EDITOR'S NOTE: This is the second in a series of three stories by Sally Lehrman, a veteran journalist and Expert Fellow of the Institute for Justice and Journalism at the University of Southern California's Annenberg School for Communication. This story focuses on health issues related to racial and ethnic identity.

Hoping to find out why adult-onset diabetes strikes Native Americans three times as often as whites, government researchers are narrowing in on a gene prevalent in Pima Indians. Concerned about the high rate among African Americans, Howard University scientists are collecting DNA samples from West Africans with the disease.

But the push to find genetic differences and develop targeted medicines won't ease sharp disparities in health status between whites and other racial groups in the United States, insist some social scientists and health specialists. While acknowledging that biology may be an important contributor to disease susceptibility and severity, they say social factors are key to bridging the gap. Dozens of genes may be involved in diabetes, for example, but they act in concert with our ability to get exercise, find healthy food and see a sympathetic doctor for the medical care we need. They say racism -- not race -- is what makes people of color more sick.

"There is undue emphasis on genetics at the expense of societal factors," says Barbara Koenig, a Stanford University anthropologist who studies contemporary biomedicine. "If you look at the history of improvements in life expectancy in the industrialized West, the things that made the most difference in terms of overall health status were not medical interventions, but those in the social domain."

Social stratification, residential segregation and neglect all contribute to the higher rates of disease and death among U.S. ethnic and racial minorities, says Carmen Nevarez, medical director of the Public Health Institute in Oakland, Calif. The roots of obesity -- and diabetes -- are easy to see among her own young, urban clients, she points out. Without a nearby grocery store, these teenagers have few options other than a bag of Cheetos for a cheap, easy breakfast. They have no structured exercise in school, and are afraid to walk outdoors for fear of being arrested or caught in gang crossfire.

Racial Health Divide

But the most critical social factor may be the health care system itself, conclude medical and public health experts at the Institute of Medicine. In a comprehensive analysis of 100 studies on treatment and outcome differences by race, they conclude that biological differences in susceptibility and disease severity aren't enough to explain the racial health divide. Instead, their recent book-length report, "Unequal Treatment: Confronting Racial and Ethnic Disparities in Healthcare," blames a pattern of lower-quality service stemming from cost-containment pressures, clinical bureaucracy, inconveniently located hospitals, and other factors, including unconscious biases held by doctors.

"Even with the same symptoms and stage of the disease, differences persist," says Brian Smedley, project director for the study, which also controls for insurance coverage and ability to pay. The committee found stark inequalities in preventive care, diagnostics and treatment no matter what the disease, and these in turn connected to higher rates of mortality. Blacks and Latinos who arrived at hospitals with the same severity of heart disease, for example, received catheterization or bypass surgery less often. African Americans with a colorectal tumor were 41 percent less likely than whites to receive major treatment such as cutting out the cancerous cells.

In one comprehensive study of 1.7 million patients, African Americans received major therapeutic procedures less often than whites in 37 of 77 conditions, according to the report. In contrast, minority patients underwent limb amputations in greater proportions and were given anti-psychotic medications more often. "Clearly, these disparities are unacceptable and they require a comprehensive response to correct them," Smedley says.

Call for Data

The report recommended structural changes in health services delivery, such as strengthening long-term relationships between doctors and patients, providing clear guidelines for care, and offering training in cultural competence. It also underlined what the authors saw as a critical need for consistent data on patient and provider race, ethnicity, and language, as well as ways these might affect the process, structure, and outcomes of care.

"The federal dataset is very limited," says Smedley. Indeed, a 2001 Commonwealth Fund report found that health agencies' efforts to collect statistics by race, ethnicity and language were sorely lacking, despite widespread agreement on their value in improving care quality and access.

The concerns about disparate medical treatment come at a time when California is debating the role of "race" in society -- as a classification system and as a way to measure and redress inequalities. Some have proposed that racial categories themselves can contribute to unequal health status. Even the Institute of Medicine committee acknowledged that skin color, racial identity and ancestry don't always match up. Focusing on race in medicine can reinforce misperceptions that it represents biological reality instead of a social ideology, the health specialists said. More dangerously, argues sociologist Yehudi Webster at California State University-Los Angeles in the American Sociological Association newsletter, race classifications can trigger the very attitudes and awareness that may underlie differential care by doctors.

