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I've been sitting on some thoughts about "the Black middle class" as object of study/inquiry.
First, I'll outline some of my latest reading:
(1) Dána-Ain Davis (2019) Reproductive Injustice: Racism, Pregnancy, & Premature Birth - which examines PTB/LBW to middle-class Black women & the role of medical/obstetric racism https://twitter.com/Arrianna_Planey/status/1233898378813169664?s=20
(1) Dána-Ain Davis (2019) Reproductive Injustice: Racism, Pregnancy, & Premature Birth - which examines PTB/LBW to middle-class Black women & the role of medical/obstetric racism https://twitter.com/Arrianna_Planey/status/1233898378813169664?s=20
I paired Davis (2019) with
(2) Bridges (2011) Reproducing Race: An Ethnography of Pregnancy as a Site of Racialization - a study of pregnancy & birth experiences of Medicaid-insured BW in a NYC hospital https://twitter.com/Arrianna_Planey/status/1297661984511537160?s=20
(2) Bridges (2011) Reproducing Race: An Ethnography of Pregnancy as a Site of Racialization - a study of pregnancy & birth experiences of Medicaid-insured BW in a NYC hospital https://twitter.com/Arrianna_Planey/status/1297661984511537160?s=20
In terms of healthcare worker experiences across professional hierarchy- how race/ism is experienced differently when cross-cut by workplace hierarchies in HC.
(3) Adia Harvey Wingfield (2019) Flatlining: Race, Work, & Health Care in the New Economy https://twitter.com/Arrianna_Planey/status/1295745869992603652?s=20
(3) Adia Harvey Wingfield (2019) Flatlining: Race, Work, & Health Care in the New Economy https://twitter.com/Arrianna_Planey/status/1295745869992603652?s=20
And I am currently finishing up
(4) Tina Sacks (2019) “Invisible Visits: Black middle-class women in the American healthcare system https://twitter.com/Arrianna_Planey/status/1312533768532492293?s=20
(4) Tina Sacks (2019) “Invisible Visits: Black middle-class women in the American healthcare system https://twitter.com/Arrianna_Planey/status/1312533768532492293?s=20
What we know:
- middle/upper middle-class Black folx may have
resources, rates of private insurance coverage, but they still face racist stereotypes in the course of healthcare help-seeking- & for BW, this includes racist, misogynist, & classist stereotyping- misogynoir
- middle/upper middle-class Black folx may have
resources, rates of private insurance coverage, but they still face racist stereotypes in the course of healthcare help-seeking- & for BW, this includes racist, misogynist, & classist stereotyping- misogynoir
We also know that the health "gains" associated with private insurance coverage & higher income are illusory for Black folks in the middle class. E.g. https://twitter.com/Arrianna_Planey/status/1309839440504856576?s=20
We also know that higher levels of education are not protective for U.S.-born Black women, nor for daughters of Black immigrants, when as they experience pregnancy & childbirth. & this persists when we factor for n'hood context- a high SES, but segregated n'hood =! protective
And, in terms of healthcare costs, Black folks in the middle class/middle-income deciles are potentially more likely to be pushed out of the middle class by the costs of care compared w/ white folks in the middle class https://twitter.com/Arrianna_Planey/status/1151815313039777792?s=20
And structural factors, such as #EnvironmentalRacism mean that middle-class Black folks are disproportionately exposed to environmental hazards compared w/ low-SES white people (i.e. class is not nec. protective against #EnvironmentalRacism) https://twitter.com/Arrianna_Planey/status/1164538013264863235?s=20
And there are also intraclass relations among Black folks to consider. I like this quote from Angela Davis (thread), which hits on the social distance that respectability politics demands of its adherents, who likely interface more w/ white spaces https://twitter.com/Arrianna_Planey/status/1089179778874331136?s=20
"...in studies that adjust statistically for [SES], Black-white health disparities do not disappear. This represents somewhat of a paradox that Black people, regardless of their material resources, cannot "buy" the same same health as their white counterparts." (Sacks 2019, 6)
We know that the median wealth of white households is ~20X higher than that of Black households
E.g. Higher levels of educational attainment/credentials = higher levels of debt for Black folks (which is not measured when we look at just income) https://www.pewresearch.org/wp-content/uploads/sites/3/2011/07/SDT-Wealth-Report_7-26-11_FINAL.pdf
E.g. Higher levels of educational attainment/credentials = higher levels of debt for Black folks (which is not measured when we look at just income) https://www.pewresearch.org/wp-content/uploads/sites/3/2011/07/SDT-Wealth-Report_7-26-11_FINAL.pdf
I've talked about it before, but I was raised in an upper middle-class Black household. And even then, my experience of class was fundamentally different from my white classmates in similar income strata. College was a real awakening.
IME, being raised in an upper middle-class Black household meant that I was socialized into "middle class norms". I learned the hypervigilance of being Black in white/upwardly mobile spaces (work, school, & even the church that my parents attended). https://twitter.com/Arrianna_Planey/status/1157044539506548739?s=20
I also learned that I had to work twice or thrice as hard to "belong" in these spaces. That I had to have a certain self-presentation/manner/carriage.
I was put in ballet classes so that I could have a certain comportment. I remember being one of 2 Black girls in the studio.
I was put in ballet classes so that I could have a certain comportment. I remember being one of 2 Black girls in the studio.
In retrospect, I was literally groomed into middle-class-ness as a Black girl. And that carried w/ it particular gendered norms, which had white womanhood as a reference point.
Anyway, all of that socialization, all the careful self-presentation... all of it is stripped away when I'm in the ED.
No one cares about my pain. When I'm disrobed in the exam room, the subtle class markers disappear. I'm just another unremarkable patient.
No one cares about my pain. When I'm disrobed in the exam room, the subtle class markers disappear. I'm just another unremarkable patient.
So, over time, I learned to include subtle status markers- nice stud earrings that don't get lost if I'm admitted, mention of my profession, etc. It literally changes how doctors treat me.
I hate it, but it's true. A wedding ring changes how doctors- incl Black docs- treat me.
I hate it, but it's true. A wedding ring changes how doctors- incl Black docs- treat me.
In Sacks (2019), one of the study participants- an upper-middle-class Black woman- shares an experience of being racially stereotyped by a Black woman doctor, countering a commonly touted "solution" to redressing inequities in HC provision- provider-patient concordance.
In Metzl's (2010) Protest Psychosis, he made an important point that provider-patient concordance studies are premised on the assumption that racism in medicine can be reduced to the race(s) of the provider & the patient, defining the 'problem' as that specific interaction.
[I'm not going to get into it here, but my experience of health care changes when doctors realize that my husband is white and unafraid to advocate for me (beyond being my power of attorney). The doctors all stood a little straighter & stopped ignoring my pain complaints.]
FYI: Here's an calculator that estimates income %ile by assigned race/ethnicity in 2018 US dollars
e.g. by race, the 98th %tile of income earners has an income (2018 USD) of:
white: $250,020
Black: $156,170
Asian (yes, we need to disaggregate): $255,600 https://twitter.com/Arrianna_Planey/status/1157046534258745344?s=20
e.g. by race, the 98th %tile of income earners has an income (2018 USD) of:
white: $250,020
Black: $156,170
Asian (yes, we need to disaggregate): $255,600 https://twitter.com/Arrianna_Planey/status/1157046534258745344?s=20
So, there's nearly a $100K income difference between the 98th %ile of Black earners and the 98th %ile of white earners (in 2018 US dollars)
Anyway, if you want my thoughts on provider-patient concordance studies, here they are https://twitter.com/Arrianna_Planey/status/1297907545273708551?s=20
