You framed the question in an either/or way that doesn't apply.

It is not racist to say that smoking kills you and you shouldn't do it. That's one of those things that, even though it's addictive, there is some personal responsibility involved. People do quit smoking, and nobody is putting a gun to your head to make you buy cigarettes.

That said, the question of resource allocation is important, as is the way that environmental toxins all seem to get dumped in low-income and minority neighborhoods.

But the key thing is to differentiate betwee those health problems that have a more institutional basis and those that don't. Not all health problems are created equal. The quit smoking campaign aimed at New York's Puerto Rican/latin community is a good example of one way to deal with it (those are the ads with the guy who has a tracheotomy hole in his throat). It's a good ad campaign.

But an ad campaign won't deal with the fact that minority neighborhoods don't get the resources to have better doctors, health care and insurance. So that requires a different solutions. It's a matter of the right tool for the right job. Too damned often people frame these questions in a binary fashion when it just doesn't work that way.

This is what the whole Environmental Justice movement is about!

"The traditional response is that health problems are based on personal responsibility and racist ideas of genetics, so if you want to be healthier you have to eat better and take care of yourself and no one can take responsibility if your community has a higher rate of certain diseases."

I'm sorry, but this goes too far. It is not "racist" to note that one ethnic group is more at risk for a condition than another. Most diseases do have a genetic element... for instance, if you have a lot of family members with diabetes, that means you are at a higher risk of getting diabetes. This extends to ethnic groups which tend to have a shared lineage.

For example:
- Breast cancer strikes white and Jewish women more than African-American and Hispaic women
- A-A people are more at risk for high blood pressure
- Sickle cell disease is largely an African-American condition, although not exclusively
- Similarly, cystic fibrosis is associated with whites

No ethnic group comes out the "winner" here, as you can see. None are more healthy than another. It just means that different groups face different specific threats on average.

Any health care provider who is so obsessive about racism that they ignore these kinds of facts do their patients a grave disservice.

That said, there is no question that minorities receive a lack of health care in general due to a multitude of factors, including racism.

On the other hand, when you look at the way that resources are distributed and how low income communities of color rarely...

A pretty important distinction was kind of glossed over in that sentence. "Low income" and "communities of color" are not equivalent, though for historical reasons seem to have a high rate of correlation in contemporary society. Are we talking about race or class? These are two interrelated social phenomena, but they aren't the same thing, and I daresay that if the causal relationship being put forth is based on lack of access to resources, class is what needs to be analyzed here. Race seems, if not irrelevant, incidental.

You need to see the documentary series "Unnatural Causes" and then talk about that question.

"Unnatural Causes" rocks!

I think that the fact that communities of color and minority people individually are exposed to things that will adversely effect their health is undeniable. Not only are people who are lower-income (and thanks Matt for bringing in the discussion of the dangers of conflating 'low-income' with 'minority,' while recognizing that the two are linked due to current and historical racism) exposed to more occupational hazards (like poor ventilation in nail-salons), but also neighborhoods that have more minority residents have a greater exposure to pollutants -- regardless of socio-economic status. (Meaning that rich white neighborhoods are exposed to less pollutants than rich largely minority neighborhoods, poor white has less pollutants than poor minority...)

All this is according to Rachel Morello-Frosch, who is an environmental justice advocate and researcher that lectured to my public health class last week.

She also says that minority communities are ESPECIALLY vulnerable to environmental raciscm due to compounding these negative exposures with the health effects of other types of racism (which include poverty, stress, malnutrition, material deprivation...).

FC, more white women may be diagnosed with breast cancer, but more black women die from it.

And yay for Rachel Morello-Frosch, she's in my major department.