STUDY IN JAMA NETWORK OPEN LINKS RACIAL WEALTH GAP TO HEALTH INEQUITIES

BOSTON, MA – For years, public policy makers have recognized that, on average, Black Americans have significantly less wealth than White Americans and die earlier, and they have grappled with a simple question: what could close the wealth and longevity gaps?

Now, top researchers from Harvard Medical School, the University of Pennsylvania, Johns Hopkins University, Drexel University and Duke University have an answer. After analyzing longitudinal wealth and health data for 33,501 Black and White middle-aged Americans for up to 26 years in a government Health and Retirement Study, the comprehensive data points to reparations as an intervention that can begin to balance the scales.

In a newly published study in JAMA Network Open, the researchers conclude that providing reparations to Blacks would help close the wealth gap and, in turn, reduce the health and longevity gaps that currently exists with Whites. Specifically, researchers concluded that reparation payments could “substantially narrow” racial inequities in mortality.

Researchers noted that the median life expectancy of Black participants in the study was 77.5 years, four years shorter than the life expectancy of 81.5 years for White participants, a difference that “reflects the pervasive effects of structural racism,” they noted. Meanwhile, on average, in 2019, White households had a mean wealth of $980,549, or six times more than the mean wealth of $142,330 in Black households.

They concluded that the wealth gap accounts for a “considerable portion of these inequities in survival.”

Researchers wrote that few studies have studied the role of wealth in racial health inequality, and they projected the effect of equalizing wealth through reparations payments, concluding that differences in wealth accounted for much of the life expectancy gap.  In their analysis, they indicate that fully closing the wealth gap would nearly equalize the chances of dying between Whites and Blacks, decreasing the current racial inequity in life expectancy.

“Many health workers are aware of the deadly impacts of racism on health for Black people, but few have supported reparations as a remedy,” said Dr. Michelle Morse, a co-author of the study and internal medicine physician and Assistant Professor at Harvard Medical School. “This research makes it clearer than ever for the medical and public health community to consider reparations as a remedy to advance racial justice and health equity.”

The data, rarely available in health studies, includes net value of investments, housing equity, vehicles, and other assets. Researchers sought to identify existing health disparities and the potential health effects of a significant wealth transfer to Blacks.

“Wealth may improve health through stable access to health care, housing, food, and education, while offering protection from chronic stress associated with economic uncertainty. Parental wealth plays a key role in children’s educational and economic opportunities,” the report says, adding that transferring wealth to Black Americans would “likely” aid historically Black universities, colleges, and hospitals, as well as offering possible “psychological benefits” for recipients.

“Our study demonstrates a reparations plan that raised Black net worth sufficiently to eliminate the racial wealth gap for Black American descendants of U.S. slavery would lengthen Black lives dramatically,” said Dr. William Darity Jr., professor of Economics, African and African American Studies at Duke University, and a co-author of the study.

Key findings include:

• Among the research subjects, whose average age was 59 at the outset of the study, the odds of dying for Blacks was 26% higher than for Whites, equivalent to 4.0 fewer years of remaining life expectancy.
• After adjusting for differences in wealth, survival did not differ significantly by race.
• Payments to close the mean racial wealth gap were associated with significant-to-complete reductions of the difference in life expectancy.

“Our findings add to the compelling moral case for reparations,” said Dr. Kathryn Himmelstein, a study co-author and infectious disease fellow at Harvard’s Massachusetts General and Brigham and Women’s Hospitals. “Compensating Black families for the economic legacy of slavery and discrimination would do more than heal their finances – it would improve their health and add years to their lives.”

Some activists and scholars have long advocated reparations for Black Americans as compensation for the racism that began with slavery and continued with Jim Crow laws, New Deal programs that initially excluded many Black Americans, housing policies that limited Black families from gaining intergenerational wealth, and other racist government policies and practices. Reparations advocates point to historical precedents like the U.S. government’s payments to previously interned Japanese Americans and Germany’s payments to Holocaust survivors. Poll data from 2021 suggest 36% of all Americans, including 86% of Black Americans, support reparations (up from 15% of Americans in 2014), and 196 members of Congress have signed on to a bill that would establish a federal commission to study reparations.

But the study’s authors cautioned that reparations payments “would not fully address structural determinants of health that would continue to be operative, such as political power, social capital, incarceration, policing, and discrimination in health care.”

Long-term solutions would need to include “eliminating ongoing practices that harm Black households, such as discriminatory lending and disproportionate burdens of penalties and fines,” researchers wrote.

Researchers also recognized the findings “merely document the association between wealth and survival, and any causal interpretation rests on the unproven assumption that greater wealth improves health.”

In conclusion, grappling with this issue, researchers concluded: “Racism harms the health and well-being of Black individuals through multiple mechanisms. Our study explores the importance of one mechanism—wealth inequality—through which past and present racial injustices increase mortality. Reparations payments are a means to redress the harms of enslavement and other racist policies and practices. Our study explores the importance of one mechanism—wealth inequality—through which past and present racism is associated with increased mortality.”