The Impact of Hate-Motivated Behavior on African American Health

By Selen Ozturk

At the 13th annual virtual Black Physicians Forum, health experts shared how racism underlies hate-motivated behavior which adversely impacts African American health.

Above: William Jahmal Miller, MHA, the Chief Administrative Officer of Mercy Medical Group and Dr. Flojaune Cofer, an epidemiologist and 2024 candidate for Sacramento Mayor.

SACRAMENTO, Calif. — In the context of increased social unrest in recent years, addressing the impact of hate-motivated behavior on African American health is critical, physicians and community leaders shared at the 13th annual virtual Black Physicians Forum.

The event was hosted by Sac Cultural Hub Media Foundation and the UC Davis Health Office for Health Equity, Diversity and Inclusion. The forum featured keynote speaker Dr. Flojaune Cofer — an epidemiologist and 2024 candidate for Sacramento

Mayor; and moderator William Jahmal Miller, MHA — the Chief Administrative Officer of Mercy Medical Group.

Social Determinants of Health and Trauma

Data show African Americans fare worse than their white counterparts across a range of health indicators, including infant and maternal mortality, as well as rates of asthma, diabetes and Alzheimer’s.

Social determinants of health are key to improving these trends across African American communities, said Dr. Cofer.

These determinants not only “include the physical factors in our environment, like safe housing, areas for recreation, and the availability of nutritious foods, and clean air and water, but also the social and economic factors like racism and poverty… job opportunities, and community or family violence,” she added. She presented these determinants in terms of five domains: economic, educational, health, neighborhood and built environments, and social or community contexts. Although hate-motivated behavior can cross domains, it often fits most squarely in a social and community-based context, in terms of “the experiences that we’re having and our connection or disconnection with one another.”

African Americans remain among the groups most targeted for racially motivated hate crimes and hate incidents, both of which have been trending upward in recent years, according to data from the FBI.

The perpetuation and experience of hate-motivated behaviors is effectively

by MIKE STOBBE AP Medical Writer

were innately worse than those of white people. That assumption ended up in modern guidelines and algorithms for assessing risk and deciding on further care. Test results were adjusted to account for — or “correct” for — a patient’s race or ethnicity.

One example beyond lung function is a heart failure riskscoring system that categorizes Black patients as being at lower risk and less likely to need referral for special cardiac care.

Credit: Shutterstock

NEW YORK (AP) — Racial bias built into a common medical test for lung function is likely leading to fewer Black patients getting care for breathing problems, a study published Thursday suggests.

As many as 40% more Black male patients in the study might have been diagnosed with breathing problems if current diagnosis-assisting computer software was changed, the study said.

Doctors have long discussed the potential problems caused by race-based assumptions that are built into diagnostic software. This study, published in JAMA Network Open, offers one of the first real-world examples of how the the issue may affect diagnosis and care for lung patients, said Dr. Darshali Vyas, a pulmonary care doctor at Massachusetts General Hospital.

The results are “exciting” to see published but it’s also “what we’d expect” from setting aside race-based calculations, said Vyas, who was an author of an influential 2020 New England Journal of Medicine article that catalogued examples of how race-based assumptions are used in making doctors’ decisions about patient care.

For centuries, some doctors and others have held beliefs that there are natural racial differences in health, including one that Black people’s lungs examined through a lens of trauma, Cofer said. She defined trauma as an event or series of events “that are experienced by an individual as physically or emotionally harmful, or even life-threatening,” leaving a “lasting and perpetual adverse effect on their ability to function their mental, their physical, their social, their emotional or spiritual well-being.”

Forms of Racism

Racism critically underlies hate-motivated behavior which adversely impacts the health of African American community members. Racism can take many forms beyond personally mediated actions involving “an acute stressor, an individual insult or a discriminatory act,” Coffer said.

Beyond this individual scale there’s cultural racism, “which determines which group qualities and characteristics are valued or devalued” in a society; internalized racism, “when we accept the negative things that are said about our own abilities our worth”; and institutional racism, which are “discriminatory race- or class-based policies or practices that can be formal or informal, that can continue to perpetuate themselves long after they’re formally in place because of the way that they shape the foundation of how we operate.”

To discuss hate-motivated behavior, she continued, is to discuss the intersection of two or more of these forms of racism, and the way in which economic, educational, health, environmental, and social systems amplify or mitigate the harm caused by this racism.

Forms of Hate-Motivated Behavior

Coffer went on to discuss various forms of hate-motivated behavior, which she defined as intentional “verbal or nonverbal expressions of discrimination.”

Examples include hate speech in-person or on social media; hate crimes directed toward individuals based upon their actual or perceived racial group; and societal hate-based discrimination in the form of white supremacist ideology. These forms of hate-motivated behavior against African Americans are a “public health threat … shaping the context in which we’re living,” she said. When perpetrators of this behavior act “in ways that are threatening … with impunity, that really challenges our ability to be able to be healthy, because one aspect of safety is our emotional safety our physical safety. And when that is violated, we are deeply challenged able to live the lives that we should be able to live.”

