Obama's 'My Brother's Keeper' initiative, and the limits of racial uplift

This past Thursday, President Obama announced the My Brother’s Keeper initiative, a partnership between the public and private sectors aimed at bettering outcomes for some of the nation’s most at-risk young men.  I of course appreciate what New York Times columnist Charles Blow (and Obama) are emphasizing here, but the materialist part of me gets frustrated with this approach to things. 

The struggles of young black men ultimately don't come down to the lack of hugs from their fathers, though obviously we all need that. Material conditions can facilitate nurturing relationships, and they can undermine them. When one looks to the material conditions under which so many young African-American men live, one finds things that are attributable largely to poverty, and are thus shared by many poor Latino and white kids too. But one also finds conditions that have been uniquely imposed upon blacks in this country, and one must address those too.

If Obama wants to truly address the underlying issues, he would create universal preschool, change the welfare system to directly attack child poverty, desegregate suburban housing and schools along lines of race and class, pump massive resources into inner-city schools, and radically transform our predatory criminal justice system, which does more to destroy the lives of young black boys and their families than any uplift efforts can possibly counter. 

Of course, I know that if Obama had a pliant Congress he actually would do many of these things, so I don't blame him entirely. But there is a danger to having our first black president approach these issues in this way, by essentially containing the problem to the behaviors of black adults, and the institutions in black communities, thereby absolving from responsibility and reparation those public and private institutions that sustain racial inequality and white privilege. On the subject of racial inequality, when something is proposed with which everyone nods in agreement (as appears to be the case here), that probably means it isn't worth much. Bit cynical of me, I suppose.

The real American exceptionalism: our lives are stressful, unhealthy, and short

Back in October 2012, New York Times writer Scott Shane described the idea of 'American exceptionalism' as an "opiate,“ inducing a kind of hubristic national stupor that prevents us from seeing things as they truly are.

The idea that God or history has uniquely blessed the United States, justifying a proselytizing posture toward the rest of the world, is an old one.  It returned to our national discourse in the last couple of years, when conservatives accused President Obama of backsliding in his belief that Americans are the 'chosen people.'

As Shane argued, the idea that American identity is a kind of calling can have positive consequences:  “this national characteristic...may inspire some people and politicians to perform heroically, rising to the level of our self-image."  But it can also be deeply dysfunctional, as politicians of all stripes trip over one another to reassure Americans "that their country, their achievements and their values are extraordinary," while profound problems are left unaddressed.

American patriotism has always -- and uniquely -- had this 'Stuart Smalley' taint to it, but as we collectively whistle through the graveyard of apparent national decline, it seems to have over-ripened a bit.  If John Winthrop's idea of America as the 'city on a hill' drawing the "eyes of all people" was to be more than just an expression of jingoism, it demanded (and demands) a delicate balance between description and aspiration.  When it morphs into mere self-affirmation, however, we Americans become a danger to ourselves -- and to others, who increasingly keep their eyes on us for fear of what might happen if they don't.

Sadly, as a recent international health study bracingly reminds us, most of the ways in which the United States is exceptional today are negative.

The Institute of Medicine just released a study comparing American health care outcomes to other industrialized countries.  And all rhetoric about the U.S. having the 'best health care system in the world' aside, the realities are shocking.  Despite spending far more per capita on health care than any other nation, the data make it abundantly clear that the American way of life has become nasty, increasingly brutish, and comparatively short.

The optimistic takeaway here is that almost everything described below is attributable to (and capable of being ameliorated by) public policy -- in health, but in much broader areas as well.  In other words, if we can once again rediscover our aspirational identity as Americans, change is possible.

Physician Steven Woolf, a professor at Virginia Commonwealth University, chaired the panel that wrote the report.  He and his co-authors were "stunned by the findings."  Americans "have a long-standing pattern of poorer health that is strikingly consistent and pervasive" over a person's lifetime, the study found.

The U.S. is at or near the bottom in virtually every health outcome:  life expectancy, obesity, diabetes, heart disease, and homicide.  We have much higher rates of death before the age of 50, accounting for most of the gap between the United States and our peer nations.

