The social institutions of our culture also inform our socialization. Formal institutions—like schools, workplaces, religion and the government—teach people how to behave in and navigate these systems. Other institutions, like the media, contribute to socialization by inundating us with messages about norms and expectations. Chapter 4.3 discussed institutional discrimination, or discrimination that pervades the practices of whole institutions, such as housing, medical care, law enforcement, employment, and education. This section will dive deeper into the social institution of family, criminal justice system, religion, healthcare, education, economics, politics and the impact these institutions have on the lives of African Americans.
Criminal Justice System: Black Male Incarceration and Mortality
Black male incarceration is often considered as one important explanation for the imbalanced sex ratios discussed earlier. Although Black males make up 6% of the population, they make up 50% of those who are incarcerated. This incarceration rate for Black males increased by a rate of more than four between the years of 1980 and 2003. The incarceration rate for African American males is 3,045 out of 100,000 compared to 465 per 100,000 white American males. In many areas around the country, the chance that Black males will be arrested and jailed at least once in their lifetime is extremely high. For Washington, D.C., this probability is between 80 and 90%.
Because Black males are incarcerated at six times the rate of white males, the skewed incarceration rates harm these Black males as well as their families and communities. Incarceration can affect former inmates and their future in society long after they leave prison. Those that have been incarcerated lose masculinity, as incarceration can affect a man's confirmation of his identity as a father and a breadwinner for the family. After being released from prison, efforts to reestablish or sustain connections and be active within the family are often unsuccessful. Incarceration can be damaging to familial ties and can have a negative effect on family relations and a man's sense of masculinity.
The New Jim Crow
The New Jim Crow: Mass Incarceration in the Age of Colorblindness is a book by Michelle Alexander, a civil rights litigator and legal scholar. Though the conventional point of view holds that systemic racial discrimination mostly ended with the civil rights movement reforms of the 1960s, Alexander posits that the U.S. criminal justice system uses the War on Drugs as a primary tool for enforcing traditional, as well as new modes of discrimination and oppression. These new modes of racism have led to not only the highest rate of incarceration in the world, but also a disproportionately large rate of imprisonment for African American men.
Alexander points out that mass incarceration is "a stunningly comprehensive and well-disguised system of racialized social control that functions in a manner strikingly similar to Jim Crow." The culmination of this social control is what Alexander calls a "racial caste system," a type of stratification wherein people of color are kept in an inferior position. Its emergence, she believes, is a direct response to the Civil Rights Movement. It is because of this that Alexander argues for issues with mass incarceration to be addressed as issues of racial justice and civil rights. To approach these matters as anything but would be to fortify this new racial caste. Thus, Alexander aims to mobilize the civil rights community to move the incarceration issue to the forefront of its agenda and to provide factual information, data, arguments and a point of reference for those interested in pursuing the issue. Her broader goal is the revamping of the prevailing mentality regarding human rights, equality and equal opportunities in America, to prevent future cyclical recurrence of what she sees as “racial control under changing disguise”. According to the author, what has been altered since the collapse of Jim Crow is not so much the basic structure of US society, as the language used to justify its affairs. She argues that when people of color are disproportionately labeled as “criminals”, this allows the unleashing of a whole range of legal discrimination measures in employment, housing, education, public benefits, voting rights, jury duty, and so on.
Alexander argues that the War on Drugs has a devastating impact on inner city African American communities, on a scale entirely out of proportion to the actual dimensions of criminal activity taking place within these communities. During the past three decades, the US prison population exploded from 300,000 to more than two million, with the majority of the increase due to drug convictions. This led to the US having the world's highest incarceration rate. The US incarceration rate is eight times that of Germany, a comparatively developed large democracy. Alexander claims that the US is unparalleled in the world in focusing enforcement of federal drug laws on racial and ethnic minorities. In the capital city of Washington, D.C. three out of four young African American males are expected to serve time in prison. While studies show that quantitatively Americans of different races consume illegal drugs at similar rates, in some states Black men have been sent to prison on drug charges at rates twenty to fifty times those of white men. The proportion of African American men with some sort of criminal record approaches 80% in some major US cities, and they become marginalized, part of what Alexander calls "a growing and permanent "undercaste".
