An article in the Yale Alumni Magazine told the story of Clyde Murphy, a black man who was a member of the Class of 1970. Clyde was a success story. After Yale and a law degree from Columbia, Clyde spent the next 30 years as one of America's top civil rights lawyers. He was also a great husband and father. But despite his success, personally and professionally, Clyde's story had a sad ending.
Članak iz Yale Alumni Magazine -a govori o priči Clyde Murphya, crnca koji je bio član generacije 1970. Njegova je priča uspješna. Nakon Yale-a i pravne diplome s Columbie, Clyde je proveo idućih 30 godina kao jedan od najboljih američkih odvjetnika za ljudska prava. Također je bio odličan muž i otac. Ali usprkos njegovom uspjehu, profesionalnom i osobnom, Clydeova priča ima tužan završetak.
In 2010, at the age of 62, Clyde died from a blood clot in his lung. Clyde's experience was not unique. Many of his black classmates from Yale also died young. In fact, the magazine article indicated that 41 years after graduation from Yale, the black members of the Class of 1970 had a death rate that was three times higher than that of the average class member. It's stunning.
U 2010., u 62. godini života, Clyde je umro od krvnog ugruška u plućima. Clyde nije jedini koji je to doživio. Mnogo njegovih crnih kolega s Yale-a je također umrlo mlado. Zapravo, članak ukazuje na to da 41 godinu nakon diplomiranja na Yaleu, crni članovi generacije 1970. imaju stopu smrtnosti trostruko veću od prosječnog studenta. To je nevjerojatno.
America has recently awakened to a steady drumbeat of unarmed black men being shot by the police. What is even a bigger story is that every seven minutes, a black person dies prematurely in the United States. That is over 200 black people die every single day who would not die if the health of blacks and whites were equal.
Ameriku je nedavno probudila vijest o nenaoružanim crncima pretučenima od strane policije. Još značajniji podatak je da svakih 7 minuta, u SAD-u preuranjeno umre 1 crna osoba. To je preko 200 ljudi koji umru svakoga dana, a koji nebi umrli da je zdravlje crnih i bijelih ljudi jednako.
For the last 25 years, I have been on a mission to understand why does race matter so profoundly for health. When I started my career, many believed that it was simply about racial differences in income and education. I discovered that while economic status matters for health, there is more to the story. So for example, if we look at life expectancy at age 25, at age 25 there's a five-year gap between blacks and whites. And the gap by education for both whites and blacks is even larger than the racial gap. At the same time, at every level of education, whites live longer than blacks. So whites who are high school dropouts live 3.4 years longer than their black counterparts, and the gap is even larger among college graduates. Most surprising of all, whites who have graduated from high school live longer than blacks with a college degree or more education.
U posljednjih 25 godina ja sam bio na misiji da shvatim zašto je rasa toliko bitna kada se radi o zdravlju. Kada sam počeo svoju karijeru, mnogi su jednostavno vjerovali da je to zbog rasnih razlika u primanjima i obrazovanju. Otkrio sam da, iako ekonomski status utječe na zdravlje, tu postoji nešto više. Naprimjer, pogledajmo očekivani životni vijek u dobi od 25 godina, u dobi od 25 godina pojavljuje se petogodišnji jaz između crnaca i bijelaca. A jaz u edukaciji između bijelaca i crnaca je još veći od rasnog jaza. U isto vrijeme, na bilo kojoj razini edukacije, bijelci žive duže od crnaca. Bijelci koji odustanu od srednje škole žive 3.4 godine duže od njihovih crnih kolega, a jaz je još veći među diplomantima. Ono što najviše iznenađuje je to što bijelci sa završenom srednjom školom žive dulje od crnaca s diplomom ili s većim stupnjem obrazovanja.
So why does race matter so profoundly for health? What else is it beyond education and income that might matter?
Pa zašto je rasa tako duboko povezana sa zdravljem? Što još osim obrazovanja i dohotka može utjecati na to?
In the early 1990s, I was asked to review a new book on the health of black America. I was struck that almost every single one of its 25 chapters said that racism was a factor that was hurting the health of blacks. All of these researchers were stating that racism was a factor adversely impacting blacks, but they provided no evidence. For me, that was not good enough.
