Feeding The World

The following is a presentation I gave to my Community Health class. I was the final presenter in my group of six, on the topic of healthy food access. The others talked about:

• What is a food desert
• Healthy food access in Chicago
• How does Chicago compare to other urban areas
• Intervention efforts
• What is healthy food

My part was on “The global challenge”. Although my group did a spectacular job with their respective parts, I am only including my own contribution in this blog.

The Global Challenge

When the topic of feeding the world comes up, the first thing we think of is the problem of the world’s population, now at 7 billion,  increasing beyond the earth’s capacity to feed us all. We forget that the context of the food security challenge includes many other factors:

• Urbanization
• Growing Inequities
• Human Migration
• Globalization
• Changing Dietary Preferences
• Climate Change
• Environmental Degradation
• Trend Towards Biofuels

In 2002, the World Bank and United Nations collaborated to carry out a consultation to determine whether an in-depth assessment of international food security was needed. Two years later, they concluded that such an assessment should be undertaken, and they launched a massive, international effort that resulted in a 600-page scientific report, prepared by 400 experts from 52 countries. There were two rounds of peer reviews by 400 reviewers from 45 countries, including governments, organizations, and individuals.

58 countries accepted the final report in 2008, plus an additional three (yellow), which accepted it with reservation:

The objective of this report is clearly stated:

This Assessment is a constructive initiative and important contribution that all governments need to take forward to ensure that agricultural knowledge, science and technology (AKST)  fulfills its potential to meet the development and sustainability goals of:

• The reduction of hunger and poverty
• The improvement of rural livelihoods and human health, and
• Facilitating equitable, socially, environmentally and economically sustainable development

A section of the report included a summary of ten concerns, of which I only presented three. All ten were given out as a handout, for reference:

Agriculture At A Crossroads: Global Report Concern #1 The fundamental failure of the economic development policies of recent generations has been reliance on the draw-down of natural capital Concern #2 Failure to address the “yield gap” Concern #3 Modern public-funded AKST research and development has largely ignored traditional production systems for “wild” resources Concern #4 Failure to fully address the needs of poor people (loss of social sustainability) Calories Goods and services that confer health Basic material for a good life Security Community wellbeing Freedom of choice and action Concern #5 Malnutrition and poor human health are still widespread Research on the few globally-important foods (cereals) has been at the expense of meeting the needs for micronutrients Wealthier consumers are also facing problems of poor diet Increasing concerns about food safety Concern #6 Intensive farming is frequently promoted and managed unsustainably, resulting in the destruction of environmental assets and posing risks to human health Land clearance Soil erosion Pollution of waterways Inefficient use of water Dependence on fossil fuels (agrochemicals and machinery) Concern #7 Agricultural governance and AKST institutions have focused on producing individual agricultural commodities (e.g. cereals, forestry, fisheries, livestock), rather than seeking synergies and integrated natural resources management. Concern #8 Agriculture has been isolated from non-agricultural production-oriented activities in the rural landscape: Food processing Fiber processing Environmental services Trade and marketing Concern #9 Poor linkages among key stakeholders and actors Concern #10 Since the mid-20th century, there have been two relatively independent pathways to agricultural development: Globalization o Agricultural R&D o International Trade Localization o Relevant to local communities (IAASTD, 2009)

Concern #1

The fundamental failure of the economic development policies of recent generations has been reliance on the draw-down of natural capital.

 

 

• 80% of oceanic fisheries are being fished at or beyond their sustainable yield
• The world’s forests lose a net 5.6 million hectares (an area the size of Costa Rica) each year
• Half the world’s population lives in countries that are extracting groundwater from aquifers faster than it is replenished

(Brown L. R, 2012)

Concern #5

Malnutrition and poor human health are still widespread

• Research on the few globally-important foods (cereals) has been at the expense of meeting the needs for micronutrients
• Wealthier consumers are also facing problems of poor diet
• Increasing concerns about food safety

 

The USDA recommends that fruits and vegetables comprise about 50% of our food plate, yet fruits and vegetables represent only about 35% of global production. Grain production, on the other hand, represents about twice the amount recommended for a healthy diet.

