‘E Pluribus Unum’ Is a Cruel Mirage
(Bloomberg Opinion) -- Anyone who navigates America’s socioeconomic data is accustomed to charts that break out the country’s general population into its component racial and ethnic groups.
More often than not, the disparities illustrated are startling.
For instance, although in 2016 America’s national infant mortality rate was 5.9 per 1,000 live births, the rate for non-Hispanic Black people was 11.4 — which is more than double the rate for non-Hispanic White people (4.9), and more than triple that of Asian Americans (3.6).
Less often visualized is how these disparities stack up internationally. In many cases, the domestic divisions within the U.S. are so great as to render America’s various racial and ethnic groups as distinctly as separate countries.
Charted below are six data sets that track the human journey from cradle to grave. They illustrate the very real, inherently interconnected, and profoundly consequential impact of race and ethnicity on the American dream.
Some notes on the data: First, although where possible the U.S. data are taken from a single official source, agencies vary in how they report racial and ethnic groups. Second, international organizations, such as the Organization for Economic Cooperation and Development, aggregate data from national sources with divergent reporting schedules and methodologies. Third, I have occasionally eschewed the most recent data in favor of slightly earlier figures when, as with infant mortality, they are more complete or when, as with unemployment, they represent more stable pre-coronavirus trends. Fourth, I have tried to select countries that shed light on the U.S. data, either because they are economically similar, or because they represent illuminating outliers. So some of these charts may best be read as broad-brush indicators rather than exact comparisons.
The infant mortality rate is the number of deaths before the age of one year, for every 1,000 live births. Because such deaths are influenced by a broad range of socioeconomic factors — health care, income, diet, education, housing, pollution, sanitation, etc. — the U.S. Centers for Disease Control and Prevention calls the rate “an important marker of the overall health of a society.”
As the chart below illustrates, U.S. non-Hispanic Black infant mortality in 2016 was 16 times that of Iceland, worse than Turkey and only marginally better than Mexico. In comparison, U.S. Asian infant mortality was lower than Canada and the U.K., and on a par with Switzerland.
The United States ranked 13th out of 76 international education systems in reading literacy, according to the latest (2018) triennial survey of 15-year-olds’ educational abilities by the OECD’s Program for International Student Assessment.
PISA defines reading literacy as “students’ capacity to understand, use, evaluate, reflect on, and engage with texts in order to achieve one’s goals; develop one’s knowledge and potential; and participate in society” — all of which are clearly prerequisites for advancement in a highly technical world.
However, as the chart below demonstrates, international comparisons with the U.S. cohort are striking. U.S. Asian students topped the global ranking — outperforming even Singapore and China (as represented by the provinces Beijing, Shanghai, Jiangsu and Zhejiang). In contrast, U.S. Black students, ranking between Chile and Serbia, were 39 points below the OECD average, and 108 points below U.S. Asian students. These figures are even more remarkable if you consider that just 215 points differentiate the highest-scoring country, China (555), and the lowest, the Philippines (340).
The impact of Covid-19 on unemployment in America (and many other countries) has been so dramatic that the spike is likely to be a y-axis landmark on fever charts for generations to come.
In December 2019, before the pandemic hit, U.S. unemployment was at a 50-year low of 3.5% — 2.5% for Asians, 3.2% for White people, 4.2% for Hispanics and 5.9% for African Americans. In April 2020, the unemployment rate rocketed to 14.7% — 14.2% percent for Whites, 14.5% for Asians, 16.7% percent for African Americans, and 18.9% for Hispanics.
Although the latest June jobs report offers glimmers of hope — the unemployment rate fell to 11.1% and the number of those on temporary layoff fell by 4.8 million — the number of permanent job losses continued to grow, increasing by 588,000 to 2.9 million.
Because of such whiplash fluctuations — and because governments around the world are experimenting with complex job-protection and furlough schemes — I have illustrated the racial and ethnic inequalities within American unemployment using the annual international rates for 2019. That year, unemployment for Asian Americans was on a par with Japan, whereas U.S. Black people or [j1] African Americans had an unemployment rate similar to Lithuania.