Similarly, scientists' enthusiasm about pinpointing biological and cultural reasons for health disparities can bolster popular racist stereotypes and hierarchies, anthropologist Koenig says. "If we focus on individual (genetic) variation in particular populations, we almost always get into a 'blame the victim' mentality," she says. Groups more often affected by a disease can become stigmatized, Koenig explained, especially if the condition involves risk factors connected to lifestyle. Anti-gay activists, for example, have fixated on HIV's connection to sexual activity that they regard as immoral.

But that doesn't mean "race" is not a useful tool to understand health disparities, according to Koenig. Even as geneticists debate the biological relevance of race, agreement is broad that its social categories deeply influence well-being. Sometimes the cause is quite direct, as when darker skin among African Americans correlates with more experiences of prejudice -- and not coincidentally, researchers conclude, higher rates of hypertension.

A Legacy of Poor Access

The Institute of Medicine details a sharpening disparity in care beginning with the closing of black hospitals in the 1960s. Minority communities lost convenient geographic access and a sense of familiarity and safety, while African American doctors found themselves shut out. "What's surprising is this gap hasn't closed," says study leader Smedley. "We would expect this 40 years ago because of discrimination, gross disparities between economic status, and lack of insurance."

The committee speculated that the cost-containment emphasis in today's health system disproportionately affects African American and Latino patients. When doctors have limited resources, the most informed and assertive patients are likely to get preference. Cultural and linguistic barriers contribute to the skew, Smedley says. And even the most well-intended doctors sometimes act on unconscious stereotypes that may prompt them to prescribe some types of medication less often or stop short of recommending surgery.

In a book review in the New England Journal of Medicine, health outcomes researcher Peter Bach worried that the next step would be to threaten doctors with civil rights violations, rather than encouraging them to focus on improving the quality of care in underserved populations. In his own research, Bach, a Memorial Sloan Kettering Cancer Center physician, has identified differences in treatment as a core reason for survival differences between blacks and whites with cancer.

Sally Satel, a practicing psychiatrist and resident scholar at the American Enterprise Institute in Washington, D.C., says the Institute of Medicine's allegations of racism in the medical system are impossible to prove or disprove. The committee relied mainly on retrospective studies and therefore didn't have enough information to really understand differences in care, she says. More importantly, Satel asked, "Why focus on it? I think it's a huge distraction from the most important redress. The basic problems are economics and health literacy." Public health programs should be teaching people about wellness through grassroots programs in churches and community centers, she says, and medical savings accounts or more public health clinics might ease economic access.

Despite such criticism, the American Medical Association has now launched programs to teach its members about health care disparities, provide cultural training, create standards for treatment, and reach out to patients more effectively. The association also has encouraged race-based data collection in order to identify disparities and monitor progress against them. Separately, in March 2003, Aetna announced a program to measure use of its services by race, ethnicity and primary language. The insurer also said it would address the cultural competency of its physician network.

More attention to the ways that societal structures reinforce health disparities would be a welcome change, Nevarez says. It's not only Latinos, African Americans and Native Americans who would benefit, she emphasizes. Whites suffer from societal racism, too -- in their hearts, their pocketbooks and their own health status, she says. Pointing to the high rates of hospitalization among black children with asthma and untreated tuberculosis in immigrant communities, she wonders, what is it in urban air that makes it hard to breathe? Why haven't Americans made it a priority to screen for tuberculosis, which observes no social barriers? "In some ways, poor people and people of color are the canaries in the coal mine," Nevarez says.

REFERENCES: As California voters decide how they will vote on the racial classification initiative, Proposition 54, USC Annenberg's Institute for Justice and Journalism is distributing this series of stories -- and the following list of references assembled by graduate research assistant Shannon Seibert -- in collaboration with Alternet.org in an effort to bring context to the public discussion of the proposed amendment to the state Constitution. The stories and references also are being provided to journalists, scholars and advocates who will gather October 2-3 in Palo Alto, Calif., for a conference at Stanford University, "Colorblind Racism?: The Politics of Controlling Racial and Ethnic Data." Co-sponsored by USC Annenberg's Institute for Justice and Journalism, Stanford's Center for Comparative Studies in Race and Ethnicity and the Equal Justice Society. It will be followed by "Mapping a Strategy for Social Change" on Saturday, October 4, at the Sheraton Palo Alto.