In my pie chart, I split out corn from the rest of grain production, because corn is an interesting product in our food supply. Not only does this single crop dominate the rest of food production, but it is used for many things besides food. For example, about 30% of the corn crop is used for high fructose corn syrup. Another 30% is used for fuel. This is a problem, because the price of food in our market system is inextricably linked to the price of fuel.

What is driving the disparity between the USDA plate and global production? Is it supply, or demand? If demand, who is fueling that demand – could it be the suppliers? Something to think about.

Concern #6

Intensive farming is frequently promoted and managed unsustainably, resulting in the destruction of environmental assets and posing risks to human health

• Land clearance
• Soil erosion
• Pollution of waterways
• Inefficient use of water
• Dependence on fossil fuels (agrochemicals/machinery)

  

The Water Cycle: The existence and movement of water on, in, and above the Earth, between the atmosphere, land, water bodies, and soil. Earth's water is always in movement and changing states, from liquid to vapor to ice. The water cycle—a physical process—including the movement and changing state of water affects plant and animal (including human) life.

The Mineral Cycle: The movement of minerals or nutrients including carbon, nitrogen and other essential nutrients. This physical cycle affects plant, animal and human life.

Energy flow: The most basic physical processes within an ecosystem are photosynthesis and decomposition. Energy flow describes the movement of energy from the sun through all living or once living things.

Community Dynamics (Succession): Ecosystems, plant and animal communities are ever changing. Community dynamics, a biotic process, describes the never-ending development of biological communities.

Source: Essig, 2013

 

Nature is full of cycles; it is when those cycles are broken that a process becomes unsustainable. To be sustainable over the long term, farming processes and methods should respect the cycles of nature. These four critical cycles are four panes in the window of our ecosystem; all work together synergistically in a healthy system.

 

Desertification Vulnerability

 

• Dust storms carrying 2-3 billion tons of soil leave Africa each year
• Roughly ⅓ of the world’s cropland is now losing topsoil faster than it can be reformed

(Source: Brown L.R., 2012)

 

Holistic Management

After and Before: Kariegasfontein ranch in Aberdeen, South Africa (Savory Institute, 2014)

Alan Savory is leading an effort using a paradigm he calls “Holistic Management,” resulting in successful healing of deserts: 15 million hectares on five continents. He claims that slight increases in organic matter over huge portions of the earth’s land surface area, would result in putting masses of carbon “back where it belongs – in the soil – and more importantly, where it can actually do some good. Organically rich soils feed soil bacteria, protozoans, and fungi, active populations of which lead to ever greater plant-available nutrients and less dependence on outside fertilizer inputs.” (Savory, 2013)

 

Healing Tree Farm

Healing Tree Farm, near Traverse City, MI, 26 May 2013

Intensive use of pesticides kills the soil.

 

The green portion of land in this photo is near the farmhouse; pesticides were not applied there. The brown portion was a field that received heavy pesticide and fertilizer inputs for several years. Not much will grow there now, not even weeds, without significant quantities of inputs. The land is now being transitioned to a permaculture demonstration farm. The land will eventually heal over several years, given healthy management.

I have a favorite quote about the importance of soil from a farmer friend whom I respect and admire very much, Henry Brockman:

Highly nutritious food comes from a healthy soil that is part of a healthy farm that is part of a healthy environment. This circle of health is generated by farming practices that are based on the goal of protecting and enhancing all life, from the lives of the insects, worms, and arthropods of the vegetable field to the lives of the wildlife and domesticated life who inhabit the environment around the field.

The basic tenet of this kind of farming is to protect and enhance the tiny lives of the microorganisms of the soil.

