How racism makes us sick | David R. Williams

翻译人员: Jack Zhang

An article in the Yale Alumni Magazine

耶鲁校友杂志上的

told the story of Clyde Murphy,

一篇文章讲述了克莱德·墨菲的故事，

a black man who was a member of the Class of 1970.

他是1970 届的一位黑人校友。

Clyde was a success story.

克莱德的人生很成功。

After Yale and a law degree from Columbia,

从耶鲁毕业，并取得了 哥伦比亚大学法学学位后，

Clyde spent the next 30 years

克莱德花了 30 年的时间，

as one of America's top civil rights lawyers.

成为了美国顶级的民权律师。

He was also a great husband and father.

他还是一个出色的丈夫和父亲。

But despite his success,

但是尽管他在

personally and professionally,

个人和事业上都有所成就，

Clyde's story had a sad ending.

他的故事却有一个悲伤的结尾。

In 2010,

在 2010 年，

at the age of 62,

他 62 岁的时候，

Clyde died from a blood clot in his lung.

克莱德因为肺部血塞而去世。

Clyde's experience was not unique.

克莱德的经历并不特殊。

Many of his black classmates from Yale

他在耶鲁的很多黑人同学

also died young.

也都英年早逝。

In fact, the magazine article indicated

事实上，那篇文章写到，

that 41 years after graduation from Yale,

在从耶鲁毕业 41 年后，

the black members of the Class of 1970

1970 届黑人毕业生的死亡率

had a death rate that was three times higher

比同届平均死亡率

than that of the average class member.

高了三倍。

It's stunning.

这很令人震惊。

America has recently awakened

美国刚刚意识到

to a steady drumbeat

持续发生的

of unarmed black men being shot by the police.

赤手空拳的男性黑人 被警察枪击的事件。

What is even a bigger story

但更令人惊讶的是，

is that every seven minutes,

每七分钟，

a black person dies prematurely in the United States.

美国就有一个黑人英年早逝。

That is over 200 black people

也就是说，每天有

die every single day

超过 200 个黑人死亡，

who would not die if the health of blacks and whites were equal.

如果黑人和白人的健康条件 相同的话，他们本不会死去。

For the last 25 years,

过去的 25 年里，

I have been on a mission

我肩负着一项使命，

to understand why does race

去了解为什么种族

matter so profoundly for health.

对健康有这么重大的影响。

When I started my career,

在我的职业生涯初期，

many believed that it was simply about racial differences

许多人认为这仅仅是 源于种族之间

in income and education.

收入和教育水平的差异。

I discovered that while economic status matters for health,

我发现经济地位确实会影响健康，

there is more to the story.

但是事情并没有这么简单。

So for example, if we look at life expectancy at age 25,

比如，25 岁时候的预期寿命

at age 25 there's a five-year gap between blacks and whites.

在白人和黑人之间， 有 5 年的差距。

And the gap by education for both whites and blacks

黑人和白人之间的教育差距

is even larger than the racial gap.

比种族差距还要大。

At the same time, at every level of education,

同时，在每一个教育水平，

whites live longer than blacks.

白人都比黑人活得更久。

So whites who are high school dropouts

所以高中退学的白人

live 3.4 years longer than their black counterparts,

比同样状况的黑人能多活 3.4 年。

and the gap is even larger

大学毕业生之间的差距

among college graduates.

甚至更大。

Most surprising of all,

最令人惊讶的是，

whites who have graduated from high school

高中毕业的白人

live longer than blacks with a college degree

也比大学毕业或者 有更高学位的黑人

or more education.

活得更久。

So why does race matter so profoundly for health?

那么为什么种族 对健康的影响这么大？

What else is it beyond education and income

除了教育和收入，

that might matter?

还有什么其他的影响因素吗？

In the early 1990s,

20 世纪 90 年代早期，

I was asked to review a new book

我审阅了一本关于

on the health of black America.