Resources

Minority Health

African American Health:
MEDLINEplus: African American Health
Multicultural Health Clearinghouse: African American Health Issues

Asian American Health:
MEDLINEplus: Asian American Health
Multicultural Health Clearinghouse: Asian American Health Issues

Native American Health:
MEDLINEplus: Native American Health
Multicultural Health Clearinghouse: Native American Health Issues

Hispanic American Health:
MEDLINEplus: Hispanic American Health
Multicultural Health Clearinghouse: Latino/a Health Issues

Online Resources (Office of Minority Health)

Racism Threat Index (raised to HIGH)

Health Statistics (all ethnic and racial groups)

Environmental Racism

Cardiovascular disease & racism

Quality Healthcare for African, Asian and Latino Americans (site contains great links)

Diabetes

Diabetes in Minority Communities

Disparities in Diabetes

African Americans and Diabetes:
Diabetes in African Americans
Diabetes and African-Americans

Diabetes in African-American Women

Diabetes in Hispanic Americans

Diabetes and Heart Disease in Hispanic Americans

Hispanic Americans and Diabetes (University of Michigan)

Hispanic Americans and Diabetes (SavvyHealth.com)

Hispanic Americans Diabetes (Statistics and studies)

Native Americans and Diabetes (American Diabetes Association)

Native Americans and Diabetes (Washington Times)

Native Americans and Diabetes (prevention website, lots of links)

Diabetes Risk Test

Human Genome Project

Gene Media Forum�s Initiative on Racial Mythology

Minorities, Race, and Genomics

Race and the Human Genome

Race, Genes, and Anthropology (contains many great links)

The Reality of Race (Sally Lehrman reporting on Troy Duster, Scientific American)

The Human Genome (Science magazine)

Human Genome Project Newsroom


Minority Health Articles

"National Medical Association President Blames Racism for Health Disparities"

"The Despair of Health Disparities" (AMA)

"Black Women�s Mental Health Needs Unmet"

"Incorporating Race Consciousness into Health Care"

"Does Racism Harm Health?" (American Journal of Public Health)

"Lack of Racial and Health Data Hinders Efforts to Close Gaps in Health Care"

"Racism, Food and Health" (great article by John Robbins)

"Eliminating African American Health Disparity Via History-Based Policy" (Harvard)

"Epidemiologist Explores Racism in Health Outcomes" (Harvard)


Health Organizations

Institute of Medice of the National Academy

Public Health Institute

Office of Minority Health

Minority Health Network

HHS Initiative to Eliminate Racial and Ethnic Disparities in Health

Pan American Health Organization

Office of Minority Student Affairs (many links to minority health sites)

Published Journal Articles, Studies, and Books

Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care
Bach P. B. N Engl J Med 2003; 349:1296-1297, Sep 25, 2003. Book Reviews

Institute of Medicine�s 2002 Report (slide show)

Summary of Institute of Medicine's 2002 Report (pdf)

Barbara Koenig�s published articles

Minority Health Reports (The Commonwealth Fund)

Great "Race" and Racism Bibliography

Abstract of Graduate Dissertation on Obesity in African Americans

"The Healthcare Challenge: Acknowledging Disparity, Confronting Discrimination, and Ensuring Equality" (A Report to the US Commission on Civil Rights)

"Racial and Ethnic Disparities in Women�s Health" (power point)

The Institute for Justice and Journalism was created at the University of Southern California's Annenberg School for Communication with Ford Foundation funding to strengthen news coverage and public understanding of justice and civil rights issues.

Sally Lehrman, a freelance medical and science writer based near San Francisco, is an Expert Fellow of the Institute for Justice and Journalism at the University of Southern California's Annenberg School for Communication.

Resources compiled by Shannon Seibert.

Editors Note: This is the first in a short series of articles by Sally Lehrman, a veteran journalist and Expert Fellow of USC Annenberg's Institute for Justice and Journalism, which are being published by AlterNet in an effort to provide context about issues related to racial and ethnic identity. The Institute for Justice and Journalism was created at the University of Southern California's Annenberg School for Communication with Ford Foundation funding to strengthen news coverage and public understanding of justice and civil rights issues.



