’ Protected African-Americans

Outside of research, routine medical practice continues to treat black and white patients differently. This has been documented in countless ways, including how practitioners view pain. Racial bias in health care and over-prescription of opioid painkillers accidentally spared some African-Americans from the level of mortality from opioid medications observed in white populations.

“While African-Americans may not have died at similar rates from opioid misuse, we can be sure needless suffering and, perhaps even death, occurred because provider racism prevented them from receiving appropriate care and pain medication,” said Linda Goler Blount, president and chief executive of the Black Women’s Health Imperative.

Of course, health outcomes are a result of much more than health care. The health of people of color is also unequal to that of whites because of differences in health behaviors, education and income, to name a few factors. But there is no doubt that the health system plays a role, too. Nor is there question that a history of discrimination and structural racism underlies racial differences in all these drivers of health.

Reinforcing the fact of racial bias in health care, a recent studyfound that care for black patients is better when they see black doctors. The study randomly assigned 1,300 African-Americans to black or nonblack primary care physicians. Those who saw black doctors received 34 percent more preventive services. One reason for this, supported by the study, is increased trust and communication.

The study findings are large. If all black men received the same increase in preventive services as those in the study (and received appropriate follow-up care), it would reduce the black-white cardiovascular mortality rate by 19 percent and shrink the total black-white male life expectancy gap by 8 percent, the researchers said.

But it is unlikely all black men could see black doctors even if they wished to. Although African-Americans make up 13 percent of the U.S. population, only 4 percent of current physicians — and less than 7 percent of recent medical school graduates — are black.

This study does not stand alone. A systematic review found that racially matched pairs of patients and doctors achieved better communication. Other studies found that many nonwhite patientsprefer practitioners who share their racial identity and that they receive better care from them. They view them as better than white physicians in communicating, providing respectful treatment and being available.

Racial bias in health care, as in other American institutions, is as old or older than the republic itself.

Title VI of the 1964 Civil Rights Act stipulates that neither race, color nor national origin may be used as a means of denying the “benefits of, or be subjected to discrimination under any program or activity receiving federal financial assistance.” As nearly every facet of the American health system receives federal financing and support, well-documented and present-day discrimination in health care suggests the law has not yet had its intended effect.

Source: Race and Medicine: The Harm That Comes From Mistrust

Venture Capital Firms Abandoning $4.4 Trillion Opportunity to Invest With Black and Women Entrepreneurs

Interesting, both for the analysis itself and that it was by Morgan Stanley:

Venture capital firms across America are neglecting a $4.4 trillion opportunity to increase their returns by not investing with companies owned by multicultural and women entrepreneurs, a new survey by investment banking giant Morgan Stanley suggests.

The survey, Beyond the VC Funding Gap, found that almost 200 U.S.-based venture capital (VC) firms and diverse entrepreneurs that have raised venture capital triumphantly are not utilizing known ways to boost their exposure or increasing the probability that they will invest in more diverse founders.

A staggering 83% of VCs surveyed reported they are confident they can prioritize investments in companies led by women and multicultural entrepreneurs and maximize returns. Some 60% of VCs stated their portfolios hold too few of these companies. However, just three out of five VCs reported making investments in women and multicultural entrepreneurs is not a firm-wide priority.

Multicultural and women founders cited “not the right fit for me” and “market-related issues” among the top reasons given by VC firms for not investing in their companies.

What is perhaps most startling is the potential amount of money VCs are leaving behind by not investing in the firms. Based on data from the U.S. Census Bureau’s 2012 Survey of Business Owners and the U.S. Department of Labor’s Bureau of Labor Statistics, Morgan Stanley reported revenues for women and minority businesses were $2.4 trillion. The firm said had the number of women and minority-owned businesses and a portion of revenues matched their percentage in the labor force—56%—then 2012 gross receipts would have risen to $6.8 trillion, suggesting a missed opportunity of up to $4.4 trillion.

TAKING THE RIGHT APPROACH

“Our research indicates that with a few subtle shifts in their approach, VCs can better position themselves to take advantage of these entrepreneurs and generate superior returns. I hope that this report will help to inspire more firms to re-evaluate their investment strategies so they can capitalize on these opportunities that have historically passed them by,” stated Carla Harris, Morgan Stanley Vice Chairman, Global Wealth Management and Multicultural Client Strategy Group Head.

The NVCA did not specifically address some of the issues pertaining to multicultural and women-owned firms raised in the Morgan Stanley report. But the Washington, DC-based trade group for the nation’s venture capital industry said it is taking several steps to ensure its membership works with and engages with those firms.

The group provided BLACK ENTERPRISE this statement from Maryam Hague, NVCA’s senior vice president of industry advancement:  “Through our VentureForward initiative, NVCA is committed to expanding opportunities for people of all backgrounds to thrive in the venture ecosystem and ensuring everyone who works in this ecosystem has a welcoming professional culture and safe work environment. Some of our activities to date include: NVCA-Deloitte Human Capital Survey – this survey is intended to be an educational resource for venture capital firms to understand how to expand the diversity of their teams and portfolio companies; LP Office Hours in Palo Alto, Boston, Washington, D.C. and Los Angeles. LP Office Hours is an in-person, half-day educational program across the country for professionals of diverse backgrounds to receive advice from and connect with LPs and other GPs, with the goal of learning from LPs about the fundraising process; NVCA hosts workshops and leadership dinners in San Francisco, Boston, and cities around the U.S. interacting with VC leaders in emerging ecosystems; and we have released model HR policies and best practices for attracting and retaining diverse talent. NVCA also offers several educational opportunities to democratize access to education on VC and to support the next generation of VC leaders, e.g. VC University and the Venture Capital Symposium.”

