SubscribeThere are many different types of disadvantaged neighborhoods in America, but poor urban minority neighborhoods seem to be especially unhealthy. Some of these neighborhoods have the highest mortality rates in the country, but this is not, as many believe, mainly because of drug overdoses and gunshot wounds. It is because of chronic diseases -- mainly diseases of adulthood that are probably not caused by viruses, bacteria or other infections and that include stroke, diabetes, kidney disease, high blood pressure and certain types of cancer.
Since the time of slavery, physicians have noted that the health of impoverished blacks is, in general, worse than that of whites. Racist doctors proposed that the reasons were genetic, and that blacks were intrinsically inferior and physically weaker than whites. But there is very little evidence that poor blacks or Hispanics are genetically predisposed to the vast majority of the afflictions from which they disproportionately suffer. As the living conditions of blacks have improved over the past century, their health improved in step; when conditions deteriorated, health deteriorated, too. This has helped support the contention among researchers that much chronic disease among minority groups is caused not by genes, but by something else.
The best we have at the moment are theories that fall into two main schools of thought. One school holds that the problem has mainly to do with stress; the other holds actual deprivation responsible. These two factors are often intertwined, but the emphasis is important. "There are so many fists in the face of poor African-Americans," says Arline Geronimus, a professor of public health at the University of Michigan who leans toward the stress school, and she proceeded to list them for me. They have enormous family obligations, she explained, and while the middle class are able to purchase child care and care for elderly relatives, the poor cannot. The experience of racism and discrimination in everyday life is also still very real, and very stressful. She says that blacks are faced with a society that institutionalizes the idea "that you are a menace -- and that demeans you," she says. Nancy Krieger, a Harvard researcher, found that working-class African-Americans who said they accepted unfair treatment as a fact of life had higher blood pressure than those who challenged it.
Geronimus calls the grinding everyday stress of being poor and marginalized in America "weathering," a condition not unlike the effect of exposure to wind and rain on houses. Listening to Geronimus describe "weathering," I found it hard not to wonder whether anyone really knows what it is. Stress is subjective, a feeling, and it means different things to different people. Philip Alcabes, associate professor of urban public health at Hunter College, says that stress is like the miasma that was once thought to cause cholera in 19th-century slums. "You can't see it, you can't really measure it, but it floats over certain people, especially the poor, and makes them sick."
On his Web site, Chang is unapologetic, and promises that more games -- Hoodopoly, Hiphopopoly, Thugopoly and Redneckopoly -- are coming soon... "It draws on stereotypes not as a means to degrade, but as a medium to bring together in laughter," Chang maintains, adding, "If we can't laugh at ourselves ... we'll continue to live in blame and bitterness."Ah. Ha ha ha. No mention of a game featuring a bucktoothed Asian stereotype pulling a rickshaw through a laundromat. I suppose those kind of jokes stop being funny when it starts being you.
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posted by 111 at 3:54 PM on October 9, 2003