Synthetic fertilizer, which should be a life-promoting substance, actually deals in death. And it deals in death in many ways, polluting air and water as well as killing soil life and disrupting the soil’s intricate system for naturally providing plants with nitrogen.  (Brockman, 2001)

 

Phosphorus

 

Source: Elser & Rittmann, 2013

 

The ‘P’ in ‘N-P-K’ fertilizer is for phosphorus, one of the most important nutrients to plant and animal life. Traditionally, ground-up rock phosphate has been applied sparingly to farmland; it is not water soluble so the phosphate becomes available to plants only very slowly, over a period of years. In recent years the industry started treating the phosphate rock with acid to make it water soluble: “super phosphate”. This is used in industrial farms and is immediately available to plants, resulting in significant growth. That’s all well and good, except that excess phosphate, being water soluble, leaches into the ground water and makes its way to streams and rivers, and eventually to the oceans. There is a dead-zone in the Gulf of Mexico where no aquatic life can exist, because of this problem. (Herman Brockman, in Gelder, 2012)

• 20 million metric tons of Phosphate in fertilizers were applied in 2012 worldwide.
• Phosphorus comes primarily from Morocco (75%), #2: China (5.5%), #7: US (2%)
• Phosphorus use tripled between 1960 and 1990 (IAASTD, 2009)
• Extrapolating this trend, the US will become entirely reliant on imports within 3-4 decades. (Elser & Rittmann, 2013)

 

The series of phosphate cycles shown above illustrate a potential solution to upcoming phosphate shortages. The “current” cycle shows that mined phosphorus is the source of about 90% of the phosphate used to fertilize soil and crops; another 10% comes from weathered phosphorus. The phosphorus mines are limited. Another source of phosphorus that is currently only minimally tapped, is from animal, food, and human waste.

If we were to do a better job of recycling the phosphorus from our waste, we would reduce the need for the water-soluble fertilizer, reduce erosion and runoff into the water, the water would become less polluted, enhancing the survival of fish populations, as shown in the “transition” and “implemented” cycles of the series above.

Water

Source: Brown L. R., 2012

 

Are Industrial Methods Necessary?

Source: Liebman, 2008

The agriculture industry tells us that, despite the pollution to our water, air, and soil, despite the depletion of resources such as phosphorus, water, and fossil fuels, despite the health risks of pesticides and the super weeds and the antibiotics and the CAFOs, if we did not farm the way we do, we would not be able to feed our 7-billion mouths. Is this claim true?

A long-term (10 year) study was recently undertaken by Iowa State University, funded by a grant from the USDA. They compared the conventional 2-year corn/soybean rotation typically used, with longer, 3- and 4-year rotations that included one year of red clover, and two years of alfalfa, respectively. With each rotation paradigm, they also compared transgenic crops grown using high inputs of pesticides, with non-transgenic crops grown with minimal use of pesticides.

The results are in. They found the following:

• The 3- and 4-year rotation systems exceeded the 2-year conventional systems in yield by 4-20%.
• Weed biomass was low in all systems without significant variation.
• Net returns were highest for 3-year non-transgenic system, and lowest for the two-year non-transgenic system.

Their conclusion:

These results indicate that substantial improvements in the environmental sustainability of Iowa agriculture are achievable now, without sacrificing food production levels or farmer livelihoods. (Liebman, 2012)

The Global Report also had this to say:

Small farms are often among the most productive in terms of output per unit of land and energy.

And:

Restoration techniques are available, but their use is inadequately supported by policy. (IAASTD, 2009)

It is possible to feed our population, but we have our work cut out for us to help establish the policies that can facilitate equitable, socially, environmentally, and economically sustainable development.

Regulatory change will not happen overnight. Until it does, we can each do our part to influence the transition to sustainable farming methods, by voting with our fork.

I have made a personal commitment to consume food that has been organically grown, using sustainable methods that enhance the health of our soil and ecosystem. I know that this is not possible for many, and it did not happen over night for me; I have been working on this for several years now, taking small steps at a time.

When we talk about food deserts, we are referring to areas where healthy food is not available. We usually think of healthy food in terms of fresh fruits and vegetables. But, if we were to extend our definition of healthy food to food that has been grown to support the health of the environment, we would discover that most of us actually live in a food desert.