African Americans with a college diploma find themselves unemployed almost twice as often as whites with the same education. Hispanics must get by on only about half of the individual income that Asian Americans and whites divvy up among the bills.

And when blacks and Latinos are hospitalized with a heart problem, they are less likely than European Americans to receive catheterization, be sent home with beta blockers, or even be advised to take aspirin to protect their health.

While many Americans agree that open racial bigotry is generally a thing of the past, stark disparities in daily life persist, as documented by academic researchers, the U.S. Census Bureau and the Institute of Medicine.

Frustrated with theories plainly unable to explain the problem, sociologists increasingly are relying on a new framework to understand racism and develop solutions. "It's not just Archie Bunker any more," says Troy Duster, a sociology professor at the University of California, Berkeley, and New York University who is president-elect of the American Sociological Association.

Just in the past six months, at least five books -- including one co-authored by Duster -- have put forward a fresh analysis of racial injustice. They set aside overt prejudice and individual acts of discrimination, which they assert actually may have little impact in today's world. Instead they pull back the covers on social practices and policies sewn into the fabric of work, school and the medical system that favor whites. Even the most well-intentioned white person, they say, benefits from a legacy of accumulated preferential treatment.

In part, these scholars hope to inject new ways of thinking into California's debate over the potential value of "color-blind" government policies to create a more equitable society. They aim to create new paradigms for pushing beyond historical discrimination in order to understand the roots of ongoing racial injustice.

"Intellectuals lost track of the ability to discuss what racism is after the Civil Rights Act," says Andrew Barlow, referring to the landmark 1964 legislation that prohibited employment discrimination based on race, sex, religion or national origin. Research on inequities continued to focus solely on discriminatory acts by individuals, he explains, adding, "We are really at the beginning of a new era."

The emerging school of sociologists also is responding to intellectuals such as Stephen and Abigail Thernstrom (America in Black and White: One Nation Indivisible, 1997), and Shelby Steele (A Dream Deferred, 1999), who assert that discrimination is old news. Consisting mostly, but not entirely, of conservatives, this group says the country needs to transcend race by acknowledging the progress made over the past several decades. Race-conscious policies, they argue, only stir up resentment among whites while also promoting a lack of ambition among people of color by holding them to a lower standard.

As support for their claims, they point to the genetic evidence provided by the Human Genome Project that race has no biological foundation as a way to categorize people. They also cite a 1998 statement by the American Anthropological Association that explains "race" as a classification system invented in the 18th century to justify status differences between European settlers and conquered and enslaved peoples, then expanded to support efforts such as the Nazi extermination of Jews.

In August 2002, the American Sociological Association took a stand against such attempts to abolish "race" as untrue and irrelevant. In a statement, the professional society urged social scientists not to ignore race classifications or stop using them as a research tool, even though they may be biological fiction. "Those who favor ignoring race as an explicit administrative matter, in the hope that it will cease to exist as a social concept, ignore the weight of a vast body of sociological research that shows that racial hierarchies are embedded in the routine practices of social groups and institutions," the society wrote.

The statement sparked a debate in the society's newsletter, in which California State University-Los Angeles professor Yehudi Webster complained that sociologists -- as well as government officials, educators, and journalists -- who use race classifications promote racial awareness and separatism, which in turn foster exclusion and discrimination. Intermarriage, migration and genetic redistributions make such boundaries meaningless, Webster wrote.

While race may not hold up as a biological concept, responded Duster and Barlow, its workings as a social idea cannot be ignored. "Not everything 'real' is genetic, and we use racial categories to interact with each other in ways that have significant consequences," explains Pilar Ossorio, a microbiologist and assistant professor of law and medical ethics at the University of Wisconsin. In its statement, the sociological society urged members to track and study race-based data collected by public agencies in order to understand and respond to the deep inequities caused by racialized social and economic structures.

An increasing number of sociologists acknowledge that the old ways of understanding racial disparities are no longer very useful. Along with studying individual discrimination, they now are attempting to unravel the ways racial privilege has been structured into the day-to-day workings of institutions from education to public transportation to criminal justice. "White-Washing Race: The Myth of a Color-Blind Society," written by seven scholars including Duster, begins the story in the 1930s with Roosevelt's New Deal, aimed to protect the working class but revised by Congress to safeguard racial segregation as well.

