On Oct. 31-Nov. 1, 2022, the National Association of Chronic Disease Directors hosted a social justice-oriented thought leader round table on “Closing the Gaps: From Wealth to Health” in Washington D.C. Chronic Disease Directors and other health officials from Arizona, Louisiana, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, New Jersey, and Washington, D.C. attended alongside partners from the Robert Wood Johnson Foundation, the John Lewis Center for Social Justice, the Build Healthy Places Network, the NAACP Washington, D.C. Branch, and more. Below is a brief blog by NACDD consultants to help provide introductory information about this topic, and why and how public health should get involved in the racial wealth gap.
Prepared by: Patrilie Hernandez (NACDD State Partnerships Improving Nutrition and Equity Program Consultant) and Renaldo Wilson (NACDD Health Equity Consultant)
Watch the Press Conference from the Roundtable
Background
NACDD is committed to becoming an anti-racist organization. To that end, the focus of this Thought Leader Round Table, the Racial Wealth Gap, will center the lives and lived experience of Black people living in America. We acknowledge and understand that other groups experience discrimination and have been negatively impacted by economic inequalities in the U.S.; however, it is important that we also acknowledge and understand that the financial base of this country was built on the backs of enslaved Africans brought to the U.S. with the goal of creating and sustaining economic gain for white colonists.
We further acknowledge and understand that the descendants of those enslaved Africans (i.e., African Americans) have shouldered the burden of this historical exclusion and exploitation while continuing to be excluded and exploited in the present day. The learnings garnered from this discussion will, undoubtedly, lead to pathways for addressing the wealth gap within and across other groups that have been negatively impacted by the widening gap, and NACDD is committed to exploring this topic further through future discussions.
After considering many definitions of social justice, we chose to use the following because it identifies the drivers of social injustices, recognizes the need to acknowledge past injustices, and provides a call to action to the reader. This definition will be the foundation for our discussion as well.
“Social justice is the communal effort dedicated to creating and sustaining a fair and equal society in which each person and all groups are valued and affirmed. It encompasses efforts to end systemic violence and racism and all systems devaluing any person's dignity and humanity. It recognizes that the legacy of past injustices remains all around us. Therefore, it promotes efforts to empower individual and communal action in support of restorative justice and the full implementation of human and civil rights. Social justice imperatives also push us to create a civic space defined by universal education and reason and dedicated to increasing democratic participation.”
What is the Racial Wealth Gap?
The richest 10% of American households hold more than three-quarters of all U.S. household wealth1; of those households, only 1.9% identify as Black, despite Black Americans making up almost 15% of the U.S. population. More broadly, an estimated 41.6 million Black Americans make up households that account for a little more than 3% of all household wealth in the U.S. This is vastly disproportionate to the 3.5% of total U.S. household wealth owned by the top 400 wealthiest billionaires, who are almost all exclusively white2.
In 2019, before the COVID-19 pandemic, it was estimated that Black Americans had one-sixth the wealth of white Americans on an average, per capita basis3. This means that for every dollar the average white American has, the average Black American has only about 17 cents; similarly, for every dollar the median white household has, the median Black American household has just 10 cents. These numbers clearly demonstrate a significant racial gap in the amount of generational and accumulated wealth.
This Racial Wealth Gap has always existed. Wealth inequality between white and Black households was highest before 1860 and then rapidly plunged from the late 1800s through the 1930s, due in large part to the abolition of chattel slavery4. Since the 1950s, however, the gap has remained stagnant, and we have not seen much progress in the continued closure of the wealth gap. Data shows that since 1980, the gap has widened and grown exponentially over the past three years. It is critical to note that the pandemic has accelerated wealth concentration and negatively impacted Black and Latinx communities attempting to grapple with the aftereffects of COVID-195.
As an organization that believes in transparency and delivering evidence-based information to communities across the nation, we hope this Thought Leader Round Table serves as an opportunity to begin a discussion around the Racial Wealth Gap, a socio-economic factor that plays a significant role in generating health disparities.
Why close the Racial Wealth Gap and not just the wealth gap?
In the U.S., the current, dominant narrative says that wealth can be accumulated and maintained by high financial literacy; higher educational attainment; and making the “right” choices when it comes to purchasing, saving, and asset building. These assumptions are short-sighted as they do not reflect the roles that American history, wealth inheritance, and systemic structures play in achieving financial stability and success.
For example, major policies geared toward wealth building, such as the 1862 Homestead Act, the GI Bill of 1944, and programs to promote homeownership during the first half of the 20th century, were all poised to offer guaranteed pathways to increased wealth and assets for Americans6. These policies and programs, however, prohibited Black Americans from participating, solely based on race. Although these laws and policies utilized more coded language to exclude Black Americans from benefitting financially, these were mild compared to the overturning of legislation that specifically sought to offer reparations to formerly enslaved Black Americans after the Emancipation Proclamation was signed, symbolizing the end of chattel slavery in the U.S.