Because of my personal commitment, I have searched for organically grown food near campus. I have inquired at every restaurant on Taylor Street between the East and West campuses. The closest restaurant I have been able to find is across the street from the Sears Tower, two miles away. Organic food is also available at the Whole Foods on Canal and Roosevelt Rd. These locations are hardly close enough for me to walk to between classes to buy a lunch, so I pack my own lunch and carry it around with me to all my classes in my backpack. We are in a food desert here on campus.

At home, the nearest Whole Foods is over three miles from my home. The nearest farmer’s market that provides organically grown local produce is about 30 miles away from my home. I live in a food desert. Therefore, I am working on transitioning my backyard to a garden so that I can grow my own produce.

If more people would insist on consuming produce that has been raised sustainably, more farmers would make the effort to respond to the demand. We do not have to wait for our government to do the right thing; each of us can do what we can in our own way, to support the movement towards healing our earth.

References

Aneki.com. (n.d.). Map of the World. Retrieved March 31, 2014, from Aneki.com Rankings + Records: http://www.aneki.com/map.php

Brancaccio, D. (2012, April 30). Soybean prices on the rise, could impact other food sources. Retrieved from Marketplace Morning Report: http://www.marketplace.org/topics/economy/soybean-prices-rise-could-impact-other-food-sources

Brockman, H. (2001). Organic Matters. Congerville: TerraBooks.

Brown, L. (2012). Full Planet, Empty Plates: The New Geopolitics of Food Scarcity. New York: W.W. Norton & Company.

Brown, L. R. (2012). Presentations for Full Planet, Empty Plates: The New Geopolitics of Food Scarcity. Retrieved March 29, 2014, from Earth Policy Institute: http://www.earth-policy.org/books/fpep/fpep_presentation

CME Group. (2014, March 1). Agricultural Commodities Products. Retrieved March 29, 2014, from CME Group: http://www.cmegroup.com/trading/agricultural/

Earth Policy Institute. (2014, February 25). Food and Agriculture. Retrieved March 31, 2014, from Earth Policy Institute: http://www.earth-policy.org/data_center/C24

Elser, J. J., & Rittmann, B. E. (2013, December 25). The Dirty Way to Feed 9 Billion People. Future Tense. Retrieved March 31, 2014, from http://www.slate.com/articles/technology/future_tense/2013/12/phosphorus_shortage_how_to_safeguard_the_agricultural_system_s_future.2.html

Essig, M. (2013). Nurturing Our Planet: The Health Of The Ecosystem Processes. Savory Institute.

Gelder, M. (2012, November 16). Interview with Herman Brockman about GMOs. Retrieved March 30, 2014, from Mary's Heights Blogspot: http://marysheights.blogspot.com/2012/11/interview-with-herman-brockman-about.html

IAASTD. (2009). Agriculture at a Crossroads: Global Report. International Assessment of Agricultural Knowledge, Science and Technology for Development. Retrieved March 29, 2014, from http://www.unep.org/dewa/assessments/ecosystems/iaastd/tabid/105853/default.aspx

Liebman, M. (2008). Mixed Annual-Perennial Systems: Diversity on Iowa's Land. Iowa: Leopold Center, Iowa State University. Retrieved March 31, 2014, from http://www.leopold.iastate.edu/sites/default/files/events/Matt_Liebman_presentation.pdf

Liebman, M. (2012). Impacts of Conventional and Diversified Rotation Systems on Crop Yields, Profitability, Soil Functions, and Environmental Quality. Leopold Center for Sustainable Agriculture. Iowa State University. Retrieved March 31, 2014, from https://www.leopold.iastate.edu/sites/default/files/grants/E2010-02_0.pdf

Savory Institute. (2014). Desertification Solution: Holistic Management. Retrieved March 30, 2014, from Savory Institute: http://www.savoryinstitute.com/science/the-desertification-crisis/desertification-solution-holistic-management/

Savory, A. (2013). The Foundation of Holistic Management: New Principles & Steps For Handling Complex Decisions, E-Book One. Savory Institute. Retrieved from http://savory-institute.myshopify.com/products/holistic-management-principles-new-principles-steps-for-handling-complex-decisions

USDA. (1998). Natural Resources Conservation Service Soils. Retrieved March 29, 2014, from United States Department of Agriculture: http://www.nrcs.usda.gov/wps/portal/nrcs/detail/soils/use/worldsoils/?cid=nrcs142p2_054003

USDA. (1999). Feed Yearbook. (D. Decker, Ed.) U.S. Department of Agriculture, Market and Trade Economics Division, Economic Research Service.

