MORE ABOUT HEALTH: Structural Racism and Stress

By Karyn Pomerantz, August 8, 2017

you may be suffering from capitalism

This blog post presents the ways the ruling class of owners and financiers intentionally use racism to create profit and separate the working class.  It discusses structural racism and its manifestations in health.  Subsequent pieces will discuss how structural racism affects health because of policies in housing, education, employment and other necessities of life.

The Structures of Racism

Racism has many levels, from the interpersonal to the institutionalized. There are different ways to address each level, from developing relationships on an individual basis, to changing policies, to creating a new way to organize society without racism. How we define racism determines how we work to abolish it.  Black Lives Matter and other movements have focused people’s attention on white privilege and white supremacy. Interpersonal forms of racism include micro-aggressions, such as strangers asking people of Asian descent where they are from, retail clerks following black customers around a store, and white students rejecting the contributions of their black classmates. Mass incarceration and police violence represent more institutional forms. The historical legacy of atrocities of genocide, colonialism, and slavery, which used racism as their justification, continue to limit our ability to unite as a class, and improve our health and social relationships.

Racism is more than stereotypes and attitudes.  It is also a set of practices that exploit people and enrich others.  We need to ask who benefits from racism.  Many people say that white people are “privileged” by racism and benefit from it.  We say that people experience different LEVELS of exploitation and oppression.   Exploitation means that employees earn lower wages that do not equal the value of what they produce, leaving employers with a profit.  Oppression refers to the discrimination, repression, and marginalization specific to different groups.  A gay man may be an employer who isn’t exploited but may suffer oppression because of his sexual identity.  Black and Latin people often suffer police surveillance and excessive force regardless of their class status.

On average, white people do earn more than others, have less unemployment, live in more resourced neighborhoods, and are less likely to be victims of police violence.  However, racism did not arise from the prejudices of white people.  Colonists developed racism to justify their oppression of indigenous and African people, and keep whites from uniting with them.  Some white workers do promote and support many racist policies and ideas as we saw recently during Trump’s campaign but did not originate them.  While we need to defeat these prejudices, we cannot stop there.

We need to examine the structural factors of racism.  Who benefits from racism?  How do we organize against the root causes of oppression? This determines whether we organize together or in separate groups, whether we rely on electoral politics or organize uprisings and grassroots actions.

 Structure reveals how society is organized. This picture shows 1% of the people at the top who own corporations and banks, the next 19% who serve them, and the rest of us who works for a salary or wage or are unemployed.  There are many levels of income and exploitation within this 80%.   

 Structural racism refers to the ways that capitalism institutionalizes inequitable societal factors, such as enforcing policies that segregate schools and neighborhoods.  Structural factors describe what class holds political and economic power, controls the media and shapes messages, and determines domestic and foreign policy.  The key motivating structural features of capitalism are profit and competition.  Without competition for profit, it isn’t capitalism.        

Development of Capitalism and Racism

             From the 9th to 15th centuries, feudalism organized society.  The monarchy (kings and lords) ruled over the peasants who worked the land producing wealth for their sovereign and making just enough food and clothing for their needs.  As industrialization progressed, the monarchy aggressively pushed peasant families off the land and into the city slums.  Many worked producing clothes from the cotton that enslaved people grew.  The colonists in the US captured millions of African people to work for free harvesting cotton and tobacco. Their labor enriched southern plantation owners and northern shipbuilders, textile factories, and spurred the development of the insurance and banking industries.

            Capitalism developed in the 1700s as the main way to organize production.  Workers sold their labor in exchange for wages, earning far less than the value of what they produced. The owners took the profits that were left.  As the production increased, the capitalists required more raw materials, like cotton and rubber that they stole from other countries, such as India and the Congo.  Today we see that same practice that we call globalization.  To keep workers from uniting across countries against the capitalists, governments push patriotism and hatred of migrants and immigrants, using crass stereotypes and fear.  This persists today. 

American colonists also needed an increasing supply of labor that would work as cheaply as possible, and made a decision to build an economy based on slave labor. They settled on Africa as a source of slaves precisely because those slaves would be easily identifiable and not have knowledge of the terrain, as would Native Americans, and were abundant. White workers would be employed at low wages in northern factories or become subsistence farmers in the South, impoverished, but with more rights than slaves.