The Morgan Stanley report revealed VC firms not acting on the data on diverse entrepreneurs could be causing them to miss out on returns. That perhaps is potentially being fueled by a lack of awareness of multicultural and women firms in-house. Some 45% of VCs surveyed didn’t know how the returns from companies founded by women compared with their overall portfolio returns. And 53% of VCs were unsure about the returns of firms with multicultural founders.

A CLOSER LOOK AT THE MARKETPLACE

Still, Morgan Stanley stated a closer look at the broader marketplace reveals that companies serving diverse customers represent a huge opportunity to capitalize on consumer segments with plenty of room for more growth. For example, the firm reported that women drive 83% of all U.S. consumption, through both buying power and influence. Plus, African Americans spend $1.2 trillion annually in the U.S. And, (Latin) consumers’ buying power is expected to reach $1.7 trillion by 2020.

Concurrently, the Morgan Stanley report revealed VCs have a reputation for taking calculated “expansion risks” to invest in new and emerging markets — frequently with little precedent or data beyond their own due diligence. Of the VCs surveyed, they reported about 20% of the companies in their portfolios that embody expansion risks. Yet, when they bump into companies run by ethnic and women, entrepreneurs, VCs are less likely to educate themselves or take the risk, particularly if they are not familiar with the market or product.

Yet 88% of the VCs surveyed view the experiences of underrepresented entrepreneurs as a competitive advantage when it comes to identifying different problems that need to be solved. Companies typically created by diverse and women entrepreneurs target a market inefficiency or need they’ve identified based on their personal experiences, making them ideal candidates for the specific types of calculated expansion risks VCs should be looking at.

Concurrently, companies started by women and multicultural entrepreneurs have been and continue to be a moneymaking investment opportunity. Morgan Stanley maintains it has been investing directly in startups led by diverse founders for the past three years.

In its survey, Morgan Stanley named some firms that have provided investors hefty returns. Take Sundial Brands, one of the largest black-owned personal care products led by co-founder Richelieu Dennis. It was acquired in 2017 by consumer products giant Unilever. Sundial Brands, a former BLACK ENTERPRISE BE 100s company,  had revenues estimated at $240 million when it was purchased. After the deal, Morgan Stanley valued Sundial Brands at a whopping $1 billion.

In another eye-popping deal, Nigerian native and entrepreneur Chinedu Echeruo sold his HopStop.com pedestrian navigation service to tech powerhouse Apple for an estimated $1 billion in 2013. The transaction was stunning as HopStop had estimated revenues of just $5 million in 2012.

Morgan Stanley’s Harris defines multicultural companies as those with an  African American, Hispanic, Asian or American Indian founder.

She says VCs may have held back historically from investing in such firms because up until now there really wasn’t much evidence they were missing something. However, she says, both the evidence and the number on the size of the opportunity exists currently for them to consider doing so.

“The time is now for people to embrace the conversation if not the debate,” Harris says. “The really big surprise is that even though the multicultural and women firms can provide traditional VCs stellar or equal returns (as their peers) that they’re not investing with them for some reason,” she says.

REPRESENTATION MATTERS

Another factor that perhaps is contributing to the funding gap is a lack of diversity at VC firms.

The lack of diversity among VC firms perhaps is adding to the funding gap. The survey showed among VCs who have hired more diverse fund managers, LPs, partners or board members, 71% say it is a “very effective” way to increase the diversity of companies and founders they invest in. Some two-thirds of multicultural founders reported that they have had more success with diverse VC firms. But, only 11% of entrepreneurs have teamed up with VC firms that are diverse when it comes to gender and race.

“The fact that they (VC firms) don’t have more diversity at the table certainly limits their understanding of some of these industries,” Harris says. “Diversity would make it a lot easier to do so.”

Harris says the encouraging news is that if you look at the private equity industry some of the nation’s largest institutional investors such as CalPERS or the New York State Common Fund are now asking their investment partners about their diversity practices. She says the questions include what does diversity in your firm look like, how many businesses of color did you look at and how many multicultural firms do you have in your pipeline for partnership? Harris is confident the actions may drive VC firms to make the shift of investing with diverse and women firms along with existing partners. “Once you see some of the outside companies start to have some success, I think it’s going to feed on itself,” she says.

Morgan Stanley offered some tips on how VC firms can tap into what the firm calls a multitrillion-dollar market by working with diverse firms. Here is a condensed version of those tips:

REDEFINE HOW YOU THINK ABOUT “FIT” AND EXPANSION RISK FOR YOUR PORTFOLIO

Adjust your definition of “expansion risk” to include companies founded and led by women and multicultural entrepreneurs. This can help expand your networking efforts among diverse entrepreneurs and help you better understand the opportunities they present.

Consider diverse entrepreneurs are more seasoned players with lower risk. When diverse entrepreneurs get to pitch VCs, they’ve already often demonstrated a stronger proof of concept, management expertise, and success metrics when compared with their white, male counterparts.

Women and multicultural entrepreneurs represent an emerging market in America, much like the internet was 20 years ago or cloud-computing a decade ago. Along with pursuing new markets and products, consider investing in the new perspectives that diverse entrepreneurs offer and the markets they serve.

DIVERSIFY

Having more women and multicultural professionals at your fund is one of the most effective strategies for increasing investments in diverse founders.

By looking inward at your hiring and retention practices and prioritizing diversity, you can improve the delivery of results for your limited partners. The traditional sources for entry-level VC talent—top business schools—have large enough pools of women and multicultural graduates to fill the need.

In addition to helping VC firms source more diverse entrepreneurs and see market opportunity more clearly, firm diversity also decreases overall risk: The more diverse perspectives VCs have, the more likely they are to recognize opportunities and identify potential pitfalls.

HOLD YOUR FIRM ACCOUNTABLE AND BE A FIRST MOVER—INSTITUTIONAL INVESTORS CAN HELP

Develop a comprehensive strategy and make it public. Share data about your internal and portfolio diversity. Establishing goals for investing in more women and multicultural entrepreneurs can be an effective strategy for VCs to show their investors their commitment to effecting change; according to our survey, 86% of VCs agree that such goals would benefit themselves and their LPs.