Technorati Tags: Feeding the World,Food Security,Sustainability,Agriculture,Farming

Reflections on Racial Disparity

The following is a paper I wrote February 11 for my community health class; the assignment was to reflect on specific readings about racial disparity.

 

The readings for this week included:

• Hebert, P., Sisk, J., Howell, E., When Does a Difference Become a Disparity? Conceptualizing Racial and Ethnic Disparities in Health. Health Affairs; Mar/Apr 2008, Vol. 27 Issue 2, p374-382.
• Smedley, B., Stith, A, Nelson, A. (Ed.) Unequal treatment: Confronting Racial and Ethnic Disparities in Health Care (2002). Washington, D.C.: National Academies Press Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care.

I gripped the useless steering wheel in front of me, all senses alert, taking in the crackling roar of the windshield grinding relentlessly on the pavement. I was hanging upside down by my seatbelt and realized that I was likely facing my end. A heavy sadness wrapped around my heart with the thought that I would never see Mother again. The roar continued and I waited helplessly in the darkness for the inevitable impact that I hoped would not be too painful.

And then there was a wicked silence that told me the car had finally stopped. Instantly the adrenalin of fear kicked in and I knew it was urgent to get out of the car. On TV, the next thing to happen after a car flips is an explosion. Unlike Starksy on TV, though, who usually did everything right, I released my seatbelt to escape and landed clumsily on my head in a pile of shattered glass. The door was blocked by the weight of the car and the only way out was through the side window. The only thought that drove me forward was “GET OUT NOW!” Never mind that the shattered window still had shards of glass around the frame.

An instant later I was standing several feet away from my car. With huge relief I saw that the car was not in the middle of the Interstate as I’d feared, but well off the road in a field. I looked at my poor car resting strangely upside down, the headlights shining their beacons into the darkness like a lighthouse, the incongruously cheerful strains of Claude Bolling’s Picnic Suite haunting the night from the tape deck still playing away. “I should have turned off the car,” I thought, while the unmistakable fumes of fuel warned me to stay well clear.

Now what? I was a young woman alone in the middle of a cornfield with no homes anywhere in sight. Anyone could easily take advantage of my vulnerable situation as I realized I still faced danger. But so far I was still alive. I did a quick survey: head hurt, neck in pain, back screaming pain, dark blood trickling slowly down both forearms in tiny rivulets like condensing ice water on a glass; my hasty exit through the window had left its mark. Someone was approaching. Friend or foe, I had no choice but to wait.

“Is there anyone in the car?” He was bending over, trying to peer into my dark car. “I’m alone,” I replied. “You ok?” He asked. “Uh, I think so.” “Come with me,” and he extended his hand toward me.

The hand was black.

It was only a flickering moment but it was framed in the context of generations of mistrust and abuse between “us” and “them”. My first encounter with people of Color was as a child in a restaurant in the city with Grandma and Grandpa. All of the people working in the kitchen, collecting the glass dishes from the dining room onto metal carts for washing, were dark. I’d never seen anyone like them before in my all-white community. “You don’t want to be like THOSE People,” Grandma had said. Later as I grew up, I noted that the people with smart jobs were all white. The people cleaning the hotels, picking up the garbage, and washing the dishes, were Black. I had to agree with Grandma, I wanted something better.