The Social Security Act excluded domestic and agricultural workers from old-age pension and unemployment compensation. Three-quarters of the black population, from domestics to self-employed sharecroppers, fell through the net. Similarly, the Wagner Act, which empowered unions, also allowed labor to shut black workers out from closed shops. Loans under the Federal Housing Act differentially provided whites the wherewithal to move into new suburbs, while federal subsidies built public housing to contain black migrants from the South in urban areas.

The GI bill, enacted in 1944, radically expanded the already racially biased economic provisions of the time. While millions of returning veterans and war industry workers became eligible for low-interest mortgages and free access to higher education, whites benefited most. Federal lending rules favored segregated suburbs and they had the educational credentials to go to college. These policies formed a foundation that has supported white economic advantage generation-to-generation to this day, the book's authors write.

The racial hierarchy established over the middle of the 20th century has largely held fast because one generation builds on the accomplishments of the last, Duster explains. Like interest on a bank deposit, children collect economic potential for themselves from the property and social status of their parents. Just as directly, he argues, disadvantages such as barriers to well-paying jobs, segregation in housing and discrimination in lending reverberate from parent to child. "The past becomes relevant to the present as personal wealth and assets are reproduced from generation to generation," agrees Barlow. His new book on globalization makes a similar argument about the historical underpinnings of U.S. racial stratification. Furthermore, privileges in housing, jobs, education and other arenas reinforce and augment one another, he says.

And far from lessening over time, Barlow argues that the disparities built into American society are becoming more entrenched. In the 1960s and '70s, business regulation, low-income housing, job training, public health and other social programs successfully began to compensate for long-term economic advantages held by white people. But starting in the 1980s, the growth of the service sector and technology information jobs, the mobility of businesses, and policy changes such as deregulation and the curtailment of taxes reversed the trend. As industry extends its global reach and creates large pools of investment capital in developed countries, whites are clinging tightly to their privileges, he says. "A greater disparity in income and growing inequality makes more and more of the middle class experience a sense of crisis, so they try to buffer themselves," says Barlow, who describes himself as a civil rights activist as well as a sociologist. "We need to think about racism in a new way."

Scholars now are studying the cause and effect of racial stratification in more detail. New York University doctoral candidate Julie Sze, for example, is identifying the neighborhoods where medical waste incinerators most often are built, then examining both why those sites were chosen and how those decisions may contribute to health disparities such as higher rates of asthma among African Americans. Other research explores economic issues such as the ways housing segregation limits people's job options. Sociologists Lawrence Bobo of Harvard University and Eduardo Bonilla-Silva of Texas A&M are studying hidden racial animosity, while others have investigated differences in the ways the same teachers treat students of different races.

Barlow, Duster and colleagues emphasize that whites may have no awareness of their privileged status even as they protect their interests. When parents successfully fight to protect funding for suburban high schools, for example, they enable those facilities to offer advanced placement classes and leadership opportunities that in turn help students win a spot in the best colleges. Urban educators rarely have such advocates, and thus are unable to offer the same level of academic advantages. But both parents and graduates of top-tier schools -- most often white or Asian American -- are likely to consider their achievements solely the result of the young peoples' own hard work.

While whites will acknowledge that disparities in education or other realms exist, Barlow says, they are more likely to attribute these to a lack of ambition and effort on the part of minorities than to structural favoritism toward whites built into U.S. institutions for generations.

"You don't need to be a racist to promote policies that are race-conscious," says David Wellman, a professor of community studies at UC-Santa Cruz and one of the "White-Washing Race" authors. "Most whites don't see white as a race. Like a fish in water, they don't think about whiteness because it's so beneficial to them."

