How health systems can truly value Black lives: help close the racial wealth gap – STAT
Institutional declarations of support for Black lives were ubiquitous in the aftermath of the murder of George Floyd. The radical, transformative change demanded by hundreds of thousands of protestors across the country, however, has not been realized.
Health systems can and must help move the country in that direction. Addressing immediate social needs, such as food insecurity, housing, or access to health care, as some health systems are now doing, is important. But to truly value Black lives, they must also be willing to tackle one of the most upstream drivers of racial health disparities: the racial wealth gap.
At its most basic, wealth is the value of one’s assets minus the total amount of their debt. The racial wealth gap is large, exists within every income level, and has not changed in more than a century. The median net worth of a White family in the United States in 2019 was $188,200, compared to just $24,100 for a Black family.
The reasons for this gap are myriad and complex. But many of them can be traced back to a common denominator of structural racism: the end of slavery, when Black families were released into “freedom” with little to no assets; the effects of historical redlining and present-day home-valuation disparities on intergenerational wealth building through homeownership; subtle tax code differences that disproportionately affect how much Black families receive on their returns; and more.
In an essay we wrote for the New England Journal of Medicine, we described the opportunities health systems have to reconceptualize their roles in building Black wealth. Wealth matters for health, which should make it a natural focus for health systems seeking to prevent and treat illness. Greater wealth is associated with a reduced likelihood of early death, lower rates of chronic diseases such as high blood pressure and diabetes, and better overall functional status over the life course. Given the racial wealth chasm that exists, it’s no surprise that it can be hard to move the needle on health disparities without addressing this upstream determinant.
Consistent with an anti-poverty medicine model, we describe three key approaches — reducing expenses, maximizing income, and decreasing debt/increasing savings — to doing this work and offer examples of how each one might be implemented. This work is readily accomplished through medical-financial partnerships. These cross-sector collaborations between health and community-based financial organizations can improve the financial, physical, and mental well-being of those they serve.
To reduce expenses, for example, health systems can connect staff and patients with public benefits to which they are eligible, better allowing families to cover basic needs. To maximize income, health systems can provide …….