Liberation and Healing

Just as each of the above levels of “dehumanization and distress” contribute to the institutional systems which encourage these behaviors, so does every level of “liberation and healing,” said Coffer.

To challenge hate-motivated behavior from the perspective of public health, she added, practitioners and policymakers continued on page 8

Black men were likely under diagnosed with lung problems because of bias in software, study suggests...continued than 2,700 Black men and 5,700 white men tested by University of Pennsylvania Health System doctors between 2010 and 2020. The researchers looked at spirometry and lung volume measurements and assessed how many were deemed to have breathing impairments under the race-based algorithm as compared to under a new algorithm. Researchers concluded there would be nearly 400 additional cases of lung obstruction or impairment in Black men with the new algorithm. to the return of Jesus Christ, there will be a distinct and discernable period of 3.5 years [1,260 days] and we will know when this period of time is upon us by the following series of events and circumstances:

A worldwide power structure controlled by Satan, ran by the Beast, will be established with total control over the lives of all people on the planet. Happening Now! [Revelation 13:5].

The military and police forces of the Beast will occupy [trample] Jerusalem. Happening Now! [Revelation 11:2, Matthew 24:15, and Luke 21:20].

All the flesh and blood descendants of Jacob will be persecuted and violently oppressed. Happening Now! [Jeremiah 30:7, Matthew 24:21].

And one more event that will occur during this 3.5-year period. The final, global witness of God's truth accomplished by those who are known as "the two witnesses." [Revelation 11:1-14].

I tell you, the prophecy of [Daniel 2] alone shows we are in the 'time of the end', and all the other evidence proves we are in the very end times. The Biblical signs are clear for all to see, but as [Ezekiel 12: 2] states, “You have eyes to see but do not see, and ears to hear but do not hear, for you are a rebellious house. Ever seeing but never perceiving, and ever hearing but never understanding;” [Mark 4:12].

Listen, I cannot overstate that we are living right in the end of times for this world. Sure, many people throughout history have proclaimed that we were living in the last days and the end of the world was near, and some of the Bible signs have always existed from the early days. But never has there been a time before when ALL these events were evident in so many diverse places and with such frequency and intensity. Please repent before it is too late! God’s Final Warning! TIME IS ALMOST UP!

And He said to me, " Do not seal up the words of the prophecy of this Book, for the time is near. Let the one who does wrong, still do wrong; and the one who is filthy, still be filthy; and let the one who is righteous, still practice righteousness; and the one who is holy, still keep himself holy. Behold, I am coming quickly, and My reward is with Me, to render to every man according to what he has done. I am the Alpha and the Omega, the first and the last, the beginning and the end. Blessed are those who wash their robes, so that they may have the right to the tree of life and may enter by the gates into the city. Outside are the dogs [the godless, the impure, those of low moral character] and the sorcerers [with their intoxicating drugs, and magic arts], and the immoral persons [the perverted, the molesters, and the adulterers], and the murderers, and the idolaters, and everyone who loves and practices lying [deception, cheating]. Multitudes, multitudes in the valley of decision; for the day of the Lord is near in the valley of decision! [Joel 3:14].

WITNESS FOR JUSTICE #1154

Tug of War

Michael Neuroth

Director, Washington Office

Acting

Another is an equation used in determining kidney function that creates estimates of higher kidney function in Black patients.

The new study focused on a test to determine how much and how quickly a person can inhale and exhale. It’s often done using a spirometer — a device with a mouthpiece connected to a small machine.

After the test, doctors get a report that has been run through computer software and scores the patient’s ability breathe. It helps indicate whether a patient has restrictions and needs further testing or care for things like asthma, chronic obstructive pulmonary disorder or lung scarring due to air pollutant exposure.

Algorithms that adjust for race raise the threshold for diagnosing a problem in Black patients and may make them less likely to get started on certain medications or to be referred for medical procedures or even lung transplants, Vyas said.

While physicians also look at symptoms, lab work, X-rays and family histories of breathing problems, the pulmonary function testing can be an important part of diagnoses, “especially when patients are borderline,” said Dr. Albert Rizzo, the chief medical officer at the American Lung Association.

The new study looked at more

Earlier this year, the American Thoracic Society, which represents lung-care doctors, issued a statement recommending replacement of race-focused adjustments. But the organization also put a call out for more research, including into the best way to modify software and whether making a change might inadvertently lead to overdiagnosis of lung problems in some patients.

Vyas noted some other algorithms have already been changed to drop race-based assumptions, including one for pregnant women that predicts risks of vaginal delivery if the mom previously had a cesarean section.

Changing the lung-testing algorithm may take longer, Vyas said, especially if different hospitals use different versions of race-adjusting procedures and software.