Resources

Human Genome Project

Gene Media Forum�s Initiative on Racial Mythology

Minorities, Race, and Genomics

Race and the Human Genome

Race, Genes, and Anthropology (contains many great links)

The Reality of Race (Sally Lehrman reporting on Troy Duster, Scientific American)

The Human Genome (Science magazine)

Human Genome Project Newsroom


American Sociological Association

Read the ASA�s official statement

Read the ASA�s Press Release, August 2002


American Anthropological Association

Race, Genes, and Anthropology (contains many great links)

Read the AAA�s Statement on Race


1964 Civil Rights Act

http://usinfo.state.gov/usa/infousa/laws/majorlaw/civilr19.htm


Federal Housing Act

Text: (Citation for hardcopy: 48 Stat. 1246)

History of the Federal Role in Housing

A Brief History of Federal Housing Policy

History of Black Ghettos

Major Federal Housing Acts and Agencies

More info on federal housing laws and executive orders


Wagner Act (aka National Labor Relations Act):

Text

African Americans and the labor movement


Social Security Act

Text

1935 Senate Finance Committee Report


Demographics

US Census Bureau

Miscellaneous

Great link for essay on historic black/white relations



Reference Books with Publisher�s Comments
(Publisher�s Comments from Powells.com)

Barlow, Andrew. Between Fear and Hope: Globalization and Race in the United States. Lanham, Maryland: Rowman & Littlefield, 2003.

This book is an original contribution to the study of race. It provides a structural analysis of race, and a methodology for connecting global to national and local racial processes. Written in a lively and down to earth style, this book is a call to action in a time of fear and hope.

Bonilla-Silva, Eduardo. Racism Without Racists: Color-Blind Racism and the Persistence of Racial Inequality in the United States. Lanham, Maryland: Rowman & Littlefield, 2003.

Racism is alive and well although it has changed its clothes. Color-blind racism combines elements of liberalism in the abstract with anti-minority views to justify contemporary racial inequality.

Brown, Michael et al., Whitewashing Race: The Myth of a Colorblind Society. Berkeley and Los Angeles: UC Press, 2003.

White Americans, abetted by neo-conservative writers of all hues, generally believe that racial discrimination is a thing of the past and that any racial inequalities that undeniably persist -- in wages, family income, access to housing or health care -- can be attributed to African Americans' cultural and individual failures. If the experience of most black Americans says otherwise, an explanation has been sorely lacking--or obscured by the passions the issue provokes. At long last offering a cool, clear, and informed perspective on the subject, this book brings together a team of highly respected sociologists, political scientists, economists, criminologists, and legal scholars to scrutinize the logic and evidence behind the widely held belief in a color-blind society -- and to provide an alternative explanation for continued racial inequality in the United States. While not denying the economic advances of black Americans since the 1960s, Whitewashing Race draws on new and compelling research to demonstrate the persistence of racism and the effects of organized racial advantage across many institutions in American society -- including the labor market, the welfare state, the criminal justice system, and schools and universities. Looking beyond the stalled debate over current antidiscrimination policies, the authors also put forth a fresh vision for achieving genuine racial equality of opportunity in a post-affirmative action world.

Conley, Dalton. Being Black, Being in the Red: Race, Wealth and Social Policy in America. Berkeley and Los Angeles: UC Press, 1999.

Being Black, Living in the Red demonstrates that many differences between blacks and whites stem not from race but from economic inequalities that have accumulated over the course of American history. Property ownership -- as measured by net worth -- reflects this legacy of economic oppression. The racial discrepancy in wealth holdings leads to advantages for whites in the form of better schools, more desirable residences, higher wages, and more opportunities to save, invest, and thereby further their economic advantages. Dalton Conley shows how factoring parental wealth into a reconceptualization of class can lead to a different future for race policy in the United States. As it currently stands, affirmative action programs primarily address racial diversity in schooling and work -- areas that Conley contends generate paradoxical results with respect to racial equity. Instead he suggests an affirmative action policy that fosters minority property accumulation, thereby encouraging long-term wealth equity, or one that -- while continuing to address schooling and work -- is based on social class as defined by family wealth levels rather than on race.

Doane, Ashley. Whiteout: The Continuing Significance of Racism. Routledge, 2003.

Feagin, Joe. White Men on Race. Boston: Beacon Press, 2003.