Source: Venture Capital Firms Abandoning $4.4 Trillion Opportunity to Invest With Black and Women Entrepreneurs

How Racial Bias May Have Saved 14,000 Black Lives

Really interesting study on one of the rare positive impacts of implicit bias and discrimination:

When the opioid crisis began to escalate some 20 years ago, many African-Americans had a layer of protection against it.

But that protection didn’t come from the effectiveness of the American medical system. Instead, researchers believe, it came from racial stereotypes embedded within that system.

As unlikely as it may seem, these negative stereotypes appear to have shielded many African-Americans from fatal prescription opioid overdoses. This is not a new finding. But for the first time an analysis has put a number behind it, projecting that around 14,000 black Americans would have died had their mortality rates related to prescription opioids been equivalent to that of white Americans.

Starting in the 1990s, new prescription opioids were marketed more aggressively in white rural areas, where pain drug prescriptions were already high. African-Americans received fewer opioid prescriptions, some researchers think, because doctors believed, contrary to fact, that black people 1) were more likely to become addicted to the drugs 2) would be more likely to sell the drugs and 3) had a higher pain threshold than white people because they were biologically different.

A fourth possibility is that some white doctors were more empathetic to the pain of people who were like them, and less empathetic to those who weren’t. Some of this bias “can be unconscious,” said Dr. Andrew Kolodny, a director of opioid policy research at Brandeis University.

This accidental benefit for African-Americans is far outweighed by the long history of harm they have endured from inferior health care, including infamous episodes like the Tuskegee study. And it doesn’t remedy the way damaging stereotypes continue to influence aspects of medical practice today. “The reason to study this further is twofold,” Dr. Kolodny said. “It’s easy to imagine the harm that could come to blacks in the future, and we need to know what went wrong with whites, and how they were left exposed” to overprescribing.

The prescription-opioid-related mortality rates of black and white Americans were relatively similar two decades ago, but researchers found that by 2010, the rate was two times higher for whites than for African-Americans.

Because African-Americans were less likely to receive those prescriptions, they were less likely to become addicted (though they were more likely to endure unnecessary and excruciating pain for illnesses like cancer).

The researchers, Monica Alexander, a statistician with the University of Toronto; Mathew Kiang, an epidemiologist at Stanford; and Magali Barbieri, a demographer at the University of California, Berkeley; published their study in the journal Epidemiology.

With additional analysis at The Upshot’s request, Mr. Kiang calculated that had the African-American population’s mortality rates caused by prescription opioids been equivalent to those of whites, black Americans would have experienced 14,124 additional deaths from 1999 to 2017.

It’s a counterfactual analysis that relies on some large assumptions. Among other things, the projection assumes that the public health and medical response to the epidemic would have remained the same even if the African-American mortality rate had been higher. And it doesn’t take into consideration any potential changes in overdoses from heroin and fentanyl had African-Americans had greater access to prescription opioids. Still, Mr. Kiang found the results “fairly remarkable in at least two ways.”

“First, it’s a good example of how more medical care is not necessarily a good thing,” he said. “Second, it’s an extremely rare case where racial biases actually protected the population being discriminated against.”

A crackdown in recent years has reduced opioid prescribing over all, “and the racial/ethnic gap in opioid prescribing has narrowed,” said Mr. Kiang, but he said it was unclear whether the gap had closed entirely.

In recent years, drug overdoses have risen sharply among black Americans, particularly among older heroin users in places where fentanyl has become widespread. One reason that the death rates from heroin and fentanyl have converged between black and white people may be simple: Heroin and fentanyl are readily available outside the health system, so they’re less affected by bias within it.

The public response to drug epidemics also tends to diverge along racial lines. During the crack epidemic, there was a greater emphasis on punishment and incarceration. With the opioid crisis primarily affecting white people, there has been more emphasis on empathy and rehabilitation. (This same disparity was seen in crack versus powder cocaine.) Race played an obvious role in the policy response, Dr. Kolodny said: “From ‘Arrest our way out of it’ to, ‘It’s a disease.’”

Huge Racial Disparities Found in Deaths Linked to Pregnancy

Yet another example of racial disparities. Have not seen and comparative Canadian studies and grateful if any readers can direct me accordingly:

African-American, Native American and Alaska Native women die of pregnancy-related causes at a rate about three times higher than those of white women, the Centers for Disease Control and Prevention reported on Tuesday.

The racial disparity has persisted, even grown, for years despite frequent calls to improve access to medical care for women of color. Sixty percent of all pregnancy-related deaths can be prevented with better health care, communication and support, as well as access to stable housing and transportation, the researchers concluded.

“The bottom line is that too many women are dying largely preventable deaths associated with their pregnancy,” said Dr. Anne Schuchat, principal deputy director of the C.D.C.

“We have the means to identify and close gaps in the care they receive,” she added. While not all of the deaths can be prevented, “we can and should do more.”

Maternal health among black women already has emerged as an issue in the 2020 presidential campaign. Senator Kamala Harris, Democrat of California, and Senator Elizabeth Warren, Democrat of Massachusetts, have both raised the glaring racial discrepancies in maternal outcomes on the campaign trail.

“Everyone should be outraged this is happening in America,” Ms. Harris recently said on Twitter. She blamed the deaths on racial bias in the health system.

The American College of Obstetricians and Gynecologists, which was not involved in the C.D.C. report, recently acknowledged that racial bias within the health care system is contributing to the disproportionate number of pregnancy-related deaths among minority women.

“We are missing opportunities to identify risk factors prior to pregnancy, and there are often delays in recognizing symptoms during pregnancy and postpartum, particularly for black women,” Dr. Lisa Hollier, immediate past president of the American College of Obstetricians and Gynecologists, said in a statement.