Racism did not originate because white people rejected black and Native people. Racism developed when European monarchies established colonies in the “New World” in the early 17th Century.  They sought resources and markets in North and South America, Asia and Africa.  Genocide of Native people allowed the seizure of land and its riches.  Slavery abducted millions of people for free labor to harvest the cotton, tobacco, and tea that made the US an imperial power.

The colonists needed to justify the enslavement of Africans, and convince whites that they were better off.  They gave whites wages and granted them a higher social and economic status.  This justification of exploitation and genocide created the ideology of racism that people express in micro-aggressions, stereotyping, and outright murder.   (See Lerone Bennett’s The Road Not Taken in this blog).  It encourages people to blame black and Latin workers for their own poverty and for dragging down the living conditions of whites.

Today, to protect their profits and power, the rulers try to convince us that voting will improve our lives and change who holds power.  African Americans held local, state, and federal government positions during Reconstruction after the Civil War and after the civil rights movement during the 1960s.  Despite the election of Barack Obama and other black politicians, structural racism persists today.  Owners of finance and corporations control what we earn, produce and buy, where we live and attend school, and whom we fight to enrich these owners.  They have instituted a system where black, Latin, Asian, and Native residents have less income and wealth, a worse education, less access to healthy foods, and more pressure to seek jobs in the military.  These are intentional policies that allow a very small, egregiously wealthy group to control society for their own benefit.

Structural Racism, Stress and Health

             Racism has huge impacts on our health.  There are many ways in which the profit system destroys our health on a daily basis, but one of the most effective agents of ill health is stress on the human mind and body.  Stress causes deficits in our immune systems, the main defense we have against illness, and by increasing the secretion of various hormones – some, like cortisol, even called “stress hormones” – takes its toll on many of our internal organs.

Stress is caused by everything that afflicts workers in a capitalist society.  This includes but is not restricted to (in no particular order):

  • being undervalued on the job (less valuable to the capitalists than their machinery since workers are more easily and cheaply replaceable),
  • being last hired and first fired for minority workers,
  • the fear of being laid off,
  • fear of deportation for immigrants
  • actually being laid off or fired (i.e., unemployed) and having to compete with other workers for a shrinking number of jobs,
  • overwork and underpayment,
  • wage theft
  • lower standards in work and pay for women and black and Latin men,
  • hazardous and tortuously boring working conditions,
  • rising prices and threats of losing one’s home and becoming homeless,
  • ever present threat of catastrophic illness,
  • no or little health insurance,
  • threat of bankruptcy or wiping out savings produced by catastrophic illness
  • seeing our teenagers and young adult children having nowhere to turn other than the police or military where they risk being killed and are forced to try to kill other workers,
  • the ever-present availability of addictive and life-destroying drugs,
  • stigma, fear, and alienation of people who are LGBT,
  • increased physical attacks against Muslim, Black, Latin, and immigrant people,
  • rise of neo-Nazis and Klan groups,
  • too little income to retire,
  • losing Medicaid for healthcare and disability care,
  • high cost of medications,
  • troublesome or non-existent close, personal relationships.

Health Consequences: High Blood Pressure and Low Birth Weight

Take high blood pressure as an example.  Many more U.S. black and Latin workers, as well as immigrant workers over time, have hypertension compared to white workers, where it is already epidemic.  The primary cause of this organ- and life-destroying medical condition is the horrendous and ubiquitous racist conditions (Krieger N. The CARDIA study).  To hide this simple and obvious fact, racist theorists have tried to claim that black people, in particular, have a greater inborn, genetic tendency to develop high blood pressure.  But antiracist investigators have shown, on the contrary, that high blood pressure is far more prevalent among U.S.-born black workers than among West African citizens remaining in Africa (from where the majority of black populations in the Western Hemisphere originated) and among African men and women who immigrate to the U.S. and have only been here relatively short times.

This is also true of bad birth outcomes in black women.  Women of African descent who live in the US have higher rates of low birth weight babies than women who live in other developed countries.  Black women with college degrees have sicker babies than white women who dropped out of high school. (When the Bough Breaks, Unnatural In other words, living in the U.S., with its extreme racist institutions and practices, rather than genetics, is the major cause of hypertension and birth problems among super-exploited workers.

Stress also gives rise to alcoholism, smoking, paralyzing depression, intimate personal violence, child abuse, and suicide.  Unemployment, poverty, and isolation fuel the opioid epidemic that has reduced the life expectancy of middle aged white women.  If white people had fought for drug treatment when drug use had a black face, there may have been more prevention, such as needle exchange programs.  Now that drug use affects so many whites, the government is claiming an epidemic and allocating millions of dollars for care.