According to the report, most of these poor health outcomes are attributable to poor childhood health.

The USA has had the highest infant mortality rate of any developed country for several decades, due partly to a high rate of premature birth and low birth weight.  Dr. Woolf and his colleagues also note that the U.S. has by far the highest rate of child poverty, though they don't really touch on its role as a possible cause. 

Here is a graphic representation of the infant mortality gap:

This gap, interestingly, has a history.  

The gap between the United States and its peer nations was relatively wide in 1950s and early 1960s, and then rapidly closed.  Why did it close, and so quickly?  Policy -- the 'War on Poverty,' including Medicare/Medicaid, among other programs, which for the first time began to connect millions of Americans to the health care system (and to food) on a relatively consistent basis. 

And then, right around 1980, the gap re-emerged.  This coincided, not surprisingly, with Reagan-era cuts in public health and social programs; but it also coincided with an ongoing increase in economic inequality and insecurity.  Since 2000, the gap between the U.S. and its peers has expanded.  While infant mortality rates among African-American and Hispanics are high, this doesn't explain the gap -- white Americans have higher comparable rates as well.

In short, while we have continued to make progress over the past two decades, our peers have had much greater success:  “although U.S. infant mortality declined by 20 percent between 1990 and 2010,” the report notes, “other high-income countries experienced much steeper declines and halved their infant mortality rates over those two decades.”

The report doesn't really offer any explanations for the infant mortality gap, or for the poor health performance of the U.S. more generally, beyond behavioral factors like drug abuse, calorie consumption, not wearing seat belts, and the ubiquity of handgun violence.

I'm not a health expert, but I do think we need to consider one factor:  inequality.

While economic inequality within nations wasn't the focus of the Institute of Health report, we know from research by epidemiologists Richard Wilkinson and Kate Pickett that it strongly correlates with (and is reproduced by) health outcomes -- such as infant mortality (see above).

This is true in two senses.

First, nations with higher rates of economic inequality tend to have poorer health outcomes across the class structure -- in other words, while health outcomes are better the richer or more educated one is, they will still be lower than those of comparably placed people in more equal countries.  The Institute of Health report confirms this.

Second, economic (and educational) inequality and health outcomes are strongly correlated within societies.  In the U.S., life expectancy for white women without a high school diploma is 73.5 years, compared with 83.9 years for white women with a college degree or more.  For white men, the gap is even larger: 67.5 years for the least educated white men compared with 80.4 for those with a college degree or better.

Because the United States is drastically more unequal than any other comparable nation, the socio-economic gradient is much sharper here -- and its getting worse.  Indeed, we now have evidence that the life span of the least educated white Americans has actually contracted, falling a full four years since 1990.  The numbers are worse for women.  Some of this is attributable to changes in the labor market:  the share of working-age adults with less than a high school diploma who did not have health insurance rose to 43 percent in 2006, up from 35 percent in 1993.  While full implementation of the Affordable Care Act in the coming years may help somewhat, the deeper problems of rising inequality and economic insecurity -- and the debilitating stress and anxiety that accompany them -- remain.

Poor health outcomes, as well as inequality, are greatly exacerbated in the U.S. by our social geography, and its intersection with the nation's original sin of race.  American metropolitan areas have become increasingly segregated by income over the past two decades.  We don't yet have a full picture of the health consequences of this trend, though it certainly is both a cause and a consequence of growing inequality during the same period.

But we do know the health consequences of America's stubbornly persistent pattern of racial segregation.  African-Americans not only have poorer health outcomes than whites overall; this is true even when income and education are held constant.  More than 100 studies over the past decade confirm that racism acts as a classic chronic stressor, with serious physiological consequences: higher blood pressure, elevated heart rate, increases in the stress hormone cortisol, suppressed immunity.  Chronic stress is also known to encourage unhealthy behaviors, such as smoking and eating too much, that themselves raise the risk of disease.  Most of these investigations have been done in the United States, but a growing body of literature originates elsewhere.  "Across multiple societies, you're finding similar kinds of relationships," David Williams, a sociologist at the Harvard School of Public Health, told the Boston Globe.  "There is a phenomenon here that is quite robust."

