Memories of our Ancestors

If you spend much time on the CDC site … well firstly you’re a nerd, but secondly you’ll note that for most morbidity and mortality rates it separates the statistics for American whites and American blacks (it also includes data for other “races”). You’ll also note that statistically and comparatively things suck for American blacks. African-Americans have higher rates of hypertension, Type II diabetes, various cardiac issues, maternal mortality, and they tend to also have a younger average age of death.

One explanation for this is racial wage disparity. And yeah, that doesn’t help. But if it were just wage disparity or just access to healthcare then we wouldn’t see such a statistically significant disparity in morbidity and mortality rates between black and white Americans. What I’m saying is if the only factor here was economic then poor white people would also have similar rates of chronic health issues and mortality. But that’s not reflected in the data.

So yeah, once again, the issue is racism.

Now, before I get really into this I need to address the ubermensch in the room. (Not Nietzsche’s ubermensch although he’s basically responsible for the idea, but the Nazi interpretation of the ubermensch.) For those of you who’ve never heard of this before its rough translation is “beyond-human,” or “above-human,” and it’s usually translated as “superman.” That latter does actually conceptually work as long as you’re giving a more inclusive interpretation to both the words “super,” and “man.”

Anyways, fascism happens when idiots think reading a page of philosophical work entitles them to control over the lives of millions based on a supernatural birthright. So Nietzche’s whole thing about the ubermensch being a means towards a superior moral code unfettered to an arbitrary religious hierarchy or doctrine got twisted. Nazis ruin everything.

The Nazi interpretation of the ubermensch was that Aryans were already without any extra work or training the superman race and everyone else was in various ways unfit, lesser, or destined only for servitude to the “master race.” We’ll loop back to that last point later. Because of course we will. This lead in WWII to …. well basically most of Nazi cruelty and in conjunction with the concept of lebensraum (room to live) served as the justification for relocation, work camps, and ultimately genocide. To my vast amusement this also gets into Blut und Boden which among other things posits that Germans being Aryans (they’re not technically) were the first to invent agriculture (not quite) and therefore are the only human race (not really a thing) that can naturally support veganism (also not true) because they’re more evolved than anyone else (lols).

So the reason besides all the pseudo science here that I’m laughing is that Hitler was REALLY into this interpretation and that’s what made him a vegan. Now, any vegan knows that if you go entirely without animal products you have to take B12 supplements. This is just a thing. If you want to be vegan, okay great. I ask you to be cognizant of the deforestation and labor issues surrounding your choice but I also do understand why you might go for that in reference to cruelty towards animals. Anyways, humans — all humans — need B12. And humans — all humans — can only get B12 via these crazy supplements usually made from concentrated algae or from animal products like meat, cheese, and eggs. Note: I’m not talking about protein here. Unless you have thalassemia or unless you’re a vegan you do not need to worry about this. It’s really hard to develop a B12 deficiency with a diet that includes really any meat or dairy at all. But …. if you do manage to become deficient the symptoms include but are not limited to hemolytic anemia, extreme irritability, extreme fatigue, tremors, coma, and death. So if you watch videos of Hitler in the 1930s and compare that to him closer to his death you’ll note that … he’s a mess. There’s some speculation that he might have suffered from Parkinson’s which can have a similar presentation and makes for a reasonable differential diagnosis. But, he was practicing blood and soil style veganism apparently with no B12 supplement. He ultimately killed himself, but if the irritability, tremors, jaundice, and fatigue were due to the B12 deficiency it would have killed him given a year or two more. Basically, his idea that he was racially superior was actively killing him. So vegans, two lessons here: 1. take your B12 supplement/eat your nutritional yeast and 2. try not to be a genocidal racist fascist dictator.

But I’ve gone off on a tangent.

My point with illustrating Hitler’s self-imposed decline in health is that there is no racial or even really hereditary basis for longevity or good health. Yeah, MDs take your family medical history because certain diseases do tend to show up in some people more than other based on genetic predisposition …. but you have to somehow activate that gene. (Now, I should note, this flies straight out the window when we’re talking about actual genetic diseases like hemophilia. I suspect that the reason the Romanovs were having such a bad time getting a boy is that Alexandra kept on miscarrying any male fetus. But that’s another tangent.) If your father died of a heart attack or if someone in your family had epilepsy, rheumatoid arthritis, multiple sclerosis, cancer, diabetes etc etc etc then yeah, you do have a higher risk for those diseases. But it’s not a death sentence. I mean, something WILL get you eventually but not necessarily what killed your parents or grandparents. What does put you at risk is if you have that kind of family health history and then experience severe and prolonged biological stress.

