You knew Freddie Gray. You’ve met him on many occasions, during your layover in Atlanta or visiting Chicago. You’ve met him passing through that small town where gas stations seemed few and far between. The fact is that Freddie Gray exists in every state within the United States of America.
You don’t have to live in Baltimore to understand the anger and frustration surrounding Gray’s death, or to know that the city’s angst is bigger than Gray. There is something about Baltimore that tugs at the very core of one’s soul – because you live in a Baltimore.
Perhaps they call your city Cleveland, Detroit, New Orleans or Oakland, but the conditions are the same.
Baltimore is simply providing a mirror that allows us to take a closer look at the epidemic conditions of poverty, lack of access to care, disproportionate unemployment rates and limited access to quality education. All of these conditions – what we call “social determinants” in public health – lead to poor life outcomes.
The conditions of Baltimore, even your Baltimore, did not develop overnight. They are historic, systemic and indicative of a failure of government.
In Baltimore, there is a significance difference in life expectancy compared to the nearby communities of Roland Park and Guilford, just six miles away. Six miles adds 20 years to the span of one’s life.
This is not a phenomenon unique to Freddie Gray’s Baltimore. New Orleans has a 25-year difference in life expectancy between Black and mostly-White neighborhoods.
Fewer than 60 percent of students in Baltimore city graduate from high school. Cleveland has a graduation rate of 59 percent. Decent employment is hard to come by in these cities as well. The West Baltimore neighborhood has an unemployment rate of almost 20 percent for those ages 25 and above, which is more than double the citywide average of 8 percent. Detroit’s unemployment rate is worse than Baltimore’s, hovering at 23 percent.
In Baltimore, 34.5 percent of households with an average size of 2.6 residents live below the poverty line, meaning they have an annual income of less than $15,930. Oakland, Calif. fares a bit better than Baltimore with 29 percent of its residents living below the poverty line. These are the poor conditions in which young people face every day, coupled with limited access to healthy foods, few safe places to walk and be active, drugs, crime, and violence.
The conditions are preventable. There is an entity charged with just that – prevention and intervention of such conditions.
The government has the primary responsibility of protecting citizens’ health and well being by implementing strategies of prevention and intervention, not unlike what occurs in cases of measles outbreaks. In the same way, the government bears the responsibility to eradicate the conditions that claim so many lives.
When we refuse to acknowledge these conditions while simultaneously condemning the righteous anger of Baltimore’s youth, we are complicit in the advancement of systemic and unjust policies.
A crucial question
What would cause young people to take to the streets? To protest? To riot? To engage in acts of civil disobedience? Twenty years subtracted from their life expectancy seems like a good starting point for the motivation of such.
If we are forthright, we will admit that this country has not been fair in its treatment of people of color and lower socioeconomic status. If we are truthful, we will concede that the Freddie Grays of Baltimore were strategically created through a mass web of systemic and unjust policies.
Until now, we have been treating the symptoms of these conditions. We need a revolution of ideas and action. We have to strike at the very root of the cause.
We must demand that the government and leadership face these conditions and act by stimulating good-paying jobs, a massive overhaul of the education system and the rebuilding of American cities.
The greater tragedy is not the looting and the destruction of property in Baltimore. The tragedy is the failure of government and leadership, for allowing these conditions to develop and persist.
If we are honest, we will face the realization that unless we act to eliminate systemic disparities of health, wealth and quality of life, every city is Baltimore waiting to happen.
Kevin Dedner, MPH, is senior consultant and managing director of Forward Solutions, a consulting firm providing strategic and technical guidance to advance policies that improve public health outcomes and foster social change.