The United States has an abysmal record on maternal health, compared with other high-income countries. Even as maternal death rates fell by more than one-third from 2000 to 2015 across the world, outcomes for American mothers worsened, according to Unicef.

The C.D.C. examined pregnancy-related deaths in the United States from 2011 to 2015, and also reviewed more detailed data from 2013 to 2017 provided by maternal mortality review committees in 13 states.

The agency found that black women were 3.3 times more likely than white women to suffer a pregnancy-related death; Native American and Alaska Native women were 2.5 times more likely to die than white women.

[The topics new parents are talking about. Evidence-based guidance. Personal stories that matter. Sign up now to get NYT Parenting in your inbox every week.]

Obstetric emergencies involving complications like severe bleeding caused most of the deaths at delivery. Disorders related to high blood pressure accounted for most deaths from the day of delivery through the sixth day postpartum.

A leading cause of pregnancy-related deaths was cardiovascular disease, which is not typically associated with young pregnant women.

Heart disease and strokes caused more than one-third of pregnancy-related deaths, the C.D.C. found. Cerebrovascular events, such as strokes, were the most common cause of death during the first 42 days after the delivery.

Cardiac disease, which disproportionately affects black women, may be present in a woman before pregnancy, but it also may appear during pregnancy. If heart disease goes undetected, it may become acute after the baby is born.

Suspensions Are Down In U.S. Schools But Large Racial Gaps Remain

Not sure what the latest Canadian trends are but in Toronto, believe overall pattern similar:

Students in U.S. schools were less likely to be suspended in 2016 than they were in 2012. But the progress is incremental, and large gaps — by race and by special education status — remain.

This data comes from an analysis of federal data for NPR in partnership with the nonprofit organization Child Trends. And it comes as the Trump administration is preparing the final report from a school safety commission that is expected to back away from or rescind Obama-era guidance intended to reduce racial disparities in school discipline.

The commission, led by Education Secretary Betsy DeVos, is expected to release its final report in the coming days.

The Child Trends analysis highlights findings that when a student disrupts class, a school can disrupt that student’s education — and his or her entire life. Research suggests suspension and expulsion, arrests and referrals to law enforcement, is associated with dropping out of school and going to jail. All of these consequences happen more frequently to black students, even in preschool. Sometimes they are punished more harshly for the same behavior as white students; often for nonviolent offenses. Students with disabilities are also punished more often and more harshly.

In 2014, with this body of evidence growing, the U.S. Department of Education issued detailed guidance on “how to identify, avoid, and remedy” what they called “discriminatory discipline.” They promoted alternatives to suspension and expulsion, and opened investigations into school districts that had severely racially skewed numbers.

In the wake of that guidance, more than 50 of America’s largest school districts instituted discipline reform. More than half the states revised their laws to try and reduce suspensions and expulsions. And, our indicators are, they succeeded.

At NPR’s request, the nonprofit Child Trends analyzed the federal Civil Rights Data Collection, which includes reports from every public school in the nation, over three years — the 2011-2012, 2013-2014, and 2015-2016 school year. They caution that this analysis, which is based on numbers self-reported by schools, can’t cover every possibility — for example, if schools are calling parents to pick students up instead of putting an official suspension on the books. Or if they are suspending fewer students, but suspending them for longer periods of time.

Still, they documented some heartening changes between 2012 and 2016.

  • The proportion of all students suspended from school at least once during the year fell from 5.6 percent to 4.7 percent.
  • Among high school students, the percentage suspended fell even more, from 9.6 to 7.6 percent.
  • Suspension rates fell around the country, in each of the biggest-population states. Only one state, Mississippi, saw a persistent increase year by year.
  • Hispanic students experienced the largest decrease –a 30 percent drop in suspensions.
  • Suspension rates fell faster for those most often suspended — Black students and students with a disability.

But, on the flip side:

  • Black high school students are still twice as likely (12.8 percent) to be suspended as white (6.1 percent) or Hispanic (6.3 percent) high school students.
  • And students with a disability are also twice as likely (12.8 percent) to be suspended as those without a disability (6.9 percent).

“This progress is incremental and large gaps by race and disability still remain,” says Kristen Harper, who directs policy development for Child Trends. She says there’s “a long way to go” and a continuing need for federal leadership. “Any efforts that could suggest that these issues are not important could undermine the work of states and districts.”

We should note that NPR previously collaborated with Child Trends on a look at the Civil Rights Data Collection’s school shooting indicator. That analysis found serious problems with the data reported. But Harper says that the out of school suspensions indicator is far more robust and reliable, partly because the data has been collected for longer, and also because suspensions are more common than shootings, so a few data entry errors are less likely to skew the overall trend.

Source: Suspensions Are Down In U.S. Schools But Large Racial Gaps Remain

USA: Yes, Jury Selection Is As Racist As You Think. Now We Have Proof

Similar to the concerns raised over the jury selection process in the trial of Gerald Stanley for the murder of Colten Boushie (Government proposes changes to jury-selection process after the …):

Race, as a matter of constitutional principle, cannot factor into the selection of jurors for criminal trials. But in the American justice system, anyone with a bit of common sense and a view from the back of the courtroom knows the colorblind ideal isn’t true in practice.

Racial bias largely seeps in through what’s called “peremptory” challenges: the ability of a prosecutor — and then a defense attorney — to block a certain number of potential jurors without needing to give the court any reason for the exclusion.

The number of challenges allowed varies by state, but commonly 15 or more are permitted. Folk wisdom, among those familiar with the song and dance, is that prosecutors use these challenges to remove nonwhite jurors, who are statistically more likely to acquit, while defense attorneys — who can step in only after the pool has been narrowed by prosecutors — typically counteract by removing more white jurors.