Health
Health Inequality
A deep connection between the field of medicine and the overall treatment and perception of African American extends back to the founding of this country. Proponents used pseudo-scientific (discussed in Chapter 1.2 as racialized science) ideas about the "natural" inferiority of Blacks to justify racism and slavery. In turn, these same forces led to a health inequality—with poor care from the medical field and higher rates of serious health issues—that persist in the present. African Americans have also faced lasting barriers in gaining employment and professional recognition in the healthcare field.
From the origins and continuation of health inequality to the fight to gain access to professional medical treatment, African American health and healthcare in U.S. history are interrelated issues. African American physicians, dentists, and nurses along with Black medical schools and hospitals have done pioneering work. While traditionally receiving less attention than issues like voting, housing, and education, the African American fight for healthcare is an important component of the Black freedom struggle, and a key aspect for understanding the current state of Black Americans.
African American health is inextricably linked to slavery. Historians estimate that as many as 50% of Africans died before leaving the continent during capture, the forced march to slave holding areas, or waiting in pens. Somewhere between 15-20% died during the Middle Passage across the Atlantic from the fifteenth through the nineteenth century. The mortality rate varied by place of origin, conditions in captivity and on the ship, and the point of destination. As many as 675,000 died during capture, captivity, or transportation to this country. Of the 450,000 Africans who made it to the U.S., an additional 4.3% died in the period between arrival and sale, and as many as 25% perished during the "acclimation period" of their first eighteen months as they adjusted to new locations, climates, and diseases.
Enslaved individuals suffered from significant health problems. The Black infant and childhood mortality rate was double the rate for whites. Over half of all Black children were born severely underweight due to the poor treatment and lack of nutrition for pregnant slaves; many women miscarried or gave birth to stillborn babies. On average, Black mothers could nurse for only four months, compared to eight months for white babies. Early weaning, horrid living conditions, and lack of nutrition led to more than 50% of Black infants dying before the age of one.
The field of medicine both justified the poor treatment of African Americans and contributed to their health problems. Building on the writings of white intellectuals going back to at least the Greeks, leading American scientists and physicians categorized African Americans as biologically inferior and less intelligent, or even sub-human. By the early 1800s, proponents of slavery used this pseudo-scientific argument to justify slavery. Defenders of slavery further argued that Africans were more genetically predisposed to work in the fields than whites. Thomas Jefferson advocated this position in his influential Notes on the State of Virginia (1805). While he concluded that enslaved Africans were "inferior to the whites in the endowments both of body and mind," Jefferson argued that they possessed some qualities that made them genetically designed to labor, notably that they "seem to require less sleep" and were "more tolerant of heat." Physicians perpetuated the belief that Africans also had resistance or immunity to diseases like yellow fever.
Medical Exploitation
Despite gains due to legislation, many African Americans remained distrustful of the government's involvement in healthcare. In the early twentieth century, the government funded forced sterilization programs in 32 states for tens of thousands of women, primarily people of color. Originating in the late nineteenth century, the eugenics movement spread in the U.S. starting in the 1900s. Eugenics was based on the concept that selective breeding should be encouraged, with government involvement, to improve society. Supported by funding from leading organizations like the Carnegie and Rockefeller foundations, scientists from top universities carried out pseudo-scientific research that demonstrated supposed negative genetic traits of certain groups that should not be allowed to reproduce: the mentally ill or disabled, those deemed sexually deviant, criminals, immigrants, the indigent, and minorities. Some doctors actively engaged in eugenicide, killing patients or willfully neglecting them—often newborns—until they died.