African-Americans are not having health issues based on their race as it pertains to their biology, they’re having health issues based on their race because of racism.

So what do I mean by biological stress?

To answer this I have to tell you a bit about yet another Hungarian. Yes. Hungarians are responsible for literally everything. At a later date I’ll tell you about the guy who both started the American nuclear program and became the first protester against it. But today I’m going to tell you about Hans Seyle.

Seyle noticed that all his patients regardless of diagnosis and symptoms pertaining to diagnosis had generalized idiopathic signs of malaise. This included things like fatigue, unwillingness to stand, and a pale coloring. The obvious thing here is they’re all sick. Of course they look unwell. But that’s actually the thing. All these sick people were sick. That was the commonality. But they didn’t all have the same disease.

So Seyle ignored it for a bit because research life is hard, but then he applied his theories regarding stressing a biological system to rat models. He tortured rats is what I’m saying. I’m honestly not sure if his experiments would have passed an IRB today because they seem pretty mean. But what he found is the animals he put under adverse conditions were more likely to fall ill than his control animals.

That may seem really obvious. If you get run down you’re more likely to catch a cold or something. If you’re getting a nice amount of sun, sleep, food, and exercise you’re less likely to get sick. Anyone’s mom can tell you this. And in fact I got a massive ear infection right after I finished my PhD thesis because I ran myself into the ground. And my mom’s reaction was basically, “you’re your mother’s daughter.” When she worked herself too hard she also got specifically ear infections. But there’s a big difference between getting sick because you pulled a month of all-nighters during which you had a diet exclusively comprised of celery and oreos and developing a chronic condition because you’ve endured a lifetime of trauma.

I’m going to tell you how my grandfather and great-grandfather died. My great-grandfather was the guy who helped smuggle a trainful of Jewish prisoners to relative safety. He and my grandfather both survived WWII even though my grandfather — and this is relevant to my point here — only escaped execution by firing squad because he asked that his last meal be something only a Hungarian would ever eat. During the Soviet occupation of Hungary both of them refused to join the Communist Party. Given that my great-grandfather was basically the leader of his town, that was a problem for the KGB and so they imprisoned and tortured my grandfather and repeatedly told both my grandfather and great-grandfather that they were killing members of my family including my father who my family apparently subsequently hid somewhere. My great-grandfather during one of these bouts of physical and psychological abuse had a heart attack and died. My grandfather survived into his seventies, but dropped dead of an aortic aneurysm while playing the accordion at a party. Best way to go ever.

Oh and also my father couldn’t work on a nuclear submarine because he is hypertensive.

So, that gives me three full generations of male ancestors with cardiac issues two of whom died from them. But, I’m not really all that concerned about my heart because I have never had to face down a firing squad nor have I been tortured by the KGB. And I had a really good childhood. Well, maybe not really good. I did go to Catholic school. But I never really feared for my life.

There’s multiple factors which can cause biological stress and therefore chronic conditions. We usually divide them into three categories these being nutritional stress, pathological stress, and psychological stress. These are pretty self-explanatory but I will get into it.

Nutritional stress is chronic malnutrition. If you miss one meal you’re fine, but if you haven’t eaten more than 300 calories a day for a month or so you are not fine. That’s going to come back to bite you. I shall ignore the obvious play on words here. It’s particularly bad for kids or women who are pregnant or nursing because they are both growing, or growing something. They have extra metabolic demands and if they don’t regularly get the food they need their body is going to have to make sacrifices. I’ll get into that shortly.

Pathological stress is basically getting very sick or suffering repeated infections. So this would be something like you picked up a parasite or you got measles. Again, if you just get a cold or even if your kid just gets a cold you’re fine, but if you get something like measles that may cause you lifelong issues.

Now, for MOST people psychological stress won’t cause major chronic physiological problems. When we talk about psychological stress in the context of biological stress we’re talking about really extreme conditions. My doctoral thesis was hard and stressful but it did not meet the threshold of psychological stress which could have permanent health implications. (At least I hope it didn’t. o.O) The reason I told you about my ancestors though is that they *were* subjected to that level of psychological stress. My grandfather had a valid reason to believe as a young man that he was about to be executed. Later he was lead to believe his father and son had both been murdered and he was tortured. My great-grandfather likewise was trying to save his town but risking the death of his son and grandson …. again while being tortured. This is existential stuff here.