Racism also appears to have an impact on fetal and infant health, setting off a likely cascade of negative consequences.

Epidemiologists James W. Collins, Jr. and Richard J. David have uncovered a disturbing fact:  American-born black women are significantly more likely to have low birth weight babies than white women are, regardless of income level or education.  The cause, they argue, is steady and life-long exposure to racism and its consequences.  Since low birth weight correlates strongly with poor health (and educational) outcomes later in life, the relationship between race, place and health is clearly a big factor in the reproduction of racial inequality in the U.S.

This relationship has been confirmed more recently in a widely publicized study in the January 2013 issue of the Journal of the American Medical Association, on racial segregation and lung cancer.  After controlling for income and smoking rates, Dr. Awori Hayanga and his colleagues found that lung cancer mortality rates (a ratio of deaths to a population) were about 20 percent higher for blacks who lived in the most segregated American counties, than for blacks living in the least segregated counties.  The more segregated the community, the higher the mortality rate for blacks -- and, disturbingly, the lower the rates were for whites.  They surmised that differential access to health insurance and relevant and timely treatment were largely at fault.  The research of Collins and David also directs us towards the stressors of racism itself, which are in part rooted in America's unequal racial geography.

“If you want to learn about someone’s health, follow him home,” Dr. Hayanga, a heart and lung surgeon at the University of Pittsburgh Medical Center, told the New York Times.   This message -- about the relationship between place, health, and inequality -- was perhaps most powerfully conveyed for an American popular audience by the award-winning documentary Unnatural Causes.

In other words, our unequal and insecure American way of life is making us sick -- and more unequal.

While the mechanisms that connect inequality with poor health outcomes are many and hard to disentangle, it seems clear that stress and insecurity are critical.  Both affect the cardiovascular and immune systems, and both are found in abundance and in greater numbers in unequal societies -- and their effects are devastating on the young in particular.

Thomas McInerny, president of the American Academy of Pediatrics, reacted to the Institute of Health study by pointing to recent research on the long-term impact of "toxic stress" on the health and cognitive development of babies and toddlers.   "It's becoming increasingly clear that the first 1,000 days of life are critically important for children's development, and can determine the course of their life span from then on," McInerny says. "Investing in children in the first three years of life provides higher returns, for improving their productivity as adults, compared to intervening later."

Back in 2007, UNICEF put together an index of child well-being.  It measured material and educational factors, health and safety, peer and family relationships, surveys of subjective well-being, and behavioral risks.  When Wilkinson and Pickett lined this index up with rates of income inequality, they found something striking:  the more unequal a society is, the worse its rates of child well-being -- not just among poor children, but overall:

These correlations and comparisons make one thing clear:  America's poor health outcomes, particularly for our children, can be ameliorated.  Why?  Because the differences between the U.S. and its peers, ultimately, are policy differences -- and thus are amenable to collective action.  We can make America healthier (and more productive) by making it less unequal, and by investing in pre-natal care, early childhood health, and high quality and universal pre-school.  "We already know what to do," Dr. Woolf says. "It's more a matter of having the resolve and resources to actually do it."

Notwithstanding the false scarcity of our current austerity politics, we have the resources.

Notwithstanding the libertarian and narcissistic braying of the privileged, our well-being is ultimately inseparable from that of our fellow Americans.

Whether we have the resolve to see this will ultimately determine whether the term 'American exceptionalism' serves to damn or praise our national experiment.

George Romney Knew Better: Educational Inequality and the Continuing Significance of Racial Segregation

Nationally, black and Hispanic/Latino public school students are now more segregated from whites than at any point in the last four decades.  Most policymakers and activists on all sides accept the fact that our metropolitan areas are segregated by race as well as class, and work within its confines.  In this age of greatly diminished expectations – the ‘twilight of common dreams,’ as Todd Gitlin once put it – it is assumed either that these patterns aren’t terribly important, or that the practical and political obstacles to changing them are too overwhelming.  Today, Democrats and Republicans alike unashamedly promote efforts to “gild the ghetto” with charter schools that are more segregated than regular public schools, and with compensatory education programs that have little chance of truly compensating. But the black-white academic achievement gap is unlikely to narrow much further without revisiting the imperative of residential integration in our metropolitan areas.  By ignoring segregation, we thrust the entire burden of our unjust social geography on urban and high poverty schools, leaving white and privileged suburbs untouched.

