VIOLENCE AS A PUBLIC HEALTH ISSUE
SLAVERY, SEGREGATION AND RACISM: TRUSTING THE HEALTH CARE SYSTEM AIN'T ALWAYS EASY!
AN AFRICAN AMERICAN PERSPECTIVE ON BIOETHICS
R. Randall , 15 St. Louis U. Pub. L. Rev. 191 -235 (1996)
A young Black male's risk of becoming a homicide victim in the United
States is one in twenty-seven, compared with one in two-hundred-five for
young White males. The risk of becoming a homicide victim for young Black
females is four times higher than for young White females in the White
community. It is clear that violence in the African American community
is a public health issue. However, even as the words "public health" arise,
I have the cloud of the failed federal Violence Initiative to combat.
The Violence Initiative was a proposed federal initiative to combat
violence in the inner-city, supposedly by focusing a more efficient effort
toward collective policy making. (217) However, the
Violence Initiative was based on two disturbing premises. The first was
that much of violent behavior in the inner city may have biological or
genetic origins. (218) The second premise was that
"factors of individual vulnerability and predisposition to violent behavior
exist--factors that may be detected at an early age." (219)
To the African American community, the initiative's intervention and problem-solving
policy mandate were to focus on the children of the inner city. (220)
[T]he advent of the federal Violence Initiative threatened the personhood
and the voice of African-Americans, and more particularly of African-American
children, by fostering biological and reductionist theories of genetic
linkage between criminally-violent behavior and inner-city youth. Furthermore,
it decontextualized and dehistoricized the idea of violence, and devalued
the worth of the African-American child by reinforcing gender and stereotypical
concepts of African-American women and men. (221)
The federal Violence Initiative failed because it wanted to focus on
the people as the cause of the problem. Yet, a public health approach is
warranted if it were to take proactive strategies to counteract the powerful
economic and political forces of our society that legitimatize these levels
of violence. If we want to reduce violence, we will have to deal with the
system that produces violence. Unfortunately, more often than not, a public
health approach focuses on the human development in our community.
A focus on human development will necessarily be flawed because any
actions or behaviors of the black community will be viewed in the historical
context in which the American experience with slavery served to legitimize
the image of African Americans as unworthy of respect and bodily integrity,
and undeserving of psychological well-being. (222)
Furthermore, the images of sex and subjugation in the national psyche further
legitimized the attempts to link social conditions with genetic deficiencies.
Thus, even though they are free from slavery, Black men and women are
bound now by a caste of race and poverty. They are "welfare queens," and
members of the "underclass." They have become mothers and fathers of sons
who have been labeled an "endangered species," and of daughters who are
caught in a cycle of "teenage pregnancy." Subsuming and denying the individuality
of African-Americans, these images represent "inherent and permanent inequality
. . . apart from any environmental influence." The social value of African-American
children has never been recognized, and now their economic value is recognized
as marginal or as having ceased to exist. Black people bear children who,
by their very existence, become the tools for their own destruction, the
murderers of their own spirits. These children become individuals who are
seen as obsolete. African-American men and women in the inner city give
birth to disposable children. (224)
FN217. Sellers-Diamond, supra note 161, at 424. As a result of Dr. Goodwin's
announcement concerning the intent and the rationale of the Violence Initiative,
he was dismissed as Director of the Alcohol, Drug Abuse, and Mental Health
Administration and demoted to the position of Director of the National
Institute of Mental Health. Under the new Clinton Administration, part
of the Violence Initiative was canceled as a coordinated effort, amidst
continuing doubts as to the integrity and legitimacy of the endeavor. Id.
FN218. See generally DEPARTMENT OF HEALTH AND HUMAN SERVICES, REPORT
OF THE SECRETARY'S BLUE RIBBON PANEL ON VIOLENCE PREVENTION (Jan. 15, 1993);
Peter R. Breggin, M.D. & Ginger R. Breggin, The Federal Violence Initiative:
Threats to Black Children (and Others), 24 PSYCHIATRY DISCOURSE 8 (1993)
(discussing the disadvantages of the federal Violence Initiative).
FN219. Sellers-Diamond, supra note 161, at 425 (citing DR. FREDERICK
K. GOODWIN, ADDRESS AT THE MEETING OF THE NATIONAL MENTAL HEALTH ADVISORY
COUNCIL 115, 117 (Feb. 11, 1992)).
FN220. Id. Dr. Goodwin, in one of the first introductions of the Violence
If you look, for example, at male monkeys, especially in the wild, roughly
half of them survive to adulthood. The other half die by violence. That
is the natural way it is for males, to knock each other off and in fact,
there are some interesting evolutionary implications of that because the
same hyperaggressive monkeys who kill each other are also hypersexual,
so they copulate more to offset the fact that more of them are dying.
Now, one could say that if some of the loss of social structure in this
society, and particularly within the high impact inner-city areas, has
removed some of the civilizing evolutionary things that we have built up
and that may be it isn't just the careless use of the word when people
call certain areas of certain cities jungles, that we may have gone back
to what might be more natural, without all the social controls that we
have imposed upon ourselves as a civilization over thousands of years in
Id. at 426 (quoting DR. FREDERICK K. GOODWIN, ADDRESS AT THE MEETING
OF THE NATIONAL MENTAL HEALTH ADVISORY COUNCIL 119-20 (Feb. 11, 1992)).
FN221. Sellers-Diamond, supra note 161, at 431 (citation omitted).
FN224. Id. at 453-54 (citation omitted).