In my household, our church was the center of our lives. As a young child, I learned that God had restored his church and reestablished the authority to act in his name using the keys of the Priesthood. Young men were ordained with levels of the Priesthood, starting at age 12, with one caveat: the Priesthood was available only to men who were not of the lineage of Cain. My parents and church leaders tried to explain the unanswerable question: “Why?” For some reason God felt that Blacks were not worthy enough for the Priesthood. Although the church reversed its position when I was a young adult, the damage had already been done in my impressionable youth. I trusted God, and trusted the church like my parents. Even after the church started extending the Priesthood to Black members, shadows of condescension persisted. Eventually I rejected the church and formally withdrew my membership, but was still left with that stain of my upbringing.

That hand was black.

Soon after I moved to Chicago, the springs in my mattress started breaking through on both sides: top and bottom. That mattress, salvaged many years before from somebody’s garbage heap at the side of the road, had been a blessing to me at a time when I could barely afford food and rent, let alone furniture. It was time to find a new mattress, and I didn’t want just any mattress, I wanted one that was 90 inches long to fit my Gelder-sized body. The yellow pages and several phone calls I’d made had yielded only one place in all of Chicagoland that offered the possibility of obtaining a custom-made 90” mattress. They gave me the address of their store over the phone and told me to ring the doorbell at the side door when I arrived.

Ring the doorbell?

I found the address on my map and it took over an hour to drive there from my apartment. As I approached the store I noticed uneasily that the neighborhood was one of “those” that I probably should not be driving around in. I found the store and parked my car across the street and sat in my seat looking at it. Bars covered the windows. The front door was secured with a chain. Graffiti marred the side wall. I checked all of my car doors to make sure they were all safely locked and felt that I should leave. But to leave meant that I would not get my 90” mattress, and I gathered myself up, got out of the car, squared my shoulders, and walked, hardly breathing, across the street and down the alley to the side door. “Who’s there?” someone hollered when I rang the bell. “Mary Gelder,” I squeaked. “I have an appointment.” They let me in and told me someone would be with me shortly, leaving me alone in a small showroom displaying three beds. The walls were covered with posters; a picture of Jesus was in the far corner. Their Jesus was apparently different than the Jesus I grew up with. I could hear some sort of work activity in a room beyond, where I imagined they might soon be making my new 90” mattress. I wondered if I’d made a mistake. I had once managed the furniture department at Sears, and learned the value of a quality mattress. I wondered where on the scale of quality a mattress made by this shop would fall: good, better, or best? Or maybe – worst?

Nobody was coming, so I walked around the room, killing the time by looking at the posters they had on the walls. Each poster featured a Black person accompanied by a brief account of his or her contribution to the Black community. Martin Luther King was among them, but he was the only one I recognized. “Why is it that I’ve never even heard of these apparently great people,” I wondered to myself. The individuals who were prominent enough in Black culture to be so revered by the store proprietor had never even crossed the threshold of my awareness. Was it that I had not paid attention in school, or was my education sorely biased?

That black hand was still extended toward me. He was waiting.

“You should read this,” the nurse told me. I was working at a nursing home in my neighborhood, and had just helped one of the patients to bed, securing her diaper and removing her dentures. I took the newspaper clipping from the nurse and glanced at it. “First Black Woman Graduates” read the headline; a photo showed a young Black woman standing in front of the wrought-iron fence bordering the campus. It was a well-yellowed article about the woman before me, now in her nineties. This woman had refused to be deprived of a college education, had made up her mind despite her race and gender to graduate, had faced the university board and somehow convinced them to admit her. She put up with whatever frictions and prejudices of the student body and faculty that had surely confronted her, and finally graduated, the first Black woman ever to do so from that university. I looked at her lying in the bed before me, a woman ultimately discarded by society into the nursing home where I worked, her eyes now vacant and confused. I wondered if she had made a difference in the world, and whether her insistence on having a college education had paid off for her. I wondered how many doors had later been opened to other women, Black and White, because of her persistence and determination to crack through that racial barrier. I felt something shift in my own opinion towards the Black struggle, and realized that this woman’s courage and persistence was, that night, making a difference to me.