However, as Richard Rothstein and I argue in "The Cost of Living Apart," in the September/October 2012 issue of The American Prospect, it wasn’t always this way.  From the mid-1960s to the mid-1970s these geographical inequalities were very much a part of our public discourse.  As Secretary of Housing and Urban Development (HUD) during Richard Nixon’s first term, Republican George Romney – Mitt’s father -- led an ultimately unsuccessful crusade to use the power of the federal purse to ‘loosen the white noose’ and open up the suburbs along lines of race and class.  He believed that racial inequalities in education and opportunity could not be overcome any other way.  Forty years on, it seems clear that George was right.  Unfortunately, as the Democratic and Republican National Conventions near, it appears that neither party is willing to take up the banner of racial integration.

Racial segregation matters -- in Providence and elsewhere

As Rothstein and I discuss in the longer paper on which our American Prospect article is based, social scientific research on school segregation is quite clear.  Geographically concentrating poor black and Latino children – as we do in the Providence metropolitan area, and throughout the United States -- is harmful.  Integration, on the other hand, is beneficial.  Because black and Hispanic children in Providence and elsewhere are much more likely to be poor than white children are, racial segregation not only isolates them – it compounds the negative consequences of poverty, by concentrating it geographically. 

While we have much more research on the consequences of racial segregation for blacks than we do for Hispanics, both groups are clearly segregated here – in Providence, and in the metropolitan area as a whole.  This is one of the ten most segregated cities in the country for Hispanics.  In the Providence-Fall River metropolitan area, according to the U.S. Census, Hispanics have a ‘dissimilarity index’ of just over 70.7%; the index for the smaller black population is 65.5.  

What does this mean?  This means that 7 out of 10 Hispanics (and almost that many blacks) in greater Providence would have to move, in order to achieve an integrated pattern.  The dissimilarity index for Hispanics is slightly lower for Providence, 57.6%.  But all this tells us is that Rhode Island’s Hispanic population is heavily concentrated in the Capital City – and segregated within it.  The average Hispanic resident of Providence lives in a neighborhood made up 45.3% of other Hispanics, despite being just over 30% of the city’s population. 

While approximately half of the residents of Providence are white, the school age population is overwhelmingly Latino and black -- 84%, according to the latest RI KidsCount Factbook.  There are many reasons why this might be the case, some of them innocent and easily explained.  But the lack of affordable housing in the suburbs, due in large part to exclusionary zoning, is clearly a major factor trapping low and moderate income Hispanics and blacks in Providence.  Because of this, and because most public school children attend neighborhood schools, one consequence of the residential segregation of blacks and Latinos is school segregation.  26.4% of Hispanic public school students in Rhode Island, for example, attend extremely segregated schools (those with a 90-100% minority student body).

Combine this with Providence’s high rates of child poverty – among the worst in the nation for two decades now – and it should be abundantly clear that segregation matters.  Hispanic and black children in the Providence area (and nationally) are not only three times more likely to grow up in poverty than white children are; they are much more likely to live in predominantly poor neighborhoods and attend high poverty schools, even when they themselves aren't poor.  Nearly four in ten black and Latino children in Providence grow up in poverty.  As a consequence the average Hispanic primary school student in the Providence metropolitan area attends a school with a poverty rate of just under 75%.  The numbers are comparably stark for black students.  For whites, who are disproportionately found in suburban schools, its 32.1%.  Just 4% of students in Barrington's public schools live in poverty.

Politicians and experts typically refer to schools as “failing” if they are filled with poor children who don’t do well on high-stakes tests.  Faced with the obstacles posed by racial segregation and geographically concentrated poverty, however, such schools may be doing as well as they possibly can.  

