Monday, April 24, 2023

Keisha Ray's "Black Health"

Keisha Ray received her PhD in philosophy, with a focus on bioethics, from the University of Utah. She is currently an assistant professor with the McGovern Center for Humanities & Ethics at UT Health Houston, where she also serves as the Director of the Medical Humanities Scholarly Concentration. Most of Ray’s work focuses on the effects of institutional racism on Black people's health, highlighting Black people's own stories in Black health discourse, and the sociopolitical implications of biomedical enhancement for marginalized populations. Her work uniquely prioritizes simple language as a matter of access and justice.

Ray applied the "Page 99 Test" to her new book, Black Health: The Social, Political, and Cultural Determinants of Black People's Health, and reported the following:
From page 99:
It is possible that one day we will have definitive scientific evidence for Black people’s heritable predisposition for hypertension. This evidence, however, would have to be tied to ethnicity and ancestry, not race. And heritability would likely prove to only be but one of many factors that influences their higher rates of hypertension. But until this happens, racial myths should not serve as a placeholder for what we do not know. The slavery hypertension hypothesis is another example of scientific racism in which racism, and the idea that Black people are genetically and evolutionary inferior, is used to explain meaningful, but largely social differences between the races. The problem is that scientific racism has been continuously discredited by rigorous research. Yet scientific explanations for poor health outcomes for Black people tend to be used as a replacement for more meritorious social explanations. Resigning to scientific racism instead of social causes also discourages solutions that can address the problem such as policy changes, medical intervention, and public health campaigns. The slavery hypertension myth is another instance of pathologizing Black people and not pathologizing the environments in which Black people live.
The Page 99 Test mostly works for my book. On page 99 there is an example of the entire premise of the book, which is that Black Americans have generally poor health, not because of genetics or biology, but because of racism in our social systems that create unequal access to the social goods people need for proper health. Furthermore, page 99 shows that if we continue to rely on scientific racism, the problem of Black people’s health will not be properly addressed with beneficial social and governmental solutions.

Page 99 gives the specific example of how Black people’s high rates of hypertension is often blamed on Black people’s genetics, an argument which concludes that Black people are predisposed to hypertension based on our enslaved ancestors need to retain water to survive being stolen and transported on slave ships by their White captors. The slavery hypertension hypothesis, however, ignores the research that has dispelled this myth. Additionally, the hypothesis ignores that Black people have high rates of stress related to a lack of social determinants of health like proper housing, education, income, access to clean air and water, among other social determinants of health. Also, Black people who have hypertension often live with other Black people who are subject to the same social conditions, which can create the conditions for many family members to all have hypertension, creating the façade of heritability. But page 99, also suggests that should we find out in the future that there is some biological explanation for Black people’s high rates of hypertension, then we would first have to explain it in terms of ethnicity and ancestry, not race, and secondly, we should be open to amending our views on the topic. But until then we should not rely on false racial myths as a substitute for the unknown.
Visit Keisha Ray's website.

--Marshal Zeringue