Why Building Black Wealth is Key to Health Equity

This post was originally published on the Robert Wood Johnson Foundation’s Culture of Health Blog.

To dismantle structural racism, says a renowned economist, our nation needs a new narrative—and systems and policies that advance racial and economic justice.

Darrick Hamilton, the Henry Cohen Professor of Economics and Urban Policy at The New School, has gained national recognition for shaping policy solutions to close the racial wealth gap, which refers to how hundreds of years of structural racism have deprived Black families of resources that accumulate and transfer from one generation to the next. The typical White family has 10 times the wealth of the typical Black family and seven times the wealth of the typical Latinx family. This stark and persistent racial wealth gap has harmed generations, driven disparities and appears to be growing, even after controlling for household characteristics and long-term education and income gains by Black people.

Hamilton’s early experiences provided an ethical orientation toward justice that shaped his career as an economist. Growing up in Bedford-Stuyvesant while attending the Quaker-run Brooklyn Friends School exposed him to two worlds in which fundamentally similar people experienced markedly different life trajectories—primarily due to one group benefitting from greater resources than the other.

In this Q&A, he shares powerful insights on the impact of the racial wealth gap, strategies to address it, and reflections on how events of the past year are shifting narratives and providing hope for change.

What impact does the racial wealth gap have on health?

The racial wealth gap has a clear and direct impact on health. The wealth position a child is born into will shape opportunity, outcomes and health throughout life. Adults living in poverty are more likely to be uninsured and forgo medical care due to concerns about cost, missing work, or finding affordable childcare. While medical debt is the number one reason for bankruptcy, those with wealth have access to resources that support health and can pay for expensive health interventions.

The racial wealth gap is also part of the reason the COVID-19 pandemic drove down life expectancy for Black and Latinx people in the United States, even more than for those who are White. White people in America were better resourced and had greater agency to withstand the pandemic’s effects than Black, Native American and Latinx workers.

What many don’t consider, however, is the everyday stress of living paycheck to paycheck without the benefit of a nest egg to buffer against an unexpected event. Adding to this stress is the psychological burden of race-related stressors tied to every transaction for Black people.

How does the ‘American Dream Narrative’—which centers personal responsibility—harm communities of color and the nation as a whole?

The nation’s dominant narrative, which states that people can achieve the American Dream of economic success through resilience and grit and by taking personal responsibility, causes great harm. We have stigmatized poverty with racist and misogynistic language such as “welfare queens and deadbeat dads,” instead of acknowledging our history. This narrative perpetuates White privilege and tells those in stigmatized groups that opportunity is there if they seize it and work twice as hard.

Working twice as hard to overcome systemic and structural barriers harms health. Evidence shows how disparities in health outcomes increase with education and income, which contradicts a narrative that emphasizes personal responsibility and hard work.

For example, racial differences in infant mortality actually worsen with higher levels of both education and income. It’s clear that the stigma and burden of overcoming racist structures leads to pernicious health consequences.

Are there solutions to counter this narrative and address the racial wealth gap?

We must move away from incentivizing people to adopt attitudes, norms, and behaviors largely considered beneficial and instead empower them with resources that provide agency to achieve success. And we must recognize government’s responsibility to ensure access and adequate wealth.

To address this, the two anti-racist policies I support are reparations and baby bonds. Reparations are direct and retrospectively acknowledge dignity and redress while addressing resource deprivation. Acknowledgement is critical for dignity and government must take responsibility for state-facilitated exploitation.

However, given our egregious history and especially the on-going ways that capital tends to consolidate and iterate for some at the exclusion of others, a onetime redress is not enough. Everyone has an economic right to wealth and that’s where baby bonds come in. Baby bonds are trust accounts for children. The money is held in public trust until a child becomes an adult. Funds can then be used for buying a house, starting a business, and/or financing education. To redress wealth disparity and advance racial equity, this year Connecticut became the first state to pass a Baby Bonds type program for each child whose birth is covered through Medicaid. The laudable goal is to allow children who don’t have the benefit of inherited wealth to pursue the same asset-building opportunities as others.

How have the past year’s events—the pandemic, economic fallout, racial reckoning and political unrest—shifted the dominant narrative?

The events of the past year have created a pivotal moment when we can change the narrative. The pandemic, the summer of protest in response to George Floyd’s murder, the many dimensions of political unrest, the in-fighting within political parties, all suggest that the system is ripe for change. For example, a silver lining of the pandemic was how it led to unprecedented government interventions like sending people $1,200 checks. When lawmakers decided it was necessary to distribute money broadly and did so, they changed views about what government can do.  

The attitudes of youth are also creating momentum to change the narrative. Young people are speaking up and saying: The status quo isn’t working. We want an economy grounded in justice and sustainability.

That makes this the moment when the system we’ve had in place for 50 years is on the brink, and real change is possible. It’s a moment for social movements and philanthropies to boldly commit to economic justice, a new narrative, and to our values, without pessimism. This is the moment to recognize that economic justice includes wealth, health, the right to a job and to an income, to mobility without threat of incarceration or violence because of one’s identity, and to free mobility without stigma, constraint and fear. A moment, I hope, when we will commit to economic and racial justice for everyone.

How can the New York City Racial Justice Commission influence other communities that want to dismantle structural racism?

The New York City Racial Justice Commission has been charged with remaking the city’s Charter and shaping policy to dismantle structural racism for all in New York City.

One of the biggest impacts we can have is establishing values that emphasize inclusion, belonging, power, equity, access along race and gender as a responsibility of all aspects of government in New York City. Through this commission, I believe that our city, given its size, influence and media, can set an example for other cities, states, and the nation as a whole. That, in and of itself, is valuable.

Dr. Darrick Hamilton is on the National Advisory Committee for RWJF’s Policies for Action. Learn more about the program’s research findings on building an inclusive pandemic recovery for all.