Donald Trump is wrong about more things than one could ever hope to quantify, but his decision to make economic inequality the nominal centerpiece of his campaign was a canny (if deeply ingenuous) political choice. In response to both his win and the ongoing calamity that is and will be his presidency, many have argued that American progressives should take this election as a lesson on the perils of centering ‘identity politics’ at the expense of economic justice and working class concerns. To unify our coalition, we are told, and truly begin to drain the swamp our President-Elect has invited into the White House, we must listen less to singular voices and more to the larger group.
Economic inequality in this nation is literally making us sick — all of us. The richest 1% of American families control 37% of the national wealth, and since 1983 nearly the entirety of household wealth gained in this country has gone to upper income families. Hundreds of studies conducted over the past four decades have shown that economic inequality likely causes shorter lifespans, higher infant mortality, and elevated rates of depression, schizophrenia, and other mental illness for everybody who lives in that society, not just the poor. In the US, people who live in more unequal statesare 25% — 35% more likely to rate their own health as poor, and that number doubles for rural Americans living in the most economically unequal states.
The effects of inequality on the health of all Americans are worst for our neighbors who live in poverty. They are more likely to suffer from asthma and hypertension, their babies are more likely to be born underweight, and they are less likely to survive cancer. And the effects are magnified for minorities beyond the consequences of simple economics — Black Americans are significantly more likely to experience hypertension or diabetes than White Americans with the same income, education, and family structure. There are many theories as to why this may be, but racism almost certainly plays a role. In a study of telomeres — those bookends on the end of our DNA that shorten as we sicken and age — Black men who reported more experiences of racism had shorter telomeres. In another, Black Americans had higher rates of mortality in parts of the US where more people had googled the n-word.
The evidence tells us that these disparities in income and health can not be divorced from ‘identity politics’: Women are 50% more likely than men to earn minimum wage as full-time workers because we place less value on “women’s work” like caregiving and service. An African American man with a college degree has the same likelihood of being hired as a White man who dropped out of high school.
It is no accident that racial minorities are more likely to live with chronic diseases and are less likely to be insured, a vicious combination that drains bank accounts, inhibits the ability to provide for families, and results in delayed care and worse outcomes. It is no accident minorities are more likely to live in neighborhoods with high exposure to toxins, little healthy food, and no parks or green spaces where children can play and adults can exercise — they were systematically placed there by decades of deliberate economic policies.
It is no accident that the women hit hardest by recent attacks on reproductive health care will be poor women and women of color, even though women who have access to contraception are less likely to have unplanned pregnancies which can derail their economic futures, and are more likely to participate fully in the work force. It is no accident that paid family leave is currently only available for some full time workers in some states, even though it reduces child mortality, decreases the gender pay gap, and lessens the likelihood that a family will depend on public assistance to get by.
Donald Trump will be our 45th President, we are told, because his campaign centered economic inequality and magnified the stifled voice of working-class America into a cacophonous roar. And we are told that to fight back — and win — the progressive left must listen and speak to that economic pain before all else. That acknowledging the purpose behind these patterns risks losing us the electorate for cycle after cycle. But this argument fails at every level. It is morally inconsistent with the call to address economic inequality because it is the right thing to do, and it is inconsistent with what the evidence that tells us: We will never achieve economic equality if we do not pay attention to why certain groups of us are systematically less well off, and if we do not push up our sleeves for the hard and radical fight to break those systems and build better ones in their place.
To truly address economic justice in this nation — and to win — we must fight with empathetic self-interest. Empathy to hear the voices of “identities” we may not know by heart the way we know our own, but also a deeply absorbed self-interest, knowing that our very own health and wellbeing is bound up in the fight for a more equal society. Economic justice is inextricably linked to racial justice. Economic justice is inextricably linked to reproductive justice and gender equity. There are no boundaries here. There are no walls. We forget these intersections at the peril of our own health, and our nation’s.
Rebecca Fielding-Miller, Ph.D., is a clubmember and postdoctoral fellow, Center on Gender Equity and Health Division of Global Public Health, University of California, San Diego