Capitalist profit strivings affect every area of our lives.  The food industry relies on toxic pesticides for crops and antibiotics for livestock, both of which get into the food supply.  It creates unhealthy environments for the animals it raises for slaughter and for the workers who turn livestock into products.  The beverage industry promotes sugary drinks and blocks efforts to restrict them.  Food producers fund health associations, such as diabetes and dietitian groups, and push physical activity versus diets as interventions to promote health.  Many people turn to these junk foods to alleviate stress creating conditions ripe for diabetes, heart disease, and obesity.

Pharmaceutical companies fund both political parties to ensure favorable legislation.  They are masters of manipulating drug marketing, pricing, and media.  They have rejected any discounts for drugs in Medicaid, Medicare and the Affordable Care Act.

These industries and many others create bad health outcomes and limit the options most people have for wellness.

Structural Racism in HousingPolicies Enforce Segregation and Damage Our Health

Unaffordable housing, gentrification, and residential segregation coupled with inadequate, expensive transportation exemplify the structural nature of racism.  Previous housing policies and highway construction through black neighborhoods made it difficult for many black families to buy homes.  This reduced their amount of wealth that exists today.  In addition, realtors targeted black neighborhoods with sub-prime mortgages.  When the housing crisis hit in 2008, black homes went to foreclosure, and black homeowners lost any equity they accrued.  Housing policies also separate people into different neighborhoods preventing the development of multiracial friendships. See the May 23rd blog post, The US Government Created and/or perpetuated segregated housing – with malice of forethought  for a history of housing discrimination.  Read more in The Color of Law by Richard Rothstein.

segregation today Brookings

While overt segregation is no longer legal, segregated neighborhoods and schools are as prevalent as before if not worse.  In 2010, almost ¾ of large US cities were segregated, ¾ of black students went to schools that were segregated and under resourced.  Exclusionary zoning policies control who can live in a neighborhood by limiting or excluding certain types of housing, such as apartment buildings or less expensive housing.

The following lists some of the current housing policies federal and local governments, and private real estate companies, banks, and insurance companies implement.

  • Affordable housing does not exist, and the Housing and Urban Development (HUD) budget in people with AIDS are waiting for Ryan White financed housing.
  • Developers are pushing residents out of public housing, such as Barry Farms in DC where the local housing authority shut down their Section 8/voucher housing waiting list.
  • Developers promise that tenants can move back into their renovated neighborhoods. However, only about 25% do as the landlords change the criteria for renting, such as better credit scores.
  • Local laws often prohibit men and women leaving prison from public housing.
  • Government, real estate companies, and white residents excluded African Americans from living in white areas. About 700 counties in the north and south enforced sundown policies that warned blacks (as well as Chinese and Jewish families) not to be caught when the sun set.
  • In the summer of 2017 in DC, the transit agency, WMATA, raised bus fares to $2 each way, and its subway system can cost over $5 one way to the outer suburbs where many jobs are located.  They also eliminated bus routes that serve poor neighborhoods.

Housing problems affect health in many ways, from HIV to asthma.  Homelessness puts people at risk for exchanging sex for a place to live; HIV rates are high among people who are homeless.  Housing quality, including climate control, and the presence of vermin, lead, and other toxins, cause lead poisoning, breathing problems, and intellectual disabilities.  Public health sociologist, David Williams, links residential segregation to poor health through the lack of resources enjoyed by white families living in more resourced areas. These include poorer access to healthy food (food deserts), good schools, health facilities and healthcare providers, greenery, parks, and safe places to exercise.  On the other hand, there are plenty of toxic dumps and industrial facilities placed in black developments.  In fact, race predicts where environmental hazards exist.

Another blog piece will give more details about structural racism, health, and education, the environment, employment, and war.

To Read More:

The Color of Law by Richard Rothstein.

Sundown Towns by James Llowen.

Unnatural Causes: Does Inequality Make Us Sick? by ITV (

Race: Power of an Illusion by PBS (pbs,org/race)

Center for Law and Social Policy, CLaSP (

The Road Not Taken by Lerone Bennett.

Social Service or Social Change by Paul Kivel (

Caliban and the Witch by Silvia Federici.

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