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In his last public act, Benjamin Franklin presented to the US Congress a petition on behalf of the Philadelphia Society for the Abolition of Slavery asking for the abolition of slavery and an end to the slave trade. The petition, signed on February 3, 1790, asked the first US Congress, then meeting in New York City, to “devise means for removing the Inconsistency from the Character of the American People,” and “promote mercy and justice toward this distressed Race.”

The Senate took no action and the House tabled it, claiming the Constitution restrained them from prohibiting the importation or emancipation of slaves until 1808. Franklin, in a public forum once stated that “Slavery is such an atrocious debasement of human nature, that its very extirpation, if not performed with solicitous care, may sometimes open a source of serious evils.” With the submission of the petition, it is said that Franklin went on to state that unless Congress took a stand to free the slaves, it would be like leaving a rotten apple at the bottom of a barrel. That such would be a continuing “source of evils” on the character of American Society. He and his fellow colleagues had calculated what it would cost the then new country to purchase the freedom of every man, woman and child in slavery. France was willing to lend the new country the money as it had done for the Revolutionary War. They also determined that by 1808, there would be too many slaves for such an act to be economically feasible and that a tragic event would have to occur for this country to do as stated in the Constitution by 1808. Even with that tragic event, Franklin stated that such evils would be too ingrained into American Society and would cast a lasting economic burden on American Society.

As we recently celebrated the Independence of this nation, one should have thought of Benjamin Franklin’s words. The legacy of inaction. For instance, when the late Supreme Court Justice Thurgood Marshall once stated that,”there was no place in America where he ever had to put his hands in front of his face to know that he was black,” he was pointing out that in the minds of many Americans the idea still lurks that minorities, especially African Americans, are fundamentally inferior. It is precisely this attitude that Franklin was afraid would be ingrained in American Society.  It is what I refer to as “Silent Racism.” It is that subconscious process that occurs without the privileged individual even being aware that he or she has committed an act which is based on a preconceived notion or profile.  On an everyday level, it can be the most innocent of acts. I once gave an example of a friend driving through an upscale neighborhood, when a car started following her. As she pulled in front of her friend’s home, the woman in the other car rolled down her window and asked if my friend was lost and needed help. This might sound quite innocent, but it just so happened that my friend was black and the woman in pursuit was white. My friend suffered no long-term consequences from this incident. But think about how this plays out in every day life. What impact would such an innocent act have on one applying for a job or purchasing a home or any normal everyday act? Consider a similar act that might occurs in the delivery of healthcare.

So we now have Congress looking into Health Care Reform. It is that same body, although with different people, including some of color, that left the rotten apple at the bottom of the barrel now two-hundred and nine years later. We will get Health Reform, but will it address the Health Disparities Gap? It is easier to pass laws than to change the minds and perceptions of human beings, even those who profess to be of open minds. We all have biases. It is not that we have biases, it is about how we act on them.

In 1998, Congress mandated that  the prestigious Institute of Medicine (IOM) conclude a study to investigate whether ethnic minorities and medically underserved populations in this country are experiencing an unequal burden of cancer. Following the study, Congress held a hearing in which the study validated its results that ethnic minorities and medically underserved populations in this country were experiencing an unequal burden of cancer,  yet Congress, who mandated the IOM study, chose to ignore the recommendations calling for, among other actions, increased federal funding and a reapportioning of federal research dollars to correct those cancer disparities. It is important to note that  Congress usually takes immediate action to implement recommendations of a congressionally mandated studies like the one noted. Was Congress’ blatant disregard in this case an example of what Franklin alluded to, a continuing “source of serious evils” that became ingrained in American Society.

As the great civil rights leader Dr. Martin Luther King once said:  “Many of the ugly pages of American history have been obscured and forgotten …” We need to heed the words of Benjamin Franklin, that slavery is and continues to be a source of evil. An evil that we truly have never addressed. For it prevails in our biases, those subconscious innocent biases that play out on a daily basis. We all have negative and positive biases. Again, it is not that we have them, it is to remember that we do have.  That is is not having them, but how we act on them. Unless we keep that in mind, any hope of health reform in addressing health disparities will be for naught.

1. Billy Howard says:

   July 14, 2009 at 9:23 am

   Thanks for the history lesson and for holding a magnifying glass up to what our founding fathers really wanted for this nation.

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2. Terri Evans says:

   July 14, 2009 at 10:20 am

   In the past few years my eyes have been opened to the disparities in healthcare with hard evidence related to cancer and lupus, in particular. While I always suspected the disparity, I have now read many such studies that reveal our system’s tragic flaws in this regard. As a (mostly-lucky) lupus patient, it saddens (and angers) me to see that African American women: 1)typically develop lupus earlier in life 2) generally have more life-threatening complications and 3) have a significantly higher mortality rate than Caucasians — even at a time when lupus mortality rates are declining for other populations. One can only conclude that it must be a result of poor quality of care. It makes me fighting mad, as I know it does not have to be this way! Keep up your good work, Lovell, and thank you for sharing this important insight with Dew readers. Let us all hope for positive changes, for ALL populations in health reform.

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3. Patricia Thomas says:

   July 14, 2009 at 10:40 am

   Thanks for this excellent article. It confronts enduring and ugly truths about health disparities in the United States. Anyone interested in how racism, poverty and other structural forces determine health inequities should see the excellent documentary “Unnatural Causes.” Many libraries have copies of this 7-part series and you can view it for free!

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4. Monica De La Rosa says:

   July 20, 2009 at 4:04 pm

   The legacy of slavery obviously goes beyond health reform, it can be blamed for the breakdown in families and environments both of which contribute to health disparities. Until our young nation can accept its role in the effects of slavery on a group of people, which inadvertantly spread to all people of color, we will not evolve into a truly democratic nation where all people are equal and have equal access to services.

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