The percentage of Americans without any form of health insurance has fallen in recent years — from 15.4% in 1997 to 9.4% in 2018 — thanks in great part to the 2010 Affordable Care Act.
That said, the risk of inadequate or nonexistent access to healthcare remains high and falls unequally across race and ethnicity. In 2018, 30.4 million Americans were uninsured: 8.1% of Asians, 9% of non-Hispanic Whites, 15.2% of non-Hispanic Black people, and 26.7% of Hispanic or Latino persons.
Sadly, Covid-19’s impact on unemployment will likely threaten what advances in coverage have been made in recent years, since more than half the U.S. population receives health insurance through an employer. This conjunction, in turn, is likely to affect both the number and social impact of Covid-19 fatalities since, as the CDC notes, “age-adjusted hospitalization rates [for Coronavirus] are highest among non-Hispanic American Indian or Alaska Native and non-Hispanic black persons, followed by Hispanic or Latino persons.”
The precarious healthcare of so many millions of Americans comes into sharper focus when set against other advanced economies where the risks of being uninsured or suffering “medical bankruptcy” simply don’t arise.
America’s obesity epidemic is well known. According to the CDC, from 1999-2000 through 2017-2018, the age-adjusted prevalence of obesity (defined as a Body Mass Index ≥ 30) leapt from 30.5% to 42.4%, and severe obesity (BMI ≥40) from 4.7% to 9.2%.
Less well known are the social, economic, market and psychological forces that contribute to this epidemic — from the impact of income, education and pollution to the promotion of junk food and the prevalence of food deserts. Dismissing obesity as poor choices made by poor people makes little sense if President Donald Trump himself is obese. Furthermore, similar forces seem to be at play in America’s contrapuntal nutrition crisis: In 2018, some 37 million Americans went hungry, and 14.3 million households suffered food insecurity.
According to 2016 World Health Organization data, America is the 12th most obese country in the world, below an archipelago of Pacific Island States and Kuwait. Within this ranking, however, America’s racial and ethnic divisions are stark: Non-Hispanic Asians (25% less obese than the domestic average) rank better than Switzerland; whereas non-Hispanic Black women (14.5% more obese than the domestic average, and the heaviest U.S. cohort) rank just below the most obese country in the world, Nauru — which the BBC called “a speck in the Pacific about 3,000 km northeast of Australia with 10,000 citizens and little economy.”
Such troubling statistics have recently acquired additional urgency, as links emerge between rates of obesity and hospitalizations for Covid-19.
Life expectancy for all Americans has, unsurprisingly, improved over the generations — especially for women. A boy born in 1900 could expect to live until 46.3, and a girl to 48.3; by 2017, these had leapt to 76.1 and 86.1, respectively.
Although racial inequalities in American life expectancy have also improved over the years (to the extent that the data are comparable), they remain significant. A White child born in 1900 could expect to live to 47.6, and a non-White child to 33 (a gap of 14.6 years); in 2017, a White child could expect to live until 78.8, and a non-Hispanic Black child to 74.9 (a gap of 3.9 years). (The term “nonwhite” is itself interesting: until 1970, official U.S. data counted only “whites” and “others.”)
In 2017, the average Hispanic boy could expect to live to 79.1, and girl to 84.3; compare this to 76.4 and 81.2 for Whites, and 71.5 and 78.1 for non-Hispanic Black people.
America’s domestic disparities are further illuminated when set against an international backdrop. As the chart below shows, whereas U.S. Hispanics live longer than Brits or Germans, non-Hispanic Black men have a lower life expectancy than the average Latvian or Russian person. U.S. Black men, however, do have a higher life expectancy than Russian males (67.5 years).
From birth to death, and at every stage of life therein, an American’s race and ethnicity will help define which America they inhabit: one of the most advanced countries, or one still struggling with development.
This column does not necessarily reflect the opinion of the editorial board or Bloomberg LP and its owners.
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