Forced sterilization became the most mainstream manifestation of eugenics, with states adopting forced sterilization laws in the first decade of the twentieth century. Although masked as progressive reform (to produce the most superior citizens and to reduce government spending on providing for the "unworthy") and supported by public health advocates, scientists, physicians, and politicians, forced sterilization was a product of racism and xenophobia (xenophobia was discussed earlier in Chapter 3.5). In many ways, proponents promoted forced sterilization similar to the ways they advocated residential segregation (i.e., African Americans should be kept out of white neighborhoods to prevent the spread of disease) or anti-miscegenation (i.e., interracial marriage and children would produce "inferior," mixed race children, damaging to white purity). The Nazis partially modeled their own policies of sterilization and eugenicide in the 1930s and 1940s on American practices.
Eighteen Southern states adopted sterilization laws and often used them to target African American women. In 1964, Mississippi Freedom Democratic Party leader and voting rights advocate Fannie Lou Hamer spoke of her own experience. In 1961, Hamer underwent surgery in Mississippi for a uterine tumor. During surgery, and without her consent, the operating physician performed an unnecessary hysterectomy. Hamer highlighted the commonality of the procedure, which she dubbed a "Mississippi appendectomy," and estimated that physicians at the hospital, without consent and with no medical need, sterilized approximately 60% of Black female patients.
The Black Panther Party's health program further reflected the distrust of medical institutions. As detailed earlier, physicians used enslaved African Americans for medical experiments. Hospitals and prisons continued this practice after slavery ended, and medical colleges stole African American cadavers for student training. Perhaps the most famous example of medical exploitation was the Tuskegee Experiment, started by the U.S. Public Health Service in 1932. The program recruited 600 Black men—399 with syphilis, and 201 not infected—for a study on the effects of the disease. Administrators promised free medical treatment for participants. However, physicians did not inform the men of the purpose of the study and did not treat the individuals who had syphilis, even after penicillin was discovered as a cure in 1947. In 1972, the Associated Press reported on the story, leading to a public outcry and investigations. Recent research has demonstrated that the history of medical exploitation, particularly the Tuskegee Experiment, has led African Americans to be more distrustful of doctors and less likely to use healthcare services, contributing to the higher mortality rare.
Contemporary Health Disparities Experienced by African Americans
Health inequality persists in the U.S. The Centers for Disease Control (CDC) and Prevention found that African Americans have a significantly shorter life expectancy (75.1 years) than whites (78.7). African Americans suffer from higher rates of illness and health problems; the CDC estimates that 13.6% of African Americans are in poor health compared to 9.5% of whites. The overall mortality rate has dropped for all races in the past two decades, driven by declining deaths from cancer, heart attacks, and strokes. However, African Americans still have a mortality rate 16% higher than whites (down from 33% in 1999), and are more likely to die at every age. The discrepancy is particularly notable in infant mortality—a rate of 10.93 per 1,000 for Blacks and 4.89 per 1,000 for whites—and in maternal deaths with a rate of 43.5 Black deaths per 100,000 live births compared to 12.7 white deaths per 100,000 live births. The mortality rates for African American males are also typically higher than they are for African American females. This is another explanation for the imbalanced sex ratios mentioned earlier in the discussion on the African American Family. Between 1980 and 2003, 4,744 to 27,141 more African American males died annually than African American females. This higher mortality rate helps to explain the low marriage rates for many African American females who cannot find Black partners.
The roots of health inequality date back to the beginning of this country. Treated as racially inferior, neglected or excluded by white healthcare systems and as the victims of systematic and institutionalized racism and segregation, African Americans have suffered higher rates of disease and mortality than white Americans throughout this country's history. African Americans have fought for increased access; provided care for themselves in various forms, from enslaved midwives to Black hospitals; and made important contributions to the medical field. However, the historical vestiges of a two-tiered healthcare system remain as deeply entrenched as other aspects of structural/system racism (defined in Chapter 4.4).
