The struggle against bias in the United States is a long and enduring one. As a people, we have come a great distance in trying to recognize and conquer it. We have eliminated many instances of de jure and overt cultural discrimination against and exclusion of individuals or groups. This has come across a broad spectrum, including race, gender, religion, mental and physical illness and disability, and sexual orientation. It took large numbers of women and men of great courage who made tremendous sacrifices, often well out of the public eye, to bring us this far. And yet we have a great distance still to travel. There is no denying that outcomes and opportunities are not the same for many Americans. Nor can we say that our culture openly and warmly embraces everyone. To be sure, there are still individuals and groups who continue to espouse hatred, division, and violence. They are worthy of our collective rebuke and contempt. Such attitudes have no place in our society and pull at the threads that make up the fabric of our civilization.
OVERSTATING THE CASE
Bassett and Graves, from the Department of Health and Mental Hygiene, argue that a disparity in health outcomes in White and non-White populations “reflects institutionalized racism, present not in just one of our institutions, but in them all.” If this can be read as a sweeping condemnation of every public institution and by extension government program in the country as racist, it significantly overstates the case. A more nuanced approach acknowledges that bias (a broader term that can encompass racism and other forms of discrimination) certainly plays an important part in every aspect of the interaction of all people and manifests itself in institutions, programs, and outcomes. But one surely can go further to say that bias is one of many variables in play.
NOT THE ENTIRE STORY
Conscious and unconscious bias both play a part in our continuing life as a nation and in our everyday individual lives. But does bias fully account for every disparity in outcome and opportunity? Do these differences stem from hatred and discrimination by individuals and institutions passively and actively seeking to preserve some advantage by denying it to others? Much more is involved, particularly when examining public policy. Other factors of importance include funding adequacy, statutory and regulatory flexibility to account for variations of the target population in different parts of the country, program design, delivery mechanisms, the availability of enough qualified personnel, recipient behavior, exogenous economic circumstances, and a failure by policymakers to simply understand the people they are trying to help and the problem they are trying to address. The comparable public health situations in some urban areas and the Appalachian region are cases in point. Bias is at best a partial explanation. It is not the entire story.
POISONING THE WELL
Great caution should be used when suggesting bias in a discussion of public policy. We should tread even more carefully when accusing others of exhibiting bias. These are dangerous ways of engaging in public discourse. To be blunt, they can poison the well. Call people racists or bigots and you have challenged the very core of their being and made among the most strident ad hominem attacks possible. And to do so when discussing differences of approach in public policy among people of good will—a universe that encompasses the vast majority of the American public—is to stifle debate, to discredit legitimate ideas, and to demonize people who might have a different point of view. An inadequate or failing Medicaid or public heath program is not the same thing as Jim Crow.
BRING PEOPLE TOGETHER
Readers might think about how they want others to behave in the future. How can they get others to see their point of view? It’s one thing to make an argument. It’s quite another to bring people together and enact durable and effective solutions to thorny problems. We have been blessed as a nation to have brave souls in our history daring to say no to injustice, dedicating their lives to helping others, and finding ways to advance the common good. May it always be so.