For a long time, the opacity of court records rendered the dynamic as only that — folk wisdom — which has made it difficult to articulate the urgent need to reform this understudied aspect of our system. But now, this informal knowledge has been empirically confirmed, and the case for change couldn’t be more compelling.

My recently published research on juror removal in North Carolina conducted with colleagues at the Wake Forest University School of Law proves — for the first time with statewide evidence — that peremptory challenges are indeed a vehicle for veiled racial bias that results in juries less sympathetic to defendants of color.

Based on statewide jury selection records, our Jury Sunshine Projectdiscovered that prosecutors remove about 20 percent of African-Americans available in the jury pool, compared with about 10 percent of whites. Defense attorneys, seemingly in response, remove more of the white jurors (22 percent) than black jurors (10 percent) left in the post-judge-and-prosecutor pool.

The data also show variety within the state: Prosecutors in urban areas, which tend to have larger minority populations, remove nonwhite jurors at a higher rate than prosecutors do in other parts of the state. Finally, we discovered, to our surprise, that judges also remove black jurors “for cause” about 20 percent more often than they remove available white jurors.

When the dust settles at the close of jury selection, defense attorneys’ actions in the last leg of the process do not cancel out the combined skewed actions from prosecutors and judges. The consistent result is African-Americans occupying a much smaller percentage of seats in the jury box than they did in the original jury pool.

This winnowing of nonwhite jurors is not a quirk of just one state. Earlier this year, investigative journalists in Mississippi and Louisiana collected and published jury data from public records that confirmed similar practices in some areas within those states. And given the parallel results identified in county-level studies and in death penalty cases, the pattern probably holds true for jury selection in most states.

It is not possible, even with this new data, to say exactly why a prosecutor, defense attorney or judge decides to remove any particular juror in a single case. But this racially skewed trend, played out across many cases, is persistent. And it has two especially pernicious effects on the quality of criminal justice.

First, the defendant is not judged by a jury that reflects a cross-section of his or her community — a violation of the courts’ interpretation of the Sixth Amendment. In a system that already disproportionately prosecutes people of color, hedging the constitutional rights of defendants can be particularly harmful.

Second, excluded parts of the community become more cynical about the justice system when they repeatedly see barriers to jury service. If people from certain similar neighborhoods are constantly getting booted from juries, then it’s tempting for residents there to view the police — and prosecutors — as hostile occupiers rather than partners in public safety.

In theory, the Equal Protection Clause of the Constitution, as interpreted in Batson v. Kentucky, prevents attorneys from removing jurors on the basis of race. But “Batson claims” rarely succeed because they require the judge to declare the proposed stated reason for removal was only a pretext hiding discriminatory intent — a notoriously steep standard.

To address the problem, state courts could adopt rules such as the one that the Washington Supreme Court approved last April. The new rule makes it easier to stop juror removals rooted in implicit racial bias by outlawing peremptory challenges defended with explanations highly correlated with race, like “prior contact with law enforcement” or “living in a high-crime neighborhood.”

There are now over half a dozen states completely controlled by Democrats, whose ascendant progressive wing would presumably support such nondiscrimination protections.

Another answer — which could gain support in even the toughest of “tough on crime” red states — is simply to publish more information on jury selection. The details of judge and attorney removals of jurors is already public record, but those details usually remain buried in the hard-copy files of court clerks across the country.

While this year’s successful research shows how journalists and scholars can collect these far-flung records into a useful database, the process can take months or years of driving from courthouse to courthouse, digging out the files of cases that went to trial, recording the clerk’s notations from those files and turning to online resources for background information on judges and lawyers.

States could instead — without much work — just plainly make all jury selection information available online and keyword searchable, easing access for journalists and voters alike.

In most states, voters choose their prosecutors and their judges; and with journalists on hand to swiftly analyze digitized public records of the jury selection habits of prosecutors and judges, citizens could evaluate incumbents’ tendencies as a measure of success or failure.

These two reforms alone would greatly aid efforts to hold prosecutors and judges accountable as well as shore up public trust in the criminal justice system.

The status quo shows that a barely enforceable constitutional doctrine isn’t enough. It’s time to bring this vital process of justice from behind closed doors and into the sunlight. It’s the only way to ensure that defendants are judged by a representative cross section of their community, not the filtered few that litigants want to see in the jury box.

Source: Yes, Jury Selection Is As Racist As You Think. Now We Have Proof

‘Farming While Black’: A Guide To Finding Power And Dignity Through Food

Interesting:

Leah Penniman was told she wasn’t welcome, from her first day in a conservative, almost all-white kindergarten.

“I remember this one girl teasing me and saying brownies aren’t allowed in this school … and that really continued, that type of teasing,” she recalls. “Every time I walked into an honors classroom, they would ask me if I was in the right room,” she says.

She enjoyed learning and did well, but she also found solace in the natural world.

“No one taught me what African traditional religion was when I was little, but my sister and I intuited it and so we would spend a lot of time in the forest giving reverence to mother nature as we called to her in the trees.”

Penniman later got a summer job farming in Boston, and she was hooked. She learned about sustainable agriculture and the African roots of those practices, but she also moved to Albany, N.Y., to a neighborhood classified as a food desert. To get fresh groceries from a farm share, she walked more than two miles with a newborn baby in a backpack and a toddler in the stroller, then walked back with the groceries resting on top of and around the sleeping toddler.

She made it her goal to start a farm for her neighbors, and to provide fresh food to refugees, immigrants and people affected by mass incarceration. She calls the lack of access to fresh food “food apartheid” because it’s a human-created system of segregation.

Penniman and her staff at Soul Fire Farm, located about 25 miles northeast of Albany, train black and Latinx farmers in growing techniques and management practices from the African diaspora, so they can play a part in addressing food access, health disparities, and other social issues. Penniman’s new book, Farming While Black: Soul Fire Farm’s Practical Guide to Liberation on the Land, details her experiences as a farmer and activist, how she found “real power and dignity” through food, and how people with zero experience in gardening and farming can do the same.

