By Adam Gaffney
Few now doubt the lethality of inequality. Unequal treatment under the law has resulted in case after case of Black lives lost, whether by gunshot, suffocation, or severed spine.
And yet, as tragic as these individual cases are, the lethality of inequality is a problem that goes well beyond the problem of police brutality. More quietly – if no less painfully – lives are being lost every day as a result of entrenched inequities in health that partition Baltimore neighborhoods like yellow police tape.
This is a story that is increasingly being heard. It’s not a new story, nor is it – sadly – a story that is going away any time soon. But, clearly, taking seriously the mantra that “Black lives matter” means understanding, and tackling, the larger problem of health inequality in America.
“Death is a Social Disease”
This story, to some extent, extends back centuries. Indeed, an understanding that there are socioeconomic disparities in death is one of the oldest lessons in the discipline of public health.
In the early 19th century, for instance, the French surgeon Louis René Villermé demonstrated that the level of wealth of a Parisian neighborhood was a primary determinant of the life and death of its residents, a story told by William Coleman in his “Death Is a Social Disease: Public Health and Political Economy in Early Industrial France.” As Villermé concluded from his extensive, groundbreaking statistical investigation, “wealth” and “misery” were (as quoted by Coleman) among the “principal causes … which must be attributed the great differences noted among the mortality rates” from neighborhood to neighborhood in post-revolutionary Paris.