U ranim 1990-ima trebao sam napisati recenziju jedne nove knjige o zdravlju crnaca u Americi. Bio sam iznenađen svakim od ukupno 25 poglavlja koji su govorili o tome kako je rasizam ono što škodi zdravlju crnaca. Svi ti istraživači su tvrdili da je rasizam faktor koji nepovoljno utjele na crnce, ali nisu imali dokaza za to. Meni to nije bilo dovoljno.
A few months later, I was speaking at a conference in Washington, DC, and I said that one of the priorities for research was to document the ways in which racism affected health. A white gentleman stood in the audience and said that while he agreed with me that racism was important, we could never measure racism. "We measure self-esteem," I said. "There's no reason why we can't measure racism if we put our minds to it."
Nekoliko mjeseci poslije, bio sam govornik jedne konferencije u Washingtonu, DC, na kojoj sam rekao da je jedan od prioriteta tog istraživanja dokumentirati načine na koji rasizam može utjecati na zdravlje. Jedan gospodin, bijelac, koji je stajao u publici rekao je da, iako se slaže samnom da je rasizam važan, rasizam ne može biti izmjeren. "Mjerimo samopoštovanje", rekao sam. "Nema razloga zašto nebi mogli mjeriti rasizam ako se posvetimo tome."
And so I put my mind to it and developed three scales. The first one captured major experiences of discrimination, like being unfairly fired or being unfairly stopped by the police. But discrimination also occurs in more minor and subtle experiences, and so my second scale, called the Everyday Discrimination Scale, captures nine items that captures experiences like you're treated with less courtesy than others, you receive poorer service than others in restaurants or stores, or people act as if they're afraid of you. This scale captures ways in which the dignity and the respect of people who society does not value is chipped away on a daily basis.
I tako sam se posvetio tome te razvio 3 mjere. Prva je mjerila iskustvo diskriminacije, kao naprimjer neopravdano dobivanje otkaza ili zaustavljanje od strane policije. Ali diskriminacija je također prisutna u mnogo manjim i suptilnijim oblicima, pa tako moja druga mjera, koja je dobila naziv Mjera Svakodnevne Diskriminacije, mjeri 9 stavaka koje mjere iskustva kada su pojedinci tretirani s manjom ljubaznošću od drugih, kada im je u restoranima i dućanima pružena lošija usluga nego drugima, ili kada se ljudi ponašaju kao da vas se boje. Ova mjera prikazuje načine na koje su dostojanstvo i poštovanje ljudi koje društvo ne cijeni narušeni na dnevnoj bazi.
Research has found that higher levels of discrimination are associated with an elevated risk of a broad range of diseases from blood pressure to abdominal obesity to breast cancer to heart disease and even premature mortality. Strikingly, some of the effects are observed at a very young age. For example, a study of black teens found that those who reported higher levels of discrimination as teenagers had higher levels of stress hormones, of blood pressure and of weight at age 20. However, the stress of discrimination is only one aspect.
Istraživanje je pokazalo da su veće razine diskriminacije povezane s povećanim rizikom od mnogih bolesti, od krvnog tlaka i pretilosti do raka dojke i srčanih bolesti te čak preuranjene smrtnosti. Nevjerojatno je da su neki efekti primjećeni u vrlo ranoj dobi. Na primjer, jedno istraživanje mladih crnaca pokazalo je da su oni koji su prikazali veće razine diskriminacije kao tinejdžeri imali veće razine hormona stresa, krvnog tlaka i težine u dobi od 20 godina. Međutim, stres izazvan diskriminacijom je samo jedan aspekt.
Discrimination and racism also matters in other profound ways for health. For example, there's discrimination in medical care. In 1999, the National Academy of Medicine asked me to serve on a committee that found, concluded based on the scientific evidence, that blacks and other minorities receive poorer quality care than whites. This was true for all kinds of medical treatment, from the most simple to the most technologically sophisticated. One explanation for this pattern was a phenomenon that's called "implicit bias" or "unconscious discrimination." Research for decades by social psychologists indicates that if you hold a negative stereotype about a group in your subconscious mind and you meet someone from that group, you will discriminate against that person. You will treat them differently. It's an unconscious process. It's an automatic process. It is a subtle process, but it's normal and it occurs even among the most well-intentioned individuals.
