Expose white people to the life conditions of poor black folks and Latinos, and their state of health declines tremendously and in life-threatening ways.
This was one of several startling conclusions in a study released on Monday by the U.S. Centers for Disease Control and Prevention at the International AIDS Conference in Vienna that looked at race, poverty and HIV among heterosexuals in 23 poor inner-city neighborhoods in the United States.
The study found that when other racial ethnic groups are confronted with the same social and economic conditions faced by black Americans — social determinants of health, in public-health lingo — their HIV risk soars. The HIV rate among whites skyrocketed more than seven times from 0.23 to 1.7 percent, startlingly close to the 2.1 percent HIV rates faced by blacks and Latinos in these neighborhoods. Welcome to our America.
The study included black, Hispanic and white heterosexuals who are not intravenous-drug users or prostitutes in 23 cities, living in neighborhoods disproportionately impacted by both poverty and HIV. Seventy-seven percent of the participants were black, 15 percent were Hispanic, 4 percent were white and 3 percent represented other races. The majority of the residents in the communities surveyed were black.
Some media organizations have looked at these data and have erroneously concluded that race is not a factor in HIV transmission. This is a false analysis and an absurd and dangerous conclusion. The point is not whether race or poverty matters; the point is that race and poverty matter. Black people are disproportionately affected by HIV/AIDS. This research tells us that one of the reasons is that so many of us are poor or extremely poor. In fact, study participants whose household income was $10,000 per year were seven times as likely to have HIV as those whose household income was $50,000.
A 1999 study, partially funded by U.S. Department of Agriculture, reported that nine out of 10 black Americans who reach age 75 spend at least one of their adult years in poverty. By age 25, the findings show, 48.1 percent of black Americans have experienced at least one year in poverty. By age 40, the number grows to two-thirds, and to more than three-fourths by age 50. More than 90 percent will have lived below the poverty line by age 75. Poverty is defined as a family of four having a household income of less than $20,650 per year.
But even money does not protect black people from HIV/AIDS. More than any other racial or ethnic group, our sexual relationships cross socioeconomic lines. Moreover, a large body of research shows that even black people with insurance and high income are more likely to experience poor health than their similarly situated white peers. Whether they seek care for heart disease, cancer or even a heart transplant, they, like their low-income black counterparts, cannot escape structural determinants of health reflected as racism in medicine. Making matters worse, racism itself contributes to poor health and early death.
So does poverty matter? Of course. But to pretend that race is not a huge factor affecting who is poor in America is naive at best and maliciously racist at worst. The fact that virtually every black American will experience poverty at some point during his or her adulthood speaks volumes about AIDS in America.
Phill Wilson is the president and CEO of the Black AIDS Institute, the only national HIV/AIDS think tank in the United States focused exclusively on black people. He can be reached here.