Evidence demonstrates that even when Black people obtain advanced degrees, own their homes, have high-paying jobs, invest in asset building, and engage in other behaviors that display financial responsibility, the wealth gap remains. The “bootstrap” mentality that so often is associated with the American Dream is simply not enough to close this wealth gap, which has been exacerbated by hundreds of years of structural racism that deprived Black American families of resources that can accumulate wealth and offer the ability to transfer it from one generation to the next.
During the Thought Leader Round Table, we will bring together subject matter experts and other partners to discuss social determinants of health (SDoH) and the many issues surrounding the challenges of closing the Racial Wealth Gap.
What does closing the Racial Wealth Gap have to do with social determinants of health and improving health outcomes for all?
The Racial Wealth Gap continues to harm generations of Black Americans that have traced their roots to over 150 years before the founding of American democracy. As is widely noted, the socio-economic position a child is born into largely determines what opportunities for advancement are available to them and their health outcomes in life. Economic Stability, Health Care Access, and Educational Access and Quality are only a few of the SDoH that are driven by socioeconomic standing and heavily impact a person’s health, well-being, and quality of life7.
Systemic, Institutional, and Interpersonal Racism, coupled with restricted access to wealth – including opportunities to accumulate wealth and transferred generational wealth – have shown to take a large toll on the health of Black individuals and families, as they are disproportionately affected by inadequate access to life-saving medical care, under-diagnosis of mental health conditions, low infant birth weight, maternal death rates, and certain chronic diseases, just to name a few.
Investing in solutions that can build Black wealth and close the Racial Wealth Gap can be an important strategy in alleviating the burden of stress and trauma associated with poverty, medical debt, and racism, all factors that increase the onset of chronic disease and decrease life expectancy and quality of life.
The Thought Leader Round Table will also cover why and how Chronic Disease Directors and State Health Departments can play a critical role in developing programs and implementing policies that can promote the equitable distribution of wealth and resources, especially in communities that have been the most disproportionately impacted by systemic racism.
As of August 2021, city/town councils, health associations, and public health departments in 37 states have declared “Racism as a Public Health Crisis”8. This is a first step in calling attention to racism and shifting the narrative in a way that can drive changes to resource allocation, which can help close the Racial Wealth Gap.
Additionally, the convening also will cover why the word “equity” is being used as opposed to “equal” and aim to ensure that along with a lively discussion, everyone leaves with grounded suggestions and resources for carrying this information back to their organization.
While closing the Racial Wealth Gap will certainly move the needle in improving health outcomes in Black communities, we can’t stop there at addressing the systemic and institutional racism that is embedded into the fabric of modern medicine, healthcare, and public health.
We hope you will join us and be part of the solution as we work together toward our shared goal of ending health inequities in this nation. To learn how you can participate in and support this work, please visit our Health Equity program pages or contact NACDD at Members@chronicdisease.org.
Citations
1 Saez, E. & Zucman, G. (2016). “Wealth inequality in the United States since 1913: Evidence from capitalized income tax data.” The Quarterly Journal of Economics 131.2 (2016): 519-578.
2 Saez, E. & Zucman, G. (2019). “Progressive Wealth Taxation” Brookings Papers on Economic Activity Conference Drafts.
3 Derenoncourt, E., Kim, C. H., Kuhn, M., & Schularick, M. (2022). “Wealth of two nations: The US racial wealth gap, 1860-2020”. National Bureau of Economic Research.
4 Derenoncourt, E., Kim, C. H., Kuhn, M., & Schularick, M. (2022). “Wealth of two nations: The US racial wealth gap, 1860-2020”. National Bureau of Economic Research.
5 Chetty, R., Hendren, N., Jones, M. R., & Porter, S. R. (2020). “Race and economic opportunity in the United States: An intergenerational perspective”. The Quarterly Journal of Economics, 135(2), 711-783.
6 Hamilton, Darrick, and William A. Darity. “The political economy of education, financial literacy, and the racial wealth gap.” (2017): 59-76.
7 U.S Department of Health and Human Services. Office of Disease Prevention and Health Promotion. Healthy People 2030 “Social Determinants of Health” https://health.gov/healthypeople/priority-areas/social-determinants-health
8 American Public Health Association (APHA). Racism is a Public Health Crisis. “Racism Declarations: Opportunities for Action.” https://www.apha.org/topics-and-issues/health-equity/racism-and-health/racism-declarations