“What is God’s Final Warning?”

By Lou K. Coleman

Over the past month, our nation has been anxiously watching the “debt ceiling” tug of war play out on Capitol Hill. The debt ceiling, or limit, is the maximum amount of federal debt the government can incur at any given time. It must be raised to pay the nation’s bills to avoid a default, which, if ever reached, would send the U.S. economy into a tailspin and disrupt critically needed services.

Treasury Secretary Yellen has estimated that we will reach the current limit of $31.4tn on June 5th. What was once a routine vote has now become political theatre and brinkmanship—a tug of war between two parties seeking to score political points.

President Biden and Speaker McCarthy agreed to a compromise last weekend, and over this past week both chambers of Congress passed it in relative bipartisan fashion.

budget, even beyond what it requests, while at the same time claiming their hands are tied to help the poor.

A report released last week by the Institute for Policy Studies and National Priorities Project brings this further into focus.

Lou K. Coleman

If you don’t know let me, tell you. God’s Final Warning is that the time is near. The time is at hand. It is closer than we think. His coming will be quick. His coming will not wait on your preparation. God’s Final Warning! [Revelation 22:720]. What are you waiting for?

Accept Jesus now as your Lord and Savior! For what does it profit a man to gain the whole world and forfeit his soul? [Mark 8:36]. Do not be foolish! Too lose your soul is the greatest loss of all because it is a loss that can never be recovered.

Jesus told a story about a man who lived the American dream. He worked hard. He stored up all that he needed for a long retirement. And he said to himself: “Soul, you have ample goods laid up for many years. So, relax, eat, drink, and be merry. I’m going to enjoy myself. I’ve earned it.” But God said to him, “Fool! This night your soul is required of you” [Luke 12:1920]. Do not wait until it is too late! Whether you are young or old, the message today is for you. It is about your life, your eternal future. You soul is of greater value than the whole world and Jesus want your soul to be saved. Do not be foolish! Repent before it is too late. For you know neither the day nor the hour [Matthew 4:17; Matthew 25:13; Mark 1:15; Luke 5:32] “God’s Final Warning, “The appointed time has grown very short.”

Understand, before God judges a nation, He sends warnings. America, like Israel, has not responded with repentance, but with defiance. [Isaiah 9:10]. And if you read your Bible, you know that God had repeatedly warned the people of impending danger if they didn’t acknowledge Him, and in the end, because they did not, they paid the price for failing to listen. Don’t you do it! Don’t ignore the warnings. Repent before it is too late! Because God has also told us that prior continued in next 2 columns

As of this writing, it now awaits President Bidens signature before the Monday deadline. While the immediate debt default crisis may have been averted, the question is at what cost? The 99 page bill, in a nutshell, lifts the debt ceiling for two years in exchange for a cap (at 2023 levels) of annual federal discretionary spending on everything except the Pentagon and veterans’ programs. It also expands access but adds work requirements to safety net programs (TANF/SNAP), restarts student loan repayments, cuts IRS funding, and green lights a major gas pipeline, among many other provisions.

In this tug of war of our nation’s values, there seems to be only one clear winner—and it is not a political party. The only part of our budget exempt from the proposed cuts are the Pentagon and our nation’s broader military budget. Even though the U.S. spends more than the next ten countries combined (most of whom are allies) on our military, unquestioned support cuts across party lines. Any sense of “parity” found in past budget negotiations that kept defense and non-defense spending balanced is now gone. Except for a small but vocal minority of members, Congress will keep finding new ways to pump more money into the Pentagon’s almost $900bn

“The Warfare State: How Funding for Militarism Compromises our Welfare”i highlights how “overmilitarized” our federal budget is and how such investments are making us less safe by underinvesting in human needs. The report includes budget lines often left out of consideration (such as veterans affairs, homeland security, and law enforcement) but which are all forms of our militarized society. Ultimately, in FY23, 62% of our federal discretionary budget went to fund these programs, including direct funding for wars and weapons as well as law enforcement, incarceration, detention, and deportation. This pull toward militarism is nothing new. What is different now is the escalation of these costs, both economic and human, such that the militarized budget has almost doubled since 2001—from $587bn $1.1tn now.

Seventy years ago, this past April, President Dwight D. Eisenhower warned of these trends in his speech titled “The Chance for Peace”:

"Every gun that is made, every warship launched, every rocket fired signifies, in the final sense, a theft from those who hunger and are not fed, those who are cold and are not clothed. This world in arms is not spending money alone. It is spending the sweat of its laborers, the genius of its scientists, the hopes of its children."

President Eisenhower saw the potential pitfalls of a military-industrial (and now Congressional) complex. While it is critical that Congress raised the debt ceiling to avert an economic crisis, the final deal represents a deeper moral crisis we face as a nation. We cannot let our nation’s values be pulled further off course. Together, let us work toward a more faithful budget by prioritizing human needs over the tug of war.