非裔美国人健康状况的新书。

I was struck that almost every single one

我很惊讶书中的 25 个章节中，

of its 25 chapters

每一章都有提到

said that racism

种族歧视

was a factor that was hurting the health of blacks.

是威胁黑人健康的元素之一。

All of these researchers

所有的研究人员

were stating that racism was a factor adversely impacting blacks,

都声称种族歧视 对黑人的健康有害，

but they provided no evidence.

但是他们没有拿出证据。

For me, that was not good enough.

对于我来说，这还不够。

A few months later,

几个月后，

I was speaking at a conference in Washington, DC,

我在华盛顿特区的一个会议上讲话，

and I said that one of the priorities for research

我说研究的一个重点

was to document the ways in which racism affected health.

应该是记录种族歧视 是如何影响健康的。

A white gentleman stood in the audience

一个白人男士从观众群中站起来，

and said that while he agreed with me that racism was important,

说他虽然同意 种族歧视的问题的确很重要，

we could never measure racism.

但我们永远无法衡量种族歧视。

"We measure self-esteem," I said.

“我们能够衡量自尊心，”我说，

"There's no reason

“如果我们重视起来，

why we can't measure racism if we put our minds to it."

也应该能够衡量种族歧视。”

And so I put my mind to it

所以我付诸行动，

and developed three scales.

并研究出了三个度量方法。

The first one captured major experiences of discrimination,

第一个是捕捉明显的歧视现象，

like being unfairly fired or being unfairly stopped by the police.

比如被不公平地开除 或者被警察拦截。

But discrimination also occurs in more minor and subtle experiences,

但是歧视也会有 更轻微和间接的方式，

and so my second scale, called the Everyday Discrimination Scale,

所以第二个度量方法， 叫做“日常歧视度量”，

captures nine items

包含了 9 类指标，

that captures experiences

涉及如下经历，

like you're treated with less courtesy than others,

像你没有被礼貌地对待，

you receive poorer service than others in restaurants or stores,

你在餐厅或者商店 得到了较差的服务，

or people act as if they're afraid of you.

或者人们似乎害怕你。

This scale captures

这个度量方法涵盖了

ways in which the dignity and the respect

不被社会重视的人的

of people who society does not value

尊严和受到的尊重

is chipped away on a daily basis.

如何被不断削弱。

Research has found

研究表明，

that higher levels of discrimination

歧视的等级越高，

are associated with an elevated risk of a broad range of diseases

很多疾病的发病率也越高，

from blood pressure to abdominal obesity

从高血压到肥胖症，

to breast cancer to heart disease

到乳腺癌和心脏病，

and even premature mortality.

甚至过早死亡。

Strikingly, some of the effects are observed at a very young age.

令人惊讶的是，有些影响 在生命的早期就开始显现。

For example, a study of black teens

比如，一项关于 黑人青少年的研究发现，

found that those who reported higher levels of discrimination as teenagers

那些报告受到高度歧视的青少年，

had higher levels of stress hormones,

压力激素水平，

of blood pressure

血压

and of weight at age 20.

和体重在 20 岁的时候 都会显著升高。

However,

但是，

the stress of discrimination

种族歧视造成的压力

is only one aspect.

只是其中的一部分。

Discrimination and racism

种族歧视也在很大程度上

also matters in other profound ways for health.

影响着健康的其他方面。

For example, there's discrimination in medical care.

比如，在医疗保健中 也存在种族歧视。

In 1999, the National Academy of Medicine

1999 年，国家医药局

asked me to serve on a committee

邀请我加入一个委员会，

that found, concluded based on the scientific evidence,

该委员会基于科学证据发现，

that blacks and other minorities

黑人和其他有色人种

receive poorer quality care than whites.

接受的医疗服务 普遍比白人要差。

This was true for all kinds of medical treatment,

这涵盖了各种医疗服务，

from the most simple

涉及到从最简单

to the most technologically sophisticated.