Diskriminacija i rasizam utječu na zdravlje i na druge načine. Na primjer, diskriminacija prisutna u zdravstvu. U 1999., "National Academy of Medicine" zatražila me da sudjelujem u povjerenstvu koje je došlo do otkrića, baziranom na znanstvenim dokazima, da crnci i druge manjine primaju lošiju zdravstvenu njegu od bijelaca. To je bilo prisutno tijekom bilo kakve medicinske njege, od onih najjednostavnijih do tehnološki najprofinjenijih. Jedno objašnjenje za to je fenomen nazvan "implicitna pristranost" ili "nesvjesna diskriminacija." Istraživanje socijalnih psihologa desetljećima je indiciralo da, ukoliko netko ima negativne stereotipe o određenoj grupi u svojoj podsvijesti, prilikom susreta s nekim iz te grupe diskriminirat će tu osobu. Tretirat će ih drugačije, što je nesvjesan proces. Automatski proces. Suptilan, ali normalan proces, i događa se čak i onima koji imaju najbolju namjeru.
But the deeper that I delved into the health impact of racism, the more insidious the effects became. There is institutional discrimination, which refers to discrimination that exists in the processes of social institutions. Residential segregation by race, which has led to blacks and whites living in very different neighborhood contexts, is a classic example of institutional racism. One of America's best-kept secrets is how residential segregation is the secret source that creates racial inequality in the United States. In America, where you live determines your access to opportunities in education, in employment, in housing and even in access to medical care. One study of the 171 largest cities in the United States concluded that there is not even one city where whites live under equal conditions to blacks, and that the worst urban contexts in which whites reside is considerably better than the average context of black communities. Another study found that if you could eliminate statistically residential segregation, you would completely erase black-white differences in income, education and unemployment, and reduce black-white differences in single motherhood by two thirds, all of that driven by segregation. I have also learned how the negative stereotypes and images of blacks in our culture literally create and sustain both institutional and individual discrimination.
Ali što sam dublje kopao po utjecajima rasizma na zdravlje, efekti su postajali podmukliji. Postoji institucijska diskriminacija, koja podrazumijeva diskriminaciju koja se javlja u djelovanju socijalnih institucija. Podjela četvrti na temelju rase, koje je dovelo do crnaca i bijelaca koji žive u potpuno različitim četvrtima je klasičan primjer institucijalnog rasizma. Jedna od Američkih najbolje čuvanih tajni je da je podjela četvrti tajni izvor rasne nejednakosi u Sjedinjenim Državama. U Americi, područje u kojem živite određuje vaše mogućnosti edukacije, zaposlenja, stambene te čak mogućnosti zdravstvene njege. Jedno istražvanje 171 grada Sjedinjenih Država došlo je do zaključka da ne postoji nijedan grad gdje bijelci i crnci žive u jednakim uvjetima, i da je najgore urbano područje u kojem bijelci žive znatno bolje od prosječnih crnačkih zajednica. Drugo istraživanje je pokazalo da, ako eliminiramo statističku podjelu četvrti, među crncima i bijelcima više nema razlike u primanjima, obrazovanju i nezaposlenosti, te se smanjuje razlika između crnih i bijelih samohranih majki za dvije trećine, sve to pod utjecajem podjele. Također sam naučio kako negativni stereotipi i percepcije crnaca u našoj kulturi doslovno stvaraju i održavaju i institucijsku i individualnu diskriminaciju.
A group of researchers have put together a database that contains the books, magazines and articles that an average college-educated American would read over their lifetime. It allows us to look within this database and see how Americans have seen words paired together as they grow up in their society. So when the word "black" appears in American culture, what co-occurs with it? "Poor," "violent," "religious," "lazy," "cheerful," "dangerous." When "white" occurs, the frequently co-occurring words are "wealthy," "progressive," "conventional," "stubborn," "successful," "educated." So when a police officer overreacts when he sees an unarmed black male and perceives him to be violent and dangerous, we are not necessarily dealing with an inherently bad cop. We may be simply viewing a normal American who is reflecting what he has been exposed to as a result of being raised in this society.
