| Number 231 | November 21, 2003 |
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This Week:
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Greetings, I took a week off last week from the subject of “Social Health.” I return to it this week with—Oh, no!—a few more statistics. And a few thoughts on what those statistics mean. After this—although there is a lot more to say—I’m done with Social Health for a while. I think it’s time to do some media reviews, and maybe some end-of-the-year compilations of things. Send along requests, if you like. Long-time readers know that I can’t really predict from week to week what is coming up, so maybe you have some ideas... My apologies to the readers who got their recent Notes contributions returned to them. I now see that I listed my own P.O. Box number incorrectly during the Pledge Drive. Yikes! The correct number appears at the bottom of every e-mail issue... And thank you to the myriad readers who sent in comments on last week’s edition. I always appreciate feedback, so keep it coming! Until next week, Nygaard |
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This past Monday, November 17th, the local paper the Star Tribune ran an article headlined “Some Wealthy Aren't Sharing the Wealth.” The article talked about an online survey conducted by Harris Interactive. The survey included 712 adults with annual household income of at least $150,000 and investable assets of at least $500,000. The findings, according to the article, “purport to show how the wealthy have grown happier with increasing affluence, how their values have changed since 9/11—and how they think they need more.” Among many intriguing comments, here’s my favorite:
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One way to assess the performance of a nation is to compare over time. That is, how we are doing now, as opposed to how we were doing before. That’s mostly what the Index on Social Health looks at, and mostly what I have reported in recent weeks. The other useful way to assess performance is to compare over space. That is, how are we doing compared to other nations? There are several international projects aimed at comparing social health between countries (I listed them in Nygaard Notes #86, “How to Measure Well-Being”). I think all of them are seriously flawed. Just for one example, many indigenous people live, for the most part, outside of the money economy. So, what appear to us to be conventional economic measures are, I think, misleading. Imagine the case of a traditional farmer who, when dispossessed of her/his land, may be forced to migrate to a large city and get a “job.” So, her/his “income” goes up, which looks, in the economic sense, like a good thing. But the reality is a decline in her/his standard of living, in fact a devastating attack on the traditional, non-monetarized economy in which that person had been embedded, and would still be embedded, given the choice. In this sense, the disparity in income between the industrial countries and the poor countries is perhaps less significant than the disparity in power that allows such dislocations to occur. Capturing this complexity in a simple comparative economic scale is pretty close to impossible, with the result that I have been hesitant to even get into it. (Thanks to Bob C. for stimulating this thought!) Having said that, it’s useful to have a clue as to how the wealthy countries of the world treat their citizens. The United States, despite being the wealthiest nation in history, doesn’t stack up too well. Here are just a few quick examples, using the indicators in the Index of Social Health... INFANT MORTALITY. The United States ranks behind every other wealthy country in the world, coming in at 28th out of a list of 37 countries put together by the U.S. Centers for Disease Control. (The bottom 9 include not-too-wealthy countries like Romania and Slovakia.) It hasn’t always been this way – using the same list of countries, the U.S. ranked 11th as recently as 1960. INCOME INEQUALITY: Only two countries out of 26 relatively-wealthy countries in the Luxembourg Income Study have a greater level of inequality than the United States (Russia and Mexico are worse). HOMICIDE RATE: This isn’t even close. The only country that approaches the U.S. in this category is Northern Ireland, and our homicide rate is 68 percent higher than theirs. We’re five times higher than Canada; 18 times higher than England, and so forth. Two of the Social Health indicators are “HEALTH CARE COSTS FOR THE ELDERLY” and “THE NUMBER OF PEOPLE OF ALL AGES WITHOUT HEALTH INSURANCE.” We’re the worst here, by far. In fact, there is literally no comparison, since the United States is the only country without a national health system that guarantees access to health care for all. Et cetera. You get the idea. |
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Why have I been talking so much about race in this series on Social Health? There are many reasons. Perhaps the main reason is my belief that the most profound indicator of the moral and spiritual integrity of a society—central elements, to me, of a society’s Social Health—is how it looks out for the welfare of those among its members who cannot enforce their rightful demands for dignity and well-being. That sounds a little mysterious, so I’ll start with a small example to illustrate the point. The Social Report 2003 includes a state-by-state look at the social health of United Statesians. In that report—“The Social Health of the States 2003"—each of the states is ranked on all of the16 indicators that go into making up the Index of Social Health. It’s a useful report, but I developed a hypothesis as I read it about why these rankings may be quite misleading in one crucial respect. Here’s my hypothesis: I’ll bet that the highest-ranking states will be the states with the highest proportion of “white” people and/or the lowest proportion of people of color. And vice versa. I checked out the hypothesis by comparing the racial makeup of the top and bottom-ranking states, using Census data. I discovered that there is, indeed, a strong correlation between race and Social Health. All of the eight lowest-ranked states—states that the report considers to be doing so poorly that they can be said to be in a “state of social recession”—rank in the top ten nationally in the percentages of their populations who are either African-American or American Indian. On the other hand, not a single one of the top-ranked states is in the top ten in this regard. Correlation is not causation, I know, but it’s worth pondering why this might be. I have a couple of thoughts on it. First, since the