Why was it so hard for me to take that Black hand, to accept his humble offer of help at my moment of critical vulnerability? And why was I so disturbed when I read the suggestion by Hebert, Sisk, and Howell for a thought experiment to consider how a subject’s health “would be different if he were to relive his life to date as a different race?” How would my own health be different had I been born Black? The question shocked me enough to worry about it through the night, unable to sleep. What is it about being Black that bothered me so much at the suggestion?

It is not a question of looks or ability, nor is it an implication that I might be less of a person. It is not even a question of rightness or wrongness, although earlier in my life I did have to confront that senseless perception of race. Rather, the jolt of thinking of myself as Black brings with it a sense of deep loss of opportunity. I have to acknowledge that my life has been easier because I’ve lived in a safe, White neighborhood. Unlike the Black nursing home patient I met, some of the doors I’ve faced have been already open, ready for me to walk through. Being on the “Yes” end of things has made it easier for me to be healthy. “Yes, you can take this class.” “Yes, you can rent this apartment.” “Yes, you can have this job.” “Yes, you can be my friend.” Some of the barriers that would confront me as a Black person are deeply rooted injustices engrained in traditions, religions, role models, music and arts, political systems, and social media. Any success that I’ve enjoyed may be somewhat attributable to the fact that I’m not Black. As pointed out by Hebert/Sisk/Howell, “a person may make different choices if living a counterfactual race in a different social context.” The decisions I’ve made throughout life have stemmed from my response to a fundamental perception of my own social place. I am not relegated to the back seat, and nor were my parents, or my grandparents. In my formative years, I recognized that I belong to a race shared by our nation’s presidents, astronauts, and movie stars. As a White person, I’ve felt that I can, if only I will. Had I been Black, my perceptions, and subsequently my decisions, may have taken different paths altogether. And as a Black person, my interactions with peers, employers, and others in authority over me may have been completely different. The color of my world would likely have been in sharp contrast to what I’ve actually experienced. And that bothers me.

Accounting for the factors of disparity may be much more difficult than the Hebert/Sisk/Howell challenge implies. How can the limitations in education on the one side possibly be quantified along with the bias in education on the other? They cannot. Hebert, Sisk, and Howell demonstrated clearly the difficulties of quantifying disparities by showing that the same data may be used to show bias as well as anti-bias, depending on the artistic use of controls. There is a challenge, then, in identifying that sweet spot in the analysis, a spot that truly reveals the underlying disparity. We know that disparity lies somewhere between two extremes, but pinpointing the extent of the disparity is clearly subject to debate. If we can’t understand the extent of the disparity through analysis, can we hope to heal our racial divide? How can a healthy and fair balance between our races be secured after so many generations of abuse?

Smedley, et al provided an important list of recommendations for mechanisms and controls designed to reduce bias and stereotyping, increase consistency, and improve communication and awareness. Every step represents one means to an important, all-pervading end: trust. Establishing trust on the part of the health provider, and likewise on the part of the individual must be at the heart of any effort to eliminate disparities. If a balance may truly be found, if there is any hope of healing our culture of racism, of tearing down the iron walls around our universities and our hospitals, we must surely develop trust. Considering the historical grip of prejudice pervading our culture, this is easier said than done. But such a balance may have been found, for a moment, for two of us, that night as we stood near my car.

I wasn’t sure I could trust the individual extending his hand, but I hoped that I could. “I’m bleeding,” I said, and showed him that my hands were sticky from the blood dripping from my arms. I didn’t have AIDS or any other dread disease, but I knew he wouldn’t know that and was probably wondering. He likely felt as vulnerable as I did, and I had to give him an opportunity to protect himself if he wanted to. From me.

“Come,” he said simply. He took my bloody hand gently into his, and guided my slow, painful steps carefully across the Interstate to safety. It was a gesture of trust, of acceptance, an acknowledgement of shared risk. As his hand connected with mine, once again I felt something shift in my attitude toward the Black struggle and I found myself ready to accept his healing gift, his touch of humanity.

 

Technorati Tags: Racial Disparity,Trust