Grupa istraživača stvorila je bazu podataka koja sadrži knjige, časopise i članke koje prosječan fakultetsko-obrazovan Amerikanac pročita tijekom svog života. Omogućava nam da pogledamo tu bazu i vidimo kombinacije riječi kako ih vide Amerikanci tijekom svog razvoja unutar društva. Kada se riječ "crnac" pojavi u američkoj kulturi, koje riječi se pojavljuju uz nju? "Siromašan," "nasilan," "pobožan," "lijen," "veseo," "opasan." Kada se pojavi "bijelac," riječi koje se pojavljuju uz nju su "imućan," "napredan," "konvencionalan," "tvrdoglav," "uspješan," "obrazovan." I onda kada policajac pretjerano reagira kada vidi nenaoružanog crnog muškarca i doživi ga kao agresivnog i opasnog, to ne mora značiti da se radi o inherentno lošem policajcu. Možda se jednostavno radi o normalnom Amerikancu koji je odraz onoga čemu je bio izložen tijekom odgoja u ovom društvu.
From my own experience, I believe that your race does not have to be a determinant of your destiny. I migrated to the United States from the Caribbean island of Saint Lucia in the late 1970s in pursuit of higher education, and in the last 40 years, I have done well. I have had a supportive family, I have worked hard, I have done well. But it took more for me to be successful. I received a minority fellowship from the University of Michigan. Yes. I am an affirmative action baby. Without affirmative action, I would not be here.
Iz mog osobnog iskustva, vjerujem da nečija rasa ne mora odrediti nečiju sudbinu. Doselio sam u Sjedinjene Države s Karipskih otoka Svete Lucija u kasnim 1970-ima s ciljem višeg obrazovanja, i u posljednjih 40 godina, dobro mi ide. Imam obitelj koja me podržava, naporno radim, dobro mi ide. Ali mi je bilo potrebno više da postanem uspješan. Dobio sam stipendiju za manjine od Sveučilišta u Michiganu. Da. Ja sam dijete afirmativne akcije. Bez afirmativne akcije, ja nebi bio ovdje.
But in the last 40 years, black America has been less successful than I have. In 1978, black households in the United States earned 59 cents for every dollar of income whites earned. In 2015, black families still earn 59 cents for every dollar of income that white families receive, and the racial gaps in wealth are even more stunning. For every dollar of wealth that whites have, black families have six pennies and Latinos have seven pennies.
Ali u posljednjih 40 godina, crnci u Americi bili su manje uspješni od mene. U 1978., crna kućanstva u Sjedinjenim Državama zaradila su 59 centi za svaki zarađeni dolar koji su bijelci zaradili. U 2015., crne obitelji i dalje zarađuju 59 centi za svaki zarađeni dolar prihoda koji zarade bijele obitelji, i rasni jaz u bogatsvu je još više zadivljujući. Za svaki dolar bogatstva koji posjeduju bijelci, crne obitelji imaju 6 penija, a Latinoamerikanci 7 penija.
The fact is, racism is producing a truly rigged system that is systematically disadvantaging some racial groups in the United States. To paraphrase Plato, there is nothing so unfair as the equal treatment of unequal people. And that's why I am committed to working to dismantle racism.
Činjenica je da, rasizam stvara namješten sustav koji sistematski oduzima prednost nekim rasnim grupama u Sjedinjenim Državama. Da citiram Platona, ništa nije toliko nepošteno kao jednako tretiranje nejednakih ljudi. I zato sam se ja posvetio ukidanju rasizma.
I deeply appreciate the fact that I am standing on the shoulders of those who have sacrificed even their lives to open the doors that I have walked through. I want to ensure that those doors remain open and that everyone can walk through those doors. Robert Kennedy said, "Each time a man" -- or woman, I would add -- "stands up for an ideal or acts to improve the lot of others or strikes out against injustice, he sends forth a tiny ripple of hope, and those ripples can build a current that can sweep down the mightiest walls of oppression and resistance."
Duboko cijenim činjenicu da stojim na ramenima onih koji su žrtvovali svoje živote kako bi otvorili vrata kroz koja sam ja prošao. Želim osigurati da ta vrata ostaju otvorena i da svi mogu proći kroz njih. Robert Kennedy je rekao, "Svaki put kada se muškarac", ili žena ja bih dodao, "zauzme za neki ideal ili poboljšanje sudbina drugih ili napad na nepravdu, on šalje naprijed mali val nade, koji mogu sagraditi struju koja može oboriti najsnažnije zidove tlačenja i otpora."