Based on the revealing and provocative testimony of approximately one hundred powerful, upper-income white men, White Men on Race shows how white men see racial "others, " how they see white America, how they view racial conflicts, and what they expect for the future of the country. Covering a range of topics, from how they first encountered black Americans to views on black families, interracial dating, affirmative action, immigration, crime, and intervening in discriminatory situations, these hundred white men enlighten us on the racial perspectives of the country's white male elites as we enter the twenty-first century. These white men, mostly baby boomers ranging in age from thirty to sixty-five, reside in a variety of cities and states. Some are at the top of powerful economic and government organizations and are members of the small national governing class, while others are a tier below the top level. Others are executives in corporations, influential academics and administrators, important physicians, attorneys, and local businesspeople. The authors closely analyze the racial experiences and attitudes of this powerful group of white men and argue that the ideas they express are not isolated notions but part of a larger, troubling perspective on race in America that continues to shape white lives and actions and, ultimately, the course of the nation.

Hacker, Andrew. Two Nations Black and White: Separate, Hostile and Unequal. Ballantine Books: New York, 1992.

Why does race remain America's deepest and most enduring division? Despite all efforts to increase understanding and expand opportunities, black and white Americans still lead separate lives, continually marked by tension and hostility.

In his bestselling analysis of a divided society, Andrew Hacker explains why racial disparities persist. He clarifies the meaning of racism, conflicting theories of superiority and equality, as well as such subtle factors as guilt and sexual fears. Using completely updated statistical data to paint the stark picture of racial inequality, Two Nations depicts the realities of family life, of income and employment, as well as current controversies affecting education, politics, and crime, including the role of race in the Simpson trial. This startling look at the facts that so many choose to ignore is balanced by the voices of African Americans, and shows how race influences the attitudes and behavior of all Americans. Reasoned, accurate, and devastating, Two Nations demonstrates, better than emotional appeals can, how this great and dividing issue has defined America's history and, as Hacker forecasts it, will play a pivotal role in the coming century.

Jacoby, Tamar. Someone Else�s House: America�s Unfinished Struggle for Integration. New York: The Free Press, 1998.

In this detailed history of relations between blacks and whites in the post-civil rights era, journalist Tamar Jacoby looks at how the ideal of integration has fared since it was first advocated by Martin Luther King, Jr., arguing that though blacks have made enormous economic, political, and social progress, a true sense of community has remained elusive. Her story leads us through the volatile world of New York in the 1960s, the center of liberal idealism about race; Detroit in the 1970s, under its first black mayor, Coleman Young; and Atlanta in the 1980s and '90s, ruled by a coalition of white businessmen and black politicians. Based on extensive research and local reporting, her vivid, dramatic account evokes the special flavor of each city and decade, and gives voice to a host of ordinary individuals struggling to translate a vision into a reality.

Lewis, Amanda. Race in the Schoolyard: Reproducing the Color Line in School. Rutgers Series in Childhood Studies, 2003.

The way race and racial inequality are reproduced in day-to-day interactions in American schools is frequently invisible to even well-intentioned teachers and administrators, argues Lewis (sociology and African American studies, U. of Illinois). She uses Pierre Bourdieu's notion of social capital as an analytical tool in her ethnographic study of three schools set in urban and suburban contexts. She describes how differing levels of social capital are reproduced by schools, thereby reproducing social inequality. Annotation (c)2003 Book News, Inc., Portland, OR (booknews.com)

Oliver, Mel and Shapiro, Tom. Black Wealth, White Wealth. New York: Routledge, 1997.

The award-winning Black Wealth/White Wealth offers a powerful portrait of racial inequality based on an analysis of private wealth. Melvin Oliver and Thomas Shapiro analyze wealth -- total assets and debts rather than income alone -- to uncover deep and persistent racial inequality in America, and they show how public policies fail to redress the problem. Compelling and informative, Black Wealth/White Wealth is pioneering research. It is a powerful counterpoint to arguments against affirmative action and a direct challenge to our present social welfare policies. (Copyright 1995-2003 Muze Inc. For personal non-commercial use only. All rights reserved)

Tilly, Charles. Durable Inequality. Berkeley and Los Angeles: UC Press, 1998.