effects of white privilege are so far-reaching, the averaging of Social Health scores will tend to cast in a bad light the states that have higher proportions of people of color, that is, fewer people with white skin privilege. At the same time, the averaging of scores will tend to disguise the extent of the racial disparities in the states with the highest proportion of “white” people, since the poor treatment of the relatively small numbers of people of color will tend to be buried in the avalanche of the statistical majority of Euro-Americans. (I illustrate this elsewhere in this issue by looking at my own state of Minnesota.) What’s Missing? How is “reality” distorted when one fails to look at the correlation of racial demographics with Social Health? To me, the distortion is profound. If a society is organized in such a way that the majority population has a high level of Social Health, but certain segments of the population are living at a far lower level, then is that society really “healthy?” I think not, since there is a moral failing here. In a (literal) democracy, it is entirely possible for the majority to oppress the minority, simply by voting in their own selfish “interests.” The Social Health of any minority thus depends, at least in part, on some moral action by the majority. When we look at the “social health” of the various minority groups in a society, then, we learn far more than “how they are doing.” We learn a lot about the moral dimension of the Social Health of that society. Any index of the Social Health of a society that, like ours, has such an ongoing legacy of racial discrimination and institutionalized white privilege, must place the issue of race near the center of its analysis. If it doesn’t, the result is to remove or minimize the moral dimension of a society’s “health.” And that’s a huge distortion of reality. |
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When I worked on the Leech Lake Indian Reservation in northern Minnesota in the early 1970s, there was a joke going around (it’s probably still going around). As the joke had it, a series of interviews was being conducted with the state’s seniors to learn about their experience of living through the Great Depression of the 1930s. The survey was going well until the researchers got to the reservation. When they asked an elderly Anishinabe woman what it had been like to live in the Depression, she responded, “What? You mean, it’s over?” I thought of that joke as I looked recently at the report “The Social Health of the States 2003”—a part of the Social Report 2003, upon which I reported earlier this month. I was happy to see that Minnesota ranks 2nd among states in overall social health, behind only Iowa. (In spite of the fact that, having grown up in southern Minnesota, I was socialized to make fun of everything about Iowa—who knew?) The way the states are assigned their ranks in the Report is by taking each of the 16 indicators of Social Health and assigning a grade of “A” if a state scores in the top ten, “B” if it’s ranked from 10 to 20, “C” for 20 to 30, and so on. Minnesota got eight “A’s” and four “B’s,” giving it an overall rank of 2nd. Having spent some time at Leech Lake, however, and having lived in the inner city for three decades, I was a little suspicious of these scores. So I looked at a few of the indicators in which Minnesota got an “A” score, injecting the element of racial justice into the picture. Here’s what I learned. CHILD POVERTY: Minnesota comes in at Number 2 among states, overall, yet an analysis of Census numbers shows that Minnesota ranks 48th among U.S. states in terms of the poverty gap between white kids and black kids. I couldn’t find statistics for the gap between white kids and Indian kids, but Minnesota Milestones reports that “Historically, poverty rates in Minnesota are highest among American Indian children, closely followed by African American families.” (For the record, Iowa ranks 5th overall on this indicator, and 44th in racial disparity.) Minnesota also ranks second in the nation in the rate of INFANT MORTALITY, with a rate of 5.55 infant deaths per 1,000 births. For white people the rate is 5.2; for blacks the rate is 15.1, and for American Indians the number is 14.4. Looking only at “white” infant mortality, then, Minnesota ranks 8th among states. Looking at black infant mortality, Minnesota ranks 14th. But when one looks at the gap between the two, Minnesota ranks 28th among the 40 states for which the federal Centers for Disease Control had good numbers in their most recent report. (Interestingly, Iowa ranks dead last in this category, despite it’s overall ranking of 20th.) HEALTH INSURANCE: The percentage of uninsured black people in Minnesota in the most recent figures was 15.6 percent, the same as the overall rate in Arkansas, which ranked 33rd among states in the Social Report. The rate for American Indians was 16.2 percent, the same as Idaho (40th). 17.4 percent of Latinos in Minnesota are uninsured, the same as Nevada (41st). The racial dynamics of health care in my state are so bad that the Minnesota Department of Health has set up a special “Eliminating Health Disparities Initiative” to address the problem. Despite these horrible numbers for racial minorities, Minnesota ranks second among states overall in this indicator in the Social Report, due to the fact that only 4.6 percent of the overwhelming majority of “white” people in the population were uninsured. (I don’t know about Iowa on this one.) There’s another disparity in Minnesota’s national rankings, one that doesn’t even appear in the Social Report, but I find too striking to leave out: Criminal justice. Relative to other states, Minnesota sentences fewer people to prison than any other state, overall. At the same time, our justice system is one of the most racist in the country, judging by the numbers. Nationally, as I reported in Nygaard Notes #68, an African-American man is almost 8 times more likely to be in prison or jail than a “white” man. That’s shameful enough, but in Minnesota it’s even worse: The ratio here is 25 to 1, three times as bad! I am proud that my state has a history of providing a relatively high level of social services, and that our average Social Health is as high as it is. This is the result of much struggle, organizing, and hard work by many, many people over many years. At the same time, until we make these gains available to all Minnesotans, and not just those of European descent, the famous phrase “Minnesota Nice” will continue to sound like a compliment to “white” people, while it can only sound like some sort of ironic and bitter commentary to people of color. |