I am optimistic today because all across America, I have seen ripples of hope. The Boston Medical Center has added lawyers to the medical team so that physicians can improve the health of their patients because the lawyers are addressing the nonmedical needs their patients have. Loma Linda University has built a gateway college in nearby San Bernardino so that in addition to delivering medical care, they can provide job skills and job training to a predominantly minority, low-income community members so that they will have the skills they need to get a decent job. In Chapel Hill, North Carolina, the Abecedarian Project has figured out how to ensure that they have lowered the risks for heart disease for blacks in their mid-30s by providing high-quality day care from birth to age five. In after-school centers across the United States, Wintley Phipps and the US Dream Academy is breaking the cycle of incarceration by providing high-quality academic enrichment and mentoring to the children of prisoners and children who have fallen behind in school. In Huntsville, Alabama, Oakwood University, a historically black institution, is showing how we can improve the health of black adults by including a health evaluation as a part of freshman orientation and giving those students the tools they need to make healthy choices and providing them annually a health transcript so they can monitor their progress. And in Atlanta, Georgia, Purpose Built Communities has dismantled the negative effects of segregation by transforming a crime-ridden, drug-infested public housing project into an oasis of mixed-income housing, of academic performance, of great community wellness and of full employment. And finally, there is the Devine solution. Professor Patricia Devine of the University of Wisconsin has shown us how we can attack our hidden biases head on and effectively reduce them. Each one of us can be a ripple of hope.
Danas sam optimističan jer sam diljem Amerike, vidio te valove nade. Zdravstveni centar u Bostonu u medicinski tim dodao je odvjetnike kako bi liječnici mogli unaprijediti zdravlje svojih pacijenata tako što se pacijenti mogu obratiti odvjetnicima za svoje nemedicinske potrebe. Sveučilište Loma Linda osnovalo je odjel u blizini San Bernardina koji, uz medicinsku njegu, pruža i poslovne vještine i treninge pretežito za manjine, članove društva s manjim prihodima kako bi dobili vještine potrebne za dobivanje pristojnog posla. U Chapel Hillu, u Sjevernoj Karolini, Početnički projekt je shvatio kako osigurati smanjeni rizik od srčanih bolesti za crnce u 30-ima pružanjem usluga kvalitetnih dječjih vrtića od rođenja do pete godine starosti. U post-školskim centrima ciljem Sjedinjenih Država, Wintley Phipps i US Dream Academy ruše zatvoreni krug pružanjem visokokvalitetnog akademskog obogaćenja i mentorstva djeci zatvorenika i djeci koja zaostaju u školi. U Huntsville-u u Alabami, Sveučilište Oakwood, povijesno crna institucija, pokazuje nam kako možemo poboljšati zdravlje mladih crnaca uključivanjem procjene zdravlja u orijentaciju brucoša i davanjem potrebnih sredstava tim studentima kako bi mogli donositi zdrave odluke te pružanjem godišnjih zdravstvenih prijepisa kako bi mogli pratiti svoj napredak. A u Atlanti, u Georgi, posebno sagrađene zajednice su izbrisale negativne efekte segregacije transformacijom kriminalnog, drogom povezanog stambenog projekta u stambenu oazu različitog dohotka, akademskog performansa, wellnesa i pune zaposlenosti. Naposljetku, imamo Devine riješenje. Profesorica Patricia Devine sa Sveučilišta u Wisconsinu pokazala nam je kako možemo napasti naše skrivene sklonosti direktno i efektivno ih smanjiti. Svatko od nas može biti val nade.
This work will not always be easy, but former Supreme Court Justice Thurgood Marshall has told us, "We must dissent. We must dissent from the indifference. We must dissent from the apathy. We must dissent from the hatred and from the mistrust. We must dissent because America can do better, because America has no choice but to do better."
To neće uvijek biti lako, ali bivši vrhovni sudac Thurgood Marshall rekao je, "Ne smijemo se pomiriti. Ne smijemo se pomiriti s ravnodušnošću. Ne smijemo se pomiriti s apatijom. Ne smijemo se pomiriti s mržnjom i nepovjerenjem. Ne smijemo se pomiriti jer Amerika može bolje od toga, jer Amerika nema drugog izbora nego biti bolja od toga.
Thank you.
Hvala Vam.
(Applause)
(pljesak)