到最复杂的医疗科技。

One explanation for this pattern

对这种现象的一个解释

was a phenomenon that's called "implicit bias"

是一个被称作“潜在偏见”

or "unconscious discrimination."

或者“无意歧视”的现象。

Research for decades by social psychologists

几十年来，社会心理学家经研究发现，

indicates that if you hold a negative stereotype

如果你在潜意识中对某一个群体

about a group in your subconscious mind

有不好的印象，

and you meet someone from that group,

然后你遇见一个属于那个群体的人，

you will discriminate against that person.

你就会对那个人产生歧视。

You will treat them differently.

你会将他们区别对待。

It's an unconscious process. It's an automatic process.

这个过程是无意识和自发产生的。

It is a subtle process, but it's normal

这是一个微妙的过程， 但是这很正常，

and it occurs even among the most well-intentioned individuals.

即使是最无恶意的人 也会有这种反应。

But the deeper that I delved

但是我研究种族歧视

对健康的影响越深入，

into the health impact of racism,

the more insidious the effects became.

就发现这种影响的潜在性越高。

There is institutional discrimination,

还有社会性的歧视，

which refers to discrimination

这是存在于

that exists in the processes of social institutions.

社会机构中的歧视。

Residential segregation by race,

居住区域上的种族隔离，

which has led to blacks and whites living in very different neighborhood contexts,

使白人和黑人生活在 非常不同的社区背景下，

is a classic example of institutional racism.

这是社会性歧视很典型的例子。

One of America's best-kept secrets

美国最不为人知的秘密之一

is how residential segregation

就是居住区域上的隔离

is the secret source

实际上是造成

that creates racial inequality in the United States.

美国社会种族不平等的重要原因。

In America, where you live

在美国，你所住的地方

determines your access to opportunities

决定了你能接受到的

in education, in employment,

教育机会、就业机会、

in housing and even in access to medical care.

住房条件，甚至医疗服务。

One study of the 171 largest cities in the United States

一项覆盖美国 171 个大城市的研究

concluded that there is not even one city

总结出，没有一个城市

where whites live under equal conditions to blacks,

白人和黑人的生活条件是平等的，

and that the worst urban contexts in which whites reside

白人居住的最差的环境

is considerably better than the average context of black communities.

也比黑人社区的平均条件要好。

Another study found

另一个研究发现，

that if you could eliminate statistically

如果你能够消除

residential segregation,

居住区域上的隔离，

you would completely erase black-white differences in income,

就能够完全消除白人和黑人之间

education and unemployment,

收入、教育和就业的区别，

and reduce black-white differences in single motherhood

并能够将白人和黑人

单亲妈妈数量上的差异 缩小三分之二。

by two thirds,

all of that driven by segregation.

这些都是由种族隔离造成的。

I have also learned

我还了解到，

how the negative stereotypes

我们文化中

and images of blacks in our culture

对黑人的负面印象

literally create and sustain

是如何创造并维持了

both institutional and individual discrimination.

社会和个人的歧视。

A group of researchers have put together a database

一群研究人员创立了一个数据库，

that contains the books,

包含了一个拥有

magazines and articles

本科学位的普通美国人

that an average college-educated American would read over their lifetime.

一生中读过的书籍、杂志和文章。

It allows us to look within this database

我们能够使用这个数据库

and see how Americans have seen words paired together

来了解美国人 在他们的社区里长大时

as they grow up in their society.

所接触的文字。

So when the word "black" appears in American culture,

当“黑人”这个词出现在美国文化中，

what co-occurs with it?

一起出现的是什么？

"Poor,"

“贫穷”，

"violent,"

“暴力”，

"religious,"

“信仰宗教”，

"lazy,"

“懒惰”，

"cheerful,"

“幽默”，

"dangerous."

“危险”。

When "white" occurs,

当“白人”这个字眼出现的时候，

the frequently co-occurring words

经常一起出现的词汇是

are "wealthy,"

“富有”，

"progressive,"

“有上进心”，

"conventional,"

“传统”，

"stubborn,"

“执坳”，

"successful,"

“成功”，

"educated."