Back when Penniman was a beginner at various farms in the Northeast, she realized she was in a field where almost all people were white, and that the sustainable and organic farmers were using African techniques, without knowing where those came from.

For example, farmers grow marigolds and other beneficial flowers next to crops because those attract insects like ladybugs to do natural pest control. That’s called polyculture now, but it’s a practice that came from Nigerian and Ghanaian farmers, and Penniman’s book traces techniques like that back to their historic roots.

Farming While Black“A lot of the folks in the sustainable farming world get a lot of information through these conferences and sort of assume that … it’s either ahistorical or originated in a European community, which is an injustice and a tragedy,” Penniman says.

There are other instances of African contributions to farming technology that are not widely known.

Edda Fields-Black, an associate professor of history at Carnegie Mellon University, studies the history of West African rice farmers. She says the rice industry in South Carolina and Georgia would not have been possible without West African techniques of irrigation so that the rice fields have a good balance of salt water and fresh water to stop weeds from growing and keep the rice alive.

“We don’t always understand enough about all of the things that enslaved people built in the U.S. It’s not just brute labor, it’s not just brawn. This is technology, this is ingenuity, this is engineering, this is hydraulics. It’s all rooted in west Africa,” says Fields-Black.

She cites a 2018 report from the Southern Poverty Law Centerdetailing the “dismal” results of how little high school seniors know about the history of slavery, and says her work is about celebrating African technology, and “recovering the humanity of the enslaved.” That’s something she and Penniman have in common, she adds.

Penniman also writes that she would like her experience to help African-Americans heal from the trauma associated with farming. She details how black visitors to her farm almost all say they associate farming with slavery and plantations. One black farmer I interviewed in the past said that when he decided to quit a job in the tech industry to start a farm, part of his family thought he had lost his mind and was “going back to the plantation.”

That’s the universal experience … of being black in this country,” says Chris Bolden-Newsome, a farmer and educator at Sankofa Community Farm in Philadelphia, whom Penniman interviewed for her book.

Therefore, learning about Penniman’s book was “like a breath of fresh air,” Bolden-Newsome says. “High time that something like this be written to lift up the stories, the lived experiences and lived stories of black farmers and their descendants who are the powerhouse in America.”

Penniman and her coworkers at her farm also try to address social issues more directly. For example, she has a sliding scale of prices, where a third of her customers make more money and pay more, and that subsidizes prices for another third of her customers, who struggle to make ends meet. She has written a manual for how to develop such a system, and says that she knows of at least two farms in New York state with similar programs for low-income customers.

She says that just as her African ancestors braided seeds into their hair before boarding transatlantic slave ships, she hopes her book will inspire more people toward “picking up those seeds and carrying on that legacy about not forgetting where we come from and who we are.”

Her farm also started a youth justice program in 2013, which let young people from Albany County courts work on the farm for 50 hours in exchange for prison time.

“What was really powerful about it was these young folks said things like, ‘I’ve never been welcomed into someone’s home before, or this is the first time I’ve seen folks who look like me running their own businesses and following their dreams and owning their land,'” says Penniman.

“There’s a lot of crying that happens on our farm,” she adds.

Source: ‘Farming While Black’: A Guide To Finding Power And Dignity Through Food

How Police Killings Lead To Poor Mental Health In The Black Community

Yet another example of the effects of systemic racism on African Americans:

A recent study published in The Lancet Medical journal shows that police killings of unarmed black men leads to poor mental. NPR’s Michel Martin talks with study co-author Dr. Atheendar Venkataramani.

MICHEL MARTIN, HOST:

Now we’re going to talk about a subject that has become one of this country’s flashpoints – police shootings of unarmed black men. It happened again last Tuesday in Pittsburgh, where Antwon Rose Jr. was shot three times as he ran away from police during a traffic stop. A neighbor caught it all on camera. The video was widely shared and inspired three straight days of protests in Pittsburgh.

But the negative effects of that shooting won’t end whenever the demonstrations stop or the reporting ends – this according to a study published in The Lancet medical journal. That study looked specifically at states that had a police killing of an unarmed black man in the three months leading up to the survey. And it found that these violent encounters have a direct effect on the mental health of black Americans living in communities that have experienced police violence. The telephone survey asked respondents how many days their mental health was not good. Black respondents in states with recent police shootings were found to have significantly more of those not good days.

Dr. Atheendar Venkataramani is one of the study’s authors. He’s an assistant professor in medical ethics and health policy at the University of Pennsylvania’s Perelman School of Medicine. He joined me from member station WBUR in Boston, and I started our conversation by asking him why he and his fellow researchers wanted to look into the link between police killings and mental health.

ATHEENDAR VENKATARAMANI: My co-authors and I were very struck by the images of police killings of unarmed black Americans, and we had seen in some small, local studies, as well as through our social networks and on social media, the kinds of things that black Americans who weren’t directly part of the event but had heard about it or read about it or seen it through the videos that were released – the kinds of things they were saying about how they felt – what it made them feel and what their mental state was after viewing or hearing about such an event. And for us, it made us wonder do events like this cross the line from just being upsetting to being something that make us sick? And that’s what really motivated our study.

MARTIN: The facts are that black Americans, as you point out in the study, are nearly three times more likely than white Americans to be killed by police. They are five times more likely than are white Americans to be killed unarmed. I just think that’s important to point out because it’s important to note that white Americans are also killed by the police, but it is far more likely that an African-American male particularly will be unarmed when that occurs.

So part of the reason that I raised that is to ask whether you saw any similar effects of other groups? Like, did, for example, killings of white Americans stimulate a similar effect? Do we have any comparison that we can draw upon?