Education
Increasingly, a college degree is the key to financial well-being, while the value of a high school diploma has diminished markedly over time. Since the 1960s, rates of college graduation have increased significantly for all major racial and ethnic groups, though large gaps persist as Blacks still trail whites in college completion, according to the 2016 Pew Research Center report (Figure \(\PageIndex{8}\)).
The 2016 Pew Research Center analysis of U.S. Census Bureau data shows that while the income gap between Black and white college-degree earners is narrower than those with less education, it still remains significant. The median adjusted household income among Black householders with at least a bachelor’s degree was $82,300 in 2014, compared with $106,600 among white householders with the same level of education. Put another way, among households whose head is college-educated, Black households earn 77% what white households do (Figure \(\PageIndex{9}\)).
Education alone also does not close unemployment gaps between Blacks and whites. The unemployment rate for Blacks in 2015 was roughly double that of whites across all educational categories, according to the 2016 Pew Research Center’s analysis of Census Bureau data.
Black households have only 10 cents in wealth for every dollar held by white households (Pew Research Center, 2017). In 2016, the median wealth of non-Hispanic white households was $171,000. That’s 10 times the wealth of Black households ($17,100) – which reflects a larger gap than in 2007. The Great Recession of 2007-2009 triggered a stark decline in wealth for U.S. families and further widened the already large wealth gap between white and Black households. Yet the Black-to-white wealth gap has evolved differently for families at different income levels, according to a Pew Research Center analysis of Federal Reserve data. The wealth gap increased between middle-income Black and white families, but shrank between lower-income Black and white families from 2007 to 2016. Much of the reduction in the wealth gap among lower-income families was driven by a sharp decrease in wealth for whites Figure \(\PageIndex{10}\).
Blacks are more than twice as likely as whites to live in poverty (Income and Poverty in the United States: 2014). In 2014, about a quarter (26%) of Blacks were poor, compared with 10% of whites. The Black-white poverty gap has narrowed somewhat since the mid-1970s, when 30% of Blacks were living below the poverty line – a proportion nearly four times the share of whites living in poverty (8%).
Many Blacks view political representation as a potential catalyst for increased racial equality, according to a 2016 Pew Research Center survey. Roughly four-in-ten Black adults (38%) said that working to get more Black people elected to office would be a very effective tactic for groups striving to help Blacks achieve equality.
Following Reconstruction till 1900, large numbers of Black Americans were elected to political office at the local, state and national levels. These elected officials included: Hiram Revels, first Black U.S. Senator (who was also a member of the Lumbee Nation) and Frederick Douglass, appointed President of the Freedman's Saving Bank and diplomat to the Dominican Republic. As discussed in Chapter 7.2, the Jim Crow era and backlash against the Black middle class all but contributed to the absence of Black elected officials for the better part of the 20th century. Only 11 Black senators have been elected in all of U.S. history, with Reverend Raphael Warnock, who won a highly contested runoff in Georgia in 2021. Barack Obama, the most famous of these was elected as the first Black President. Shirley Chisholm was the first African American to run for President in 1972; in her bid to run on the Democratic Party ticket, she announced, “I am not the candidate of Black America, although I am Black and proud. I am not the candidate of the women’s movement in this country, although I am a woman, and equally proud of that... I am the candidate of the people of America.”