“有教养的”。

So when a police officer

所以当一个警察

overreacts when he sees an unarmed black male

看见一个赤手空拳的黑人时，

and perceives him to be violent and dangerous,

会把他看作是暴力和危险的。

we are not necessarily dealing with an inherently bad cop.

这个警察并不一定 从本质上就是怀有恶意的。

We may be simply viewing

我们看到的可能只是

a normal American

一个普通的美国人，

who is reflecting what he has been exposed to

在自己的社会经历影响下

as a result of being raised

而做出的

in this society.

本能的反应。

From my own experience,

根据我自己的经历，

I believe that your race

我相信你的种族

does not have to be a determinant of your destiny.

决定不了你的命运。

I migrated to the United States

我在 20 世纪 70 年代晚期

from the Caribbean island of Saint Lucia

从加勒比海岛国圣卢西亚

in the late 1970s

移民到美国，

in pursuit of higher education,

为了追求高等教育。

and in the last 40 years,

在过去的 40 年里，

I have done well.

我过得还不错。

I have had a supportive family,

我有一个支持我的家庭，

I have worked hard,

我努力工作，

I have done well.

我生活得挺好的。

But it took more for me to be successful.

但是我需要付出 更多代价来取得成功。

I received a minority fellowship from the University of Michigan.

我在密歇根大学 接受了一个有色人种的奖学金，

Yes. I am an affirmative action baby.

没错，我因平权法案而受益，

Without affirmative action,

没有平权法案，

I would not be here.

我不会站在这里。

But in the last 40 years,

但是在过去的 40 年里，

black America has been less successful than I have.

很多非裔美国人过得远不如我。

In 1978, black households in the United States

1978 年，美国黑人的家庭收入

earned 59 cents for every dollar of income whites earned.

是白人家庭的 59%。

In 2015,

2015 年，

black families still earn 59 cents

黑人家庭的收入

for every dollar of income that white families receive,

依旧是白人家庭的 59%，

and the racial gaps in wealth are even more stunning.

资产上的种族差距更令人吃惊。

For every dollar of wealth that whites have,

黑人家庭资产占 白人家庭资产的 6%，

black families have six pennies and Latinos have seven pennies.

拉丁美洲裔家庭资产占 白人家庭资产的 7%。

The fact is,

事实上，

racism

种族歧视

is producing a truly rigged system

正在产生一个不公平的系统，

that is systematically disadvantaging some racial groups in the United States.

使美国的一些有色人种处于劣势。

To paraphrase Plato,

借用柏拉图的话说，

there is nothing so unfair

没有什么比公平对待

as the equal treatment of unequal people.

地位不平等的人更不公平的事情。

And that's why I am committed

这也是为什么我坚定地

to working to dismantle racism.

致力于消除种族歧视。

I deeply appreciate the fact

很多人甚至

that I am standing on the shoulders

以自己的生命为代价，

of those who have sacrificed even their lives to open the doors

来打开我所踏入的大门， 我很感激自己能站在

that I have walked through.

这些人的肩膀上。

I want to ensure that those doors remain open

我想要保证这些门依旧敞开，

and that everyone can walk through those doors.

每个人都能够走过那些门。

Robert Kennedy said,

罗伯特·肯尼迪曾说：

"Each time a man" -- or woman, I would add --

“每一次，一个男人”—— 或者女人——

"stands up for an ideal

“为了一个理想献身，

or acts to improve the lot of others

或为改善别人的生活而奋斗，

or strikes out against injustice,

或为抵抗不公平而抗议，

he sends forth a tiny ripple of hope,

他传达了一丝希望，

and those ripples can build a current

然而这一丝丝希望能够聚成洪流，

that can sweep down the mightiest walls of oppression and resistance."

消除压迫和抵抗的阻碍。”

I am optimistic today

现在我很乐观，

because all across America,

因为纵观整个美国，

I have seen ripples of hope.