VENKATARAMANI: Absolutely. So we looked at the police killings of armed black Americans and the police killings of unarmed white Americans, which don’t necessarily have that same kind of salience to people as far as their relationship to structural racism. And when we looked at the impacts of those kinds of events, we didn’t find any impact on mental health nor did we find any impact on mental health of white Americans who were exposed to police killings of unarmed black Americans.

MARTIN: And you know, the survey focused on people and communities where these shootings occurred. But we live in a time when many of these deaths were caught on camera. They’ve been widely shared. Do you feel comfortable extrapolating that this effect may be broader than the people who actually lived in the places where these incidents occurred?

VENKATARAMANI: Yeah, I think we do. And so for example, Eric Garner’s killing was seen by everybody in the country. And for the purposes of our statistical design, we considered people in New York State exposed. So one of the things we think is striking is that we find these large population-level effects even when we know that we are likely to be underestimating the true burden.

MARTIN: The summary says that, you know, the interpretation is that, you know, police killings of unarmed black Americans have adverse effects on mental health among black American adults and the general population. And it suggests that programs should be implemented to decrease the frequency of police killings and to mitigate adverse mental health effects.

What would that look like? I mean, what do you hope people will do as a result of this study which validates what, frankly, has been sort of widely discussed informally among many people for some time?

VENKATARAMANI: We don’t believe we’re telling people in the black American communities something that they don’t know. I think what this study does is provides a public health rationale to further try to understand why police killings occur of unarmed black Americans. And it further motivates policies and programs that would try to reduce those events.

And from the clinical side, as a physician, these events really kind of show you that when something happens in a community that there is a trauma that is a pathology, meaning it’s a true illness, and that health systems – community health centers, public health organizations – can try to rally around people to make sure that people are OK and that we’re treating the burden of disease that’s there.

So I think that’s why it’s useful to put numbers around something that many people have noted anecdotally because it sharpens the case for action, and it also lets us know the scope of the problem and potentially how we would need to address it.

MARTIN: That’s Dr. Atheendar Venkataramani. He’s one of the authors of a study published in The Lancet which looked at the mental health effects of police shootings on black Americans.

Thanks so much for speaking with us.

VENKATARAMANI: Thank you.

MARTIN: I also want to mention that the study was funded by the National Institutes of Health and the Robert Wood Johnson Foundation. The latter is also a supporter of NPR.

Source: How Police Killings Lead To Poor Mental Health In The Black Community

USA: Suicide rates for black children twice that of white children, new data show

Significant study and yet another example of racial disparities:

African-American children are taking their lives at roughly twice the rate of their white counterparts, according to a new study that shows a widening gap between the two groups.

The 2001-2015 data, published Monday in the journal JAMA Pediatrics, confirm a pattern first identified several years ago when researchers at Nationwide Children’s Hospital in Ohio found that the rate of suicides for black children ages 5 to 12 exceeded that of young whites. The results were seen in both boys and girls.

Although suicide is rare among young children, the latest findings reinforce the need for better research into the racial disparities, lead author Jeffrey Bridge said Monday. Suicide is one of the leading causes of death for older children and adolescents in the United States.

“We can’t assume any longer that suicide rates are uniformly higher in white individuals than black,” said Bridge, an epidemiologist who directs the Center for Suicide Prevention and Research at the Columbus hospital. “There is this age-related disparity, and now we have to understand the underlying reasons. . . . Most of the previous research has largely concerned white suicide. So we don’t even know if the same risk and protective factors apply to black youth.”

Historically, suicide rates in the United States have been higher for whites than blacks across all age groups. That remains the case for adolescents, ages 13 to 17, according to the new study. White teens continue to have a 50 percent higher rate of suicide than black teens.

Overall between 1999 and 2015, more than 1,300 children ages 5 to 12 took their own lives in the United States, according to the Centers for Disease Control and Prevention. Those numbers translate into an average of one child 12 or younger dying by suicide every five days. The pace has actually accelerated in recent years, CDC statistics indicate.

The researchers based their latest analysis on the CDC’s Web-based Injury Statistics Query and Reporting System, which does not include geographical or socioeconomic data.

Although the study was unable to provide a cultural context for the racial difference in suicide rates, psychiatrist Samoon Ahmad thinks a number of reasons could account for the disparity.

“To me, the 5-12 range is more related to developmental issues and the possible lack of a family network, social network and cultural activities,” said Ahamad, a clinical associate professor at the NYU School of Medicine who was not involved in the research. “And with the introduction of social media, there is more isolation with children, not as much neighborhood play. Kids are more socially in their own vacuum.”

Ahmad described this age group as “probably the most vulnerable.” Yet adults tend to think the children are somehow too young to experience such depths of despair, he noted.

“No one talks about that with them. We tend to put them in silos, and don’t discuss these things because we think it’s too traumatic,” he said. “Instead, there must be a slow and steady flow of communication.”

Previous studies have looked at some of the characteristics and circumstances surrounding children’s suicides.

In 2017, research by Bridge and colleagues found that among children, ages 5 to 11, and young adolescents, ages 12 to 14, those who took their own lives were more likely to be male, African American and dealing with stressful relationships at home or with friends. Children who had a mental health problem at the time of death were more likely than young adolescents to have been diagnosed with attention-deficit disorder or attention-deficit hyperactivity disorder.

Young adolescents who killed themselves were more likely to have had relationship problems with a boyfriend or girlfriend. They also had higher rates of depression, according to last year’s study, which was published in the journal Pediatrics.

That 2017 report found more than a third of elementary school-aged suicides involved black children compared to just 11.6 percent of early adolescent suicides.

Bridge said his motivation for delving into this issue was a suicide in a town not far from Columbus. The child was not yet 10.

