Upward Mortality
By Kai Wright, Mother Jones. Posted May 24, 2006.

The genetics theory is driven by the commonsense observation that adult-onset diabetes runs in the family--if your parents had it, you are more likely to as well--and researchers are frantically searching for a guilty gene. The lifestyle, or "conditioning," argument blames obesity and inactivity, both of which happen to be more prevalent among African Americans.

This same genes-versus-lifestyle debate applies to a range of deadly illnesses that disproportionately plague black America--and middle-class black America in particular. From heart disease to AIDS, African Americans are dying from preventable illnesses in disturbing numbers. The diabetes mortality rate is 20 percent higher for black men than white men, and 40 percent higher for black women.

Progressive convention says the problem lies in poverty: too many black people uninsured, too few with access to routine care. And there's certainly clear enough evidence of a link between disease and poverty. But what no one can figure out is why the problem is getting worse even as socioeconomic conditions are improving. How does a successful, educated, and well-insured man like my father die before the age of 60 at the hands of a disease that is totally preventable?

Here's where the debate turns political. If genes are decisive, then no one is to blame for the racial imbalance in Americans' health. If it's lifestyle that divides the sick from the well, then the problem is a matter of personal choice.

But there's a third way to look at the disparity, one that is both more complex and more disturbing. This theory holds that black folks carry a legacy of disease that isn't genetic but that nonetheless is transferred from one generation to the next--and eventually catches up even with those who clamber up the socioeconomic ladder. Dad died, according to this theory, from the side effects of racism.