Charles Tilly, in this eloquent manifesto, presents a powerful new approach to the study of persistent social inequality. How, he asks, do long-lasting, systematic inequalities in life chances arise, and how do they come to distinguish members of different socially defined categories of persons? Exploring representative paired and unequal categories, such as male/female, black/white, and citizen/noncitizen, Tilly argues that the basic causes of these and similar inequalities greatly resemble one another. In contrast to contemporary analyses that explain inequality case by case, this account is one of process. Categorical distinctions arise, Tilly says, because they offer a solution to pressing organizational problems. Whatever the "organization" is -- as small as a household or as large as a government -- the resulting relationship of inequality persists because parties on both sides of the categorical divide come to depend on that solution, despite its drawbacks. Tilly illustrates the social mechanisms that create and maintain paired and unequal categories with a rich variety of cases, mapping out fertile territories for future relational study of durable inequality.

Thernstrom, Stephen and Abigail, America in Black and White: One Nation Indivisible. New York: Simon and Schuster, 1997.

A Bancroft Prize-winning Harvard scholar and an award-winning author and authority on race provide this monumental study of our racial progress and problems over the last 50 years -- the first major work on race and social policy from a historical perspective since Gunnar Myrdal's classic "An American Dilemma" more than a half century ago. America in Black and White demonstrates that we are not splitting into "two nations" that are separate and unequal, but instead are painfully groping our way toward a more just and cohesive society. We will reach our goals faster, say the authors, if we abandon preferential policies that have failed to accomplish this objectives, but have instead heightened racial consciousness and conflict. (Copyright 1995-2003 Muze Inc. For personal non-commercial use only. All rights reserved)

Sleeper, Jim. Liberal Racism. New York: Viking Press, 1997.

Hard-hitting reflections by a political journalist offer a way forward to liberals mired in ambivalence about race. Conservatism is faltering; liberalism is poised for renewal. But liberals themselves are still held in thrall by the contradictions and confusions of race. Worse still, many of the best-intentioned liberal policies have promoted not a color-blind society but a country seething with racial resentments. With uncompromising clarity, Jim Sleeper discusses what liberals need to do to return their political movement to the vital center. Along the way, Sleeper punctures liberal pieties to reveal politicians and journalists still stymied by race, which is still important in the face of conservative racism, and manacled to a guilt that neither advances social justice nor supports the millions of persons of all colors who are struggling to fashion a common American identity. Sleeper shows how to talk about race with a candor and compassion beyond color. (Copyright 1995-2003 Muze Inc. For personal non-commercial use only. All rights reserved.)

Steele, Shelby. A Dream Deferred. New York: Perennial (Harper Collins), 1998.

From the author of the award-winning bestseller "The Content of Our Character" comes a new essay collection that tells the untold story behind the polarized racial politics in America today. In "A Dream Deferred" Shelby Steele argues that a second betrayal of black freedom in the United States -- the first one being segregation -- emerged from the civil rights era when the country was overtaken by a powerful impulse to redeem itself from racial shame. According to Steele, 1960s liberalism had as its first and all-consuming goal the expiation of America guilt rather than the careful development of true equality between the races. This "culture of preference" betrayed America's best principles in order to give whites and America institutions an iconography of racial virtue they could use against the stigma of racial shame. In four densely argued essays, Steele takes on the familiar questions of affirmative action, multiculturalism, diversity, Afro-centrism, group preferences, victimization -- and what he deems to be the atavistic powers of race, ethnicity, and gender, the original causes of oppression. "A Dream Deferred" is an honest, courageous look at the perplexing dilemma of race and democracy in the United States -- and what we might do to resolve it.

Journalists, scholars and advocates will gather October 2-4 in Palo Alto to explore issues related to Proposition 54, the California racial classification initiative. The centerpiece conference at Stanford University, "Colorblind Racism?: The Politics of Controlling Racial and Ethnic Data," begins Thursday evening, October 2, and continues all day Friday, October 3.

The conference and other activities are co-sponsored by USC Annenberg's Institute for Justice and Journalism, Stanford's Center for Comparative Studies in Race and Ethnicity and the Equal Justice Society. The Stanford conference will be followed by "Mapping a Strategy for Social Change" sessions Saturday, October 4, at the Sheraton Palo Alto. (Information about both gatherings is available at www.equaljusticesociety.org/colorblind.)

Sally Lehrman, a freelance medical and science writer based near San Francisco, is an Expert Fellow of the Institute for Justice and Journalism at the University of Southern California's Annenberg School for Communication.

Resources compiled by Shannon Seibert.