Voting
In 1870, the 15th Amendment was ratified, guaranteeing African American (men) the right to vote; however, challenges to this right included the poll tax, the grandfather clause, and literacy tests which disenfranchised countless Black voters during the Jim Crow era encompassing most of the 20th century. The 19th Amendment was passed in 1920, guaranteeing suffrage for all women, including Black women. Yet, the struggle to vote continued. The Civil Rights Movement championed voting rights in campaigns such Freedom Summer (Mississippi) and the Selma to Montgomery (Alabama) March, registering thousands of Black voters. Fannie Lou Hamer, an organizer of Freedom Summer and co-founder of the Mississippi Freedom Democratic Party, went to the 1964 Democratic Party Convention, attempting to be part of the official delegation, gave a blistering speech with details about voter registration suppression - which was later televised nationally and gained further support for the voting rights for Black Americans. President Lyndon Johnson signed into law the Voting Rights Act of 1965, prohibiting racial discrimination in voting. While Congress amended the Act to extend its enforcement, in the last decade, significant challenges to the enforcement have been granted by the U.S. Supreme Court, thereby negating the strength of the Voting Rights Act. Additionally, Southern states, such as Florida, Alabama, Kentucky, Mississippi, Tennessee, and Virginia, deny convicted felons the right to ever vote - even after they have served their sentence, a policy which disproportionately impacts the Black population which has higher incarceration rates than other race-ethnic groups. According to the Sentencing Project (2016), one in 13 African Americans of voting age is disenfranchised, which is four times greater than non-African Americans voters. Further, over 7.4 percent of the adult African American population is disenfranchised compared to 1.8 percent of the non-African American population (Sentencing Project, 2016). In Florida, Kentucky, Tennessee, and Virginia, more than 1 in 5 African Ameicans is a disenfranchised voter due to a felony conviction. With so many disenfrancised voters, the struggle for voting rights for Black voters is far from over. Yet, through the efforts of voting rights activists such as Stacey Abrams, who co-founded the New Georgia Project in 2014 and registered more than 500,000 new voters, the state of Georgia shifted to a predominantly Democratic state in 2020, helping the Biden-Harris ticket to clench the 2020 Presidential election.
Contributors and Attributions
Content on this page has multiple licenses. Everything is CC BY-SA other than Paradox in the Black Church and Health Inequality which are CC BY-NC.
Byrd, W. M. & Clayton, L.A. (1992). An American health dilemma: a history of Blacks in the health system. Journal of the National Medical Association, 84(2), 189.
Daniel P.M. (1965). The Negro Family: The Case for National Action, Washington, D.C., Office of Policy Planning and Research, U.S. Department of Labor.
Digital History. (2016). What was life like under slavery. Digital History.
Dixon, P. (2009). Marriage among African Americans: What does the research reveal? Journal of African American Studies. 13(1): 29–46.
Dyer, W.M. (2005). Prison fathers, and identity: A theory of how incarceration affects men's paternal identity. Fathering: A Journal of Theory, Research, and Practice About Men as Fathers. 3(3): 201–219.
Fogel, R.W. (1994). Without Consent or Contract: The Rise and Fall of American Slavery. New York, NY: WW Norton & Company.
Gates, Jr., H.L. (2014). How many slaves landed in the U.S. The Root.
Paul C. Glick, ed. by Harriette Pipes McAdoo (1997). Black families (3rd ed.). Thousand Oaks, Calif. [u.a.]: Sage. p. 119.
Herbert C.C. (2007). African American Slave Medicine: Herbal and Non-Herbal Treatments. Lanham, MD: Lexington Books.
Heron, M. (2018). Deaths: leading causes for 2016. National Vital Statistics Report, US Department of Health and Human Services.
Hershberg, T. (1971). Free Blacks in antebellum Philadelphia: A study of ex-slaves, freeborn, and socioeconomic decline. Journal of Social History, 183-209.
Hood, R.G. (2001). The" slave health deficit:" The case for reparations to bring health parity to African Americans. Journal of the National Medical Association, 93(1),
Kochhar, R. & Cilluffo. A. (2017). How wealth inequality has changed in the U.S. since the great recession, by race, ethnicity and income. Pew Research Center.
McAdoo, P. (1997). Black Families. 3rd ed.. Thousand Oaks, CA.
Mintz, S. (2013). Childhood and transatlantic slavery. Children & Youth in History.
Moynihan, Daniel P. The Negro Family: The Case for National Action, Washington, D.C., Office of Policy Planning and Research, U.S. Department of Labor, 1965.