“We went into the original study because suicide rates were increasing among adolescents in the United States,” Bridge said. The local death “made us think if there was a change in the suicide rate of children, and that’s what made us look into it.”

Source: Suicide rates for black children twice that of white children, new data show

The Historian Behind Slavery Apologists Like Kanye West – The New York Times

Useful history:

A video of the rapper Kanye West discussing slavery is a sad reminder of America’s historical amnesia about the brutal realities of that institution. “When you hear about slavery for 400 years,” he said in the clip, which was widely circulated on Twitter, “that sounds like a choice.”

Mr. West seemed to suggest that enslaved African-Americans were so content that they did not actively resist their bondage, and, as a result, they bear some responsibility for centuries of persecution.

He’s not alone in his thinking. In 2016, the former Fox News host Bill O’Reilly asserted that slaves were “well fed and had decent lodgings.” Last September, the Alabama senatorial candidate Roy Moore deemed the antebellum era the last great period in American history. “I think it was great at the time when families were united,” he declared. “Even though we had slavery, they cared for one another.”

Modern scholarship has debunked such whitewashing, accurately depicting slavery as an inhumane institution rooted in greed and the violent subjugation of millions of African-Americans.

Yet countless Americans have not learned these lessons. They cling, instead, to a romanticized interpretation of slavery, one indebted to a book published 100 years ago.

In the spring of 1918, the historian Ulrich Bonnell Phillips published his seminal study, “American Negro Slavery,” which framed the institution as a benevolent labor agreement between indulgent masters and happy slaves. No other book, no monument, no movie — save, perhaps, for “Gone With the Wind,” itself beholden to Phillips’s work — has been more influential in shaping how many Americans have viewed slavery.

Born in 1877 into a Georgia family with planter roots, Phillips developed an abiding sympathy for the Old South. He studied history at the University of Georgia and then as a graduate student at Columbia University under the tutelage of William A. Dunning, a scholar with a pro-Southern bent.

After earning his doctorate in 1902, Phillips set out to correct the slanted picture of the Southern past that he believed prevailed at the time. “The history of the United States has been written by Boston and largely been written wrong,” he lamented. “It must be written anew before it reaches its final form of truth, and for that work, the South must do its part.”

Phillips certainly did his. During his 30-year career, he published nine books and close to 60 articles, earning a series of prestigious professorships that culminated in a “very flossy job,” as he put it, at Yale University. This 1930 appointment reflected his stature as the country’s leading historian of slavery and the South, as well as the influence of his most important book, “American Negro Slavery.”

He was a prodigious, albeit selective researcher. Phillips found evidence in plantation records and Southern travelogues that bolstered the book’s benign interpretation of slavery, while downplaying evidence that did not. In his hands, plantations became idyllic sites where white families had modeled the habits of civilized life for their childlike black charges. “The plantations,” Phillips wrote, “were the best schools yet invented for the mass training of that sort of inert and backward people which the bulk of the American negroes represented.”

According to Phillips, slaveholders provided the enslaved with comfortable living quarters and plentiful rations and eschewed physical discipline. They rarely sold slaves, especially if it meant breaking up families. Slave owners’ rule “was benevolent in intent” and “beneficial in effect.”

Phillips’s use of the passive voice — “in March the corn fields were commonly planted” — further distanced the reader from slaves’ coerced labor. Enslaved African-Americans, in turn, displayed gratitude and loyalty to their masters. Phillips concluded that, while slavery may have been economically inefficient, “the relations on both sides were felt to be based on pleasurable responsibility.”

“American Negro Slavery” won widespread acclaim in the North and the South. Reviewers praised Phillips for his thorough research, charming style and lack of bias. In the words of the historian John David Smith, an expert on Phillips, the book served as “the definitive account of the peculiar institution” from World War I into the 1950s.

The book set the tone for the treatment of slavery in classrooms and textbooks across the country. “There was much to be said for slavery as a transition status between barbarism and civilization,” maintained a 1930 best seller, echoing Phillips almost verbatim. “The majority of slaves were … apparently happy.”

From the beginning, however, Phillips had his critics, who insisted on telling a more truthful, unvarnished history of slavery. W.E.B. Du Bois wrote a scathing review of “American Negro Slavery,” observing, “It is a defense of American slavery, a defense of an institution which was at best a mistake and at worst a crime.” Drawing on interviews with ex-slaves, sources Phillips rejected, the historian Frederic Bancroft published a 1931 book that exploded Phillips’s misrepresentations of the domestic slave trade.

Phillips’s critics grew more vocal in the 1950s and 1960s, as a new generation of scholars challenged his benign reading of slavery and the racism that stained almost every page of “American Negro Slavery.”

Yet while Phillips’s most egregious claims fell out of favor, the legacy of “American Negro Slavery” has proved tenacious.

According to a new Southern Poverty Law Center report on how slavery is taught in public schools, current pedagogy continues to focus on slavery from the perspective of whites, not the enslaved, while failing to connect the institution to the white supremacist beliefs that supported it. Textbooks often ignore slaveholders’ desire to make money and too easily slip into grammatical constructions — Africans “were brought” to America — that absolve enslavers of their actions.

Last year, a Charlotte, N.C., teacher asked her middle-school students to list “four reasons why Africans made good slaves.” An eighth-grade teacher in San Antonio recently sent students home with a work sheet titled “The Life of Slaves: A Balanced View.” It prompted students to list the “positive” aspects of slavery along with the “negative.”

We must confront mischaracterizations of the nature of slavery, whether nurtured in the classroom or broadcast on Twitter. After all, historical accuracy on this topic is not just about getting the past right; it is also about understanding the challenges of the present.

The persistence of racial inequality in America — from police brutality and school segregation to mass incarceration and wealth disparities — reflects, to some degree, the persistence of the Phillipsian take on slavery. If the institution were little more than a finishing school for African-Americans, then why acknowledge or address its pernicious legacies today?