Black and Latino children from poor Providence families disproportionately suffer from poor health, which causes frequent school absences.  A higher percentage of Providence school children changed schools during the 2010- 2011 school year than any other district in the state. During that time period, one in four (25%) Providence children changed schools, compared to the state rate of 14%.  Providence also has a very high rate of chronic early absence, the percentage of children in kindergarten through third grade who have missed at least 10% of the school year (i.e. 18 days or more). During the 2010-2011 school year, more than one in five (22%) Providence children in grades K-3 were chronically absent.  Children from poor families are much more likely to suffer from financial crises causing repeated household moves that result in changes of teachers and schools, with a resulting loss of instructional continuity.  

Poor children are also more likely to be living in communities with high levels of crime and disorder, and to have parents who are incarcerated (or whose employment prospects are greatly limited by prior imprisonment).  Recent scholarship also indicates that children growing up in poverty experience high levels of stress at young ages, which not only affects their health -- it shapes their cognitive development too.  Poor black and Latino students in Rhode Island on average attend low-performing high schools (according to test scores), where schools spend more time on discipline and 'teaching to the test' and less on instruction, while white students mostly attend high-performing high schools.  Poverty and inferior educational opportunities combine to drive blacks and Latinos out of high school at rates higher than that of white students, increasing the chances that their own children will grow up in poverty too.  

Children stuck in high poverty schools -- who are, again, disproportionately black and Hispanic -- are often isolated from the positive peer influences of middle-class children who were read to frequently when young, whose homes are filled with books, whose adult environment includes many college-educated professional role models, whose parents have greater educational experience and the motivation such experience brings and who have the time, confidence, and ability to monitor schools for academic standards.

Recent research confirms that integration not only benefits black students but also does no harm to white classmates, provided the concentration of disadvantaged children is not great enough to slow the instructional pace or deflect time from academics to discipline. When children whose parents have strong educational backgrounds comprise a strong classroom majority, all students benefit from the academic culture established by that majority. Integration is no panacea, but without it other reforms to raise the achievement of disadvantaged children have less promise.

 George Romney understood this.

Back to the future:  George Romney and the 'white noose'

The Civil Rights Act of 1968 – the Fair Housing Law – was passed in the waning days of the Johnson Administration.  Its language was ambiguous.  It could be interpreted narrowly, as a prohibition against racial discrimination.  Or, it could be seen as requiring HUD to ‘affirmatively promote’ racial and economic integration across the metropolitan landscape.  Recognizing the role that government at all levels had played – and continued to play – in the racial segregation of American cities and suburbs, George Romney chose the latter interpretation.  Federal policy, suburban zoning laws and discrimination by realtors and the financial sector had “built a high-income white noose basically around these inner cities, and the poor and disadvantaged, both black and white, are pretty much left in the inner city,” he told Congress.”  His 1968 campaign book, The Concerns of a Citizen, urged “we must have open housing on a statewide basis; eliminate zoning that creates either large-scale economic or racial segregation; provide low-cost private housing through nonprofit organizations in all parts of the metropolitan area and throughout the state.” 

During his first 18 months in office Romney quietly developed a series of programs and proposals that put HUD (and Nixon) on a collision course with metropolitan segregation – and those who preferred to leave it untouched.  The latter group included the increasingly suburban base of the Republican Party. 

Operation Breakthrough was designed to build low and moderate-income housing in the suburbs.  While it wasn’t aimed at racial integration, Romney intended to use HUD funding to either entice or coerce suburbs into revoking their exclusionary zoning laws.  Open Communities, however, was directly aimed at the racial integration of the suburbs.  Hidden even from the White House, by the summer of 1969 Romney and his staff had taken a full inventory of all federal programs that could be used to open the suburbs, and had even draw up a list of possible target areas.

