Research Shows How Reparations Are a Prescription for Black Progress

What must be done to dismantle longstanding racist policies that deprive Black people in America of the resources needed to live a healthy life?

In my bedroom, I keep a treasured brass lamp that was the sole possession carried North by one of my enslaved great grandmothers. It reminds me of how my children will be the first generation in our family to inherit wealth.

It also brings to mind the role of intergenerational wealth in providing opportunities that influence our health. And it strengthens my dedication to the Foundation’s efforts of repairing historical harms and dismantling structural racism.

Recently, I spoke with Mary T. Bassett, M.D., director of Harvard’s FXB Center of Health and Human Rights about a research project she is leading, Making the Public Health Case for Reparations, which explores Black reparations as part of a public health strategy for achieving health equity. Here, we continue that conversation.

How is your research going, and what are you finding on this wealth and health intersection?

Dr. Bassett: For our research, we wanted to understand what would happen to mortality for Black Americans if we eliminated the racial wealth gap, which is enormous—an estimated $850,000 per household. If we closed that gap, how would it improve health? So, we had to look at data sets that are longitudinal and that measure wealth, as opposed to just annual income, because it’s wealth (the value of assets minus debts) versus income (think our salaries) that gets us through financial setbacks and cushions us against adversity.

We used two very complex data sets—the Panel Study on Income Dynamics and the Health and Retirement Survey—to measure the potential impacts of a wealth intervention on life expectancy. This analytical part of the research has been completed and findings, while not yet public, suggest substantial mortality reductions using overall mortality and preterm birth as outcomes. Manuscripts will be submitted for peer review and, given that process, we expect papers to appear in the second half of this year.

You’ve used a statistic that says it all in capturing the consequences of structural racism and its impact on health. You write that “if mortality rates of Black Americans were equal to White Americans over the course of the 20th century, there would be 8.8 million more Black Americans alive today.” How can we ensure we’re not saying the same thing 100 years from now?

Dr. Bassett: There is no biological reason why Black Americans should have shorter, sicker lives than White Americans; nor can culture or individual choice account for this disparity. The reason is longstanding racist government policies—from housing to healthcare to employment to criminal justice—that have systematically deprived Black Americans of equal rights, opportunities, wealth, and the basic resources needed to live a healthy life.

Here’s what we in healthcare and public health must do.

First, we must acknowledge the role of healthcare and public health in perpetuating racism—from forced sterilization of Black women to the infamous Tuskegee syphilis study to the exclusion of Black physicians from organized medicine. In addition, we continue to have an unequal healthcare system, in which the public hospitals and clinics that primarily serve Black populations have consistently been underfunded. That must be fixed—and we should push for getting it fixed.

Second, we must participate in local, state, and national conversations on reparations. We know that Black people have been systematically denied the opportunities for good health that White Americans enjoy. We also know that if we close the racial wealth gap and improve access to key resources that influence health, we can expect to dramatically improve the health and life expectancy of Black Americans.

Third, we must focus on health outcomes as a key measure of equity. As I said earlier, for me, eliminating the racial wealth gap is not the end goal. Eliminating racial gaps in health and longevity is the end goal. As long as Black Americans live shorter, sicker lives, equity remains theoretical.

You’re working with a young and dynamic research team on this project to explore this intersection of reparations and health. What have they taught you?

Dr. Bassett: Our team of junior researchers and early career investigators are interested in applying research methods to important societal issues. They view scholar activism as part of their contribution to public health, and they look up to people like W.E B. Dubois. These are people who will apply for NIH grants, but they also want to talk about bigger issues with less certain outcomes.

They come from many universities, including Boston University, Drexel, Duke, McGill, University of Pennsylvania, City University of New York, University of Miami, and Harvard Medical School. They also represent a range of disciplines, including history, health policy, economics, data modeling, epidemiology, sociology, and even philosophy.

Collectively, we call this group the Consortium. It’s about the exchange of ideas and collaboration; it’s not about competition. It’s about articulating obstacles and jointly considering the path forward. And it’s just been wonderful.

At this moment, what gives you hope that we will make progress on this issue and other issues related more broadly to race, health, and equity?

Dr. Bassett: What gives me hope is that there has been progress. We shouldn’t deny that there’s been enormous progress, even though much more remains to be made. The fact that reparations is no longer a fringe issue is inspiring to me.

The other thing that gives me hope, personally, is this wave of early career researchers who are very dedicated to this work, some of whom I’ve been fortunate to work with on this project. Seeing these early career investigators committed to providing evidence for an issue that we agree has moral momentum has been inspiring to me.

In addition, there’s the fact that we in health and public health are a tent under which anyone can gather. Everyone values their health. Perhaps if we framed reparations as something that would not only address the unfair gap in wealth but that would also help us all live long and healthy lives, we could build the support we need.

Learn about the New Jersey Reparations Council where RWJF’s Maisha Simmons serves as a co-director on the Council’s Health Equity Committee and Rich Besser serves as a member of the same committee.

And draw from the experience of reparations and healing in New Zealand by reading an essay by Fabiola Cineas in the Stanford Social Innovation Review and watching a Vox video she narrates—both supported by RWJF.