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Appendix C: Concluding Remarks 1475th CERD Meeting

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Racial Discrimination in Health Care in the United States as a Violation Of the International Convention on the Elimination of All Forms of Racial Discrimination, [a1] 14 University of Florida Journal of Law and Public Policy 45-91 (Fall, 2002)

Selected Paragraphs from the Summary Record of the 1475th Meeting: United States of America. 22/08/2001.(200)

12. Mr. PILLAI. He stressed that education in its entirety was the most basic and critical component of a State's efforts to promote racial equality and harmony, and its impact on health, employment and poverty could not be overemphasized. He hoped, too, that the United States Government would pay due regard to the various reports circulated by a number of civil society organizations relating to racial discrimination in education.

13. Ms. BRITZ said she wondered in general, how, in a country with such a large amount of anti-discrimination legislation, such a high degree of inequality could still exist in matters such as health care, criminal justice, educational opportunities and housing; and whether the legislation itself had particular weaknesses or whether it was not the appropriate cure for racial inequality. A more specific question concerned discrepancy as to what was understood by discrimination, as defined in article 1, paragraph 1 of the Convention and further clarified in the Committee's General Recommendation XIV. According to a Supreme Court interpretation (para. 235 of the report), discriminatory intent, as well as disparate impact, had to be shown in order to demonstrate a constitutional violation of equal protection. But intent was much more difficult to prove than impact. Reading between the lines of the report, it was clear that its authors were aware of that discrepancy.

21. Ms. JANUARY-BARDILL, while recognizing that the Fifth and Fourteenth Amendments to the Constitution prohibited racial discrimination on the part of any public authority (report, para. 177) and that there existed a vast legal environment for implementation of measures relating to the Convention (report, paras. 84-144), expressed concern that, despite the existence of the legal framework and implementing mechanisms, numerous factors continued to have a negative effect on implementation (paras. 71 and 72). High levels of institutional and systemic racial discrimination persisted, as *89 evidenced for example by lack of educational opportunity, discrimination within the criminal justice system, unequal health care for minorities and disadvantaged women, and continued inequality for the African-American population. She stressed that covert racial discrimination was sometimes more dangerous than overt racial discrimination and its effects more devastating and therefore wondered who was to blame for factors which continued to affect implementation and for inadequate funding of public services, how local, state and federal authorities were reacting to violations of legislation at the institutional level, and who would address issues relating to equal access and ensure that equal treatment continued.

23. Mr. YUTZIS, referring to article 5 and the obligation of States parties to guarantee the rights of all, noted that among the factors affecting implementation described in the report was "under-funding of federal and State civil rights agencies" (para. 71(b)), and requested statistics on levels of funding for human rights activities, specifically statistics expressed not only in actual figures, which were relative and could be misleading, but also as a percentage of gross domestic product, which would provide a better understanding of the priority and resources allotted to human rights questions, and should preferably be broken down by areas such as housing, health, etc.

31. [Mr. THORNBERRY.] On the question of affirmative action, article 2, paragraph 2, of the Convention made it very clear that special measures to remedy disadvantage were mandatory when the circumstances so warranted. Such were the special measures taken by the United States Government on behalf of Native Hawaiians (report, para. 48). Although the Supreme Court had cast doubt on the Congress's authority to legislate in such a manner, and although various lower-court judgements [sic] had ordered an end to other affirmative action programmes (report, para. 275), the notion of equality employed in the Convention was one of equality in fact, which implied that those at a disadvantage must be treated differently and that such affirmative treatment could legitimately be ended only when the need for it had clearly ceased. That goal had not been reached in the United States, as indicated in paragraph 276 of the report.


Racial Disparity in Health Status
Institutional Racism in US Health Care
Inadequacy of Legal Efforts
US Violations of ICERD
Recommendations and Conclusions
Appendix A US Report
Appendix B White Shadow Report Excerpts
Appendix C: Concluding Remarks 1475th CERD Meeting
Appendix D Concluding Observations



200. [FN200]. Summary record of the 1475th meeting: United States of America 22/08/2001 CERD/C/SR.1475 (Summary Record).

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Professor Vernellia R. Randall
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The University of Dayton School of Law
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