They were deeply critical of the failures of their predecessors.  The Kennedy and Johnson Administrations, despite all of their rhetoric, “lacked the political fortitude to deal with urban problems on a metropolitan-wide basis,” wrote Under Secretary Richard Van Dusen in an internal policy memo in the fall of 1969.  Instead, “they poured large amounts of money into the ghettos.”  “The white suburban noose around the black in the city core is morally wrong, economically inefficient, socially destructive, and politically explosive,” one staffer wrote to Romney in August 1969.  What was needed was a “frontal assault on suburbia.”  Using the carrot – the promise of federal funds – HUD began to put both programs into practice during the first six months of 1970.  Romney went to Congress in May 1970 to get legislative authority to use coercion (‘the stick’) as well.

George Romney was no lone crusader.  Indeed, it is a sign of how far even liberals have strayed in the 21^st century from the dreams of the civil rights movement, that questioning metropolitan segregation was quite common among Republicans as well as Democrats in the 60s and early 70s.  President Johnson was somewhat vexed by the fact that each urban, suburban and educational task force he appointed in his second term seemed to call for metropolitan desegregation, even as he was casting about for alternative and more politically viable approaches to the urban crisis.  This included the famous Kerner Commission, which in 1968 called for the integration of “substantial numbers of Negroes into the society outside the ghetto,” through the reorientation of federal programs and the placement of low and moderate-income housing in the suburbs.  Failure to do so would condemn blacks to a “permanently inferior economic status,” rendering the U.S. “two nations, separate and unequal.”

Angered at Romney’s secrecy, and under increasingly intense pressure from suburban officials, Nixon made his position explicit in a series of statements between December 1970 and June 1971, declaring his belief that the federal government did not have the legal authority to ‘force’ racial and economic integration of the suburbs.  While he would enforce non-discrimination law, he insisted that racial segregation in the suburbs was a byproduct of economic considerations, not discrimination.  Privately, he even considered introducing a constitutional amendment banning federal efforts to force educational and residential integration.  Romney was pushed out after the November 1972 election.  “Nixon’s policy,” according to Charles Lamb, who served on the U.S. Commission on Civil Rights in the mid-70s, “was consciously designed to protect the status quo, to shield suburbs from economic, and thus racial, integration.  Its political intent was to preserve the Republican political base for years to come.”

Federal urban policy since then has focused primarily (and weakly) on improving the quality of ghetto neighborhoods (and their residents) by devolving resources and power to municipal authorities, public-private partnerships and Community Development Corporations (CDCs), not on the forces that create and sustain metropolitan inequality.  Particularly since 1980, federal and local governments have embraced an ideology of market accommodation in policy making that emphasizes privatization, decentralization, economic competitiveness, and creating a favorable ‘business climate.’  National policymakers in both parties have continued to deploy the rhetoric of decentralization and localism – for education, as well as urban policy more generally.  This approach enjoys support from free-market advocates on the right as well as community-based activists on the left.  Politically, it has granted both political parties a kind of cheap policy grace, presenting the appearance of doing something about poverty and urban problems, but without the political and economic costs that confronting metropolitan segregation, economic insecurity and an underfunded and inadequate welfare state would actually entail.  The social consequences of this persistent localism have been profound, setting in motion a kind of “feedback loop” that reinforces patterns of place-based racial and economic inequality.

Despite the growing ideological divisions of our age, there has been a surprising political convergence on issues related to urban policy, social services, and housing.  From the spread of charter schools, to the expansion of home ownership through financial deregulation, it is apparent that left and right agree on much more than is commonly assumed.  Virtually all of these points of agreement either hide or exacerbate racial and economic segregation, or geographically concentrate its deleterious consequences.  In many ways the Obama Administration’s embrace of urban charter schools, school choice, and the use of market models for the assessment of students, teachers and schools, is emblematic of this convergence.  Despite a lack of evidence of their efficacy, and growing empirical support for the integration of schools by class as well as race, the ‘achievement gap’ is virtually never discussed in terms of the intersection between inequality and social geography.

George Romney understood that there is little chance we can substantially narrow the achievement gap without breaking up heavy concentrations of low-income minority children in urban schools, giving these children opportunities to attend majority middle-class schools outside their “truly disadvantaged” neighborhoods. But urban children cannot have a practical opportunity to attend such middle-class schools unless their parents have the opportunity to live nearby.