我已经看见了这一丝丝希望。

The Boston Medical Center

波士顿医疗中心

has added lawyers to the medical team

把律师引入了他们的医疗团队，

so that physicians can improve the health of their patients

从而改善病人的健康，

because the lawyers are addressing the nonmedical needs their patients have.

因为律师能够向病人 提供非医药类的帮助。

Loma Linda University has built a gateway college

洛马林达大学在附近的圣伯纳迪诺

in nearby San Bernardino

成立了一个附属大学，

so that in addition to delivering medical care,

除了提供医疗保健，

they can provide job skills

他们还向有色人种和

and job training

低收入人群

to a predominantly minority, low-income community members

提供技能和职业培训，

so that they will have the skills they need to get a decent job.

以便他们能够获得 一份体面工作所需要的技能。

In Chapel Hill, North Carolina,

在北卡罗来纳教堂山大学，

the Abecedarian Project has figured out

一个初学者项目已经发现了

how to ensure that they have lowered the risks for heart disease

如何通过在一个黑人 从出生到 5 岁这段时期，

for blacks in their mid-30s

为其提供高质量的护理，

by providing high-quality day care

从而降低他在 35 岁左右时的

from birth to age five.

心脏病发病几率。

In after-school centers across the United States,

在美国的幼儿托管中心，

Wintley Phipps and the US Dream Academy

温特利·菲普斯和美国造梦学院

is breaking the cycle of incarceration

正在通过向犯罪人员的孩子

by providing high-quality academic enrichment and mentoring

和跟不上学习进度的孩子

to the children of prisoners

提供高质量的教育和辅导，

and children who have fallen behind in school.

以减轻犯罪行为对下一代的影响，

In Huntsville, Alabama,

在阿拉巴马州的亨兹维尔，

Oakwood University,

欧克伍德大学，

a historically black institution,

一所传统的黑人学校，

is showing how we can improve the health of black adults

同样为我们展示了 如何提高黑人的健康状况。

by including a health evaluation

他们把健康评估

as a part of freshman orientation

当成新生入学指导的一部分，

and giving those students the tools they need

并给学生他们需要的工具

to make healthy choices

来做出有益健康的选择，

and providing them annually a health transcript

并每年向他们提供健康成绩单，

so they can monitor their progress.

帮助他们跟踪自己的进度。

And in Atlanta, Georgia,

在佐治亚州亚特兰大，

Purpose Built Communities has dismantled the negative effects of segregation

“目标社区”通过把 一个充满犯罪和毒品的

by transforming a crime-ridden,

公共住房计划，

drug-infested public housing project

转变成一个结合了 混合收入住房，

into an oasis of mixed-income housing,

学术水平，

of academic performance,

社区健康，

of great community wellness

和就业率的绿洲，

and of full employment.

消除了种族隔离的影响。

And finally,

最后，

there is the Devine solution.

还有戴文的方案。

Professor Patricia Devine

威斯康星大学的

帕特里夏·戴文教授

of the University of Wisconsin

has shown us how we can attack

向我们展现了如何

our hidden biases head on

消除我们潜在的偏见，

and effectively reduce them.

并有效减轻它们。

Each one of us

我们每一个人

can be a ripple of hope.

都可以成为一丝希望。

This work will not always be easy,

这不一定会很简单，

but former Supreme Court Justice Thurgood Marshall

但是最高法院 前法官瑟古德·马歇尔

has told us, "We must dissent.

跟我们说过：“我们一定要反对。

We must dissent from the indifference.

我们一定要反对冷漠。

We must dissent from the apathy.

我们一定要反对不作为。

We must dissent from the hatred and from the mistrust.

我们一定要反对仇恨和不信任。

We must dissent

我们一定要反对，

because America can do better,

因为美国能做得更好，

because America has no choice but to do better."

因为美国除了做得更好， 没有其他选择。”

Thank you.

谢谢。

(Applause)

（鼓掌）