When in particular a fetus or young child experiences a combination of these stresses or one of them repeatedly they are at higher risk for activation of what we call the “thrifty gene.” Now, I don’t think this is actually one gene. We just call it that for expedience sake. But what happens is the thrifty gene keeps you alive, but assumes that keeping you alive is going to be REALLY HARD. So it will divert metabolic resources from growth or other processes to protect your internal organs and even store fat. So you have a better chance of surviving adverse conditions, but at no point can you thrive.

And this is where we get back to Hans Seyle.

Seyle noted that under adverse conditions we produce stress hormones including cortisol. Now, a little cortisol is fine. Your body has to maintain homeostasis or balance and so when it starts to list a little it will produce cortisol to signal that corrective actions need to be taken, those things happen, maybe your temperature rises a bit, but in a day or so you’re right as rain. It’s fine to have a little elevated cortisol some of the time. BUT if you are under constant biological stress then your body will continue to produce cortisol and other signalling hormones to try and get itself whole. And the problem is …. it becomes too much. At some point your body will be like, “no, this is ridiculous, I’m tired, I’m raising the price for my labor.” So to get your body to do something about its massive issues you need EVEN MORE of that stress hormone to get it to react. Meanwhile the problem that started this in the first place is still not dealt with and … stress hormones like cortisol are not meant to just hang out in massive quantities in your body. They in and of themselves can start running rampant and doing things like damaging cartilage and causing immune system issues.

Now, you’ve probably seen those ads for some stupid medicine that will totes reduce your cortisol level because cortisol makes you fat and you want to be thin thin thin. Firstly, I wouldn’t advise taking anything that’s advertised to you on television. If you want to lose weight talk to your doctor. But I do need to address that concept that cortisol causes weight gain. It’s actually basically correct.

So back we go to that thrifty gene. Stressful conditions signal to your body that you are about to undergo famine conditions. Your body — among other things — stores excess fat. If you were about to go through a famine that would be really helpful. But typically, that’s not how our modern world works. The stresses might include malnutrition in that you only have access to sugar and fat rather than the variety of other nutrients you need, but typically particularly Americans are never properly without food. (Although, I am deeply concerned about children being denied meals at school. I’m not being light-hearted here, this is a problem and will have severe ramifications for them as adults.) My point is the stresses you encounter from institutionalized racism and untreated pathology can make you fat which in turn leads to …. cardiac disease and diabetes. And you will note, those diseases show up in higher rates in African American populations.

Oh, but we’re not done. Oh no. Not even close. Again I’m going to take us back to WWII. During WWII there was an event called the “Dutch famine” during which the victims were subsisting on about 500 calories a day for several months. When I was having a bout of anorexia I was eating about that much and I can tell you …. you lose weight FAST. But there’s a big difference between my eating disorder and the victims of the Dutch famine. My issue was triggered by a single instance of assault whereas for the Dutch they were living through the worst war in history and then the famine hits. It didn’t go well. As you can imagine. The really interesting (read: horrible) thing about this is that there were a number of women who were pregnant while going through this. Some survived and gave birth and some of those children lived to adulthood and had progeny of their own. But the effects of the Dutch famine were in some cases passed all the way down to the grandchildren of those women who were pregnant at the time despite the fact that the children and grandchildren had relatively easy lives compared to their grandmothers.

That’s an illustration of what we call intergenerational stress. And I really need to note here that the Dutch famine did occur during and as a result of WWII and the victims had no way of knowing when or if it would ever end, but it was still a relatively brief moment in history and the recovery was pretty swift. It’s a really useful event scientifically speaking because the stress is so isolated and contained and it really underscores what happens when biological systems “believe” they’re going to be dealing with lifelong adverse conditions.

So okay, now let’s talk about slavery and racism.

To give you an idea of how recently slavery actually was I’m going to tell you another family story. My maternal grandmother died at 90 years of age a few years ago and at her funeral my Uncle remarked that she was the last surviving grandchild of Lars Ottosen (nee: Louis ???). The joke here is that his name changed because no one was sure of his paternity, he was educated with the children of the royal family of Denmark, and he was expected to serve as a military officer. And there’s the rub. He was a pacifist. So he ran away from the royal court so he wouldn’t have to lead men to their deaths and found himself in the middle of the American Civil War. He managed to escape being pressed into service at one point jumping out a window to avoid a recruiter. The point is, he lived during the American Civil War and his granddaughter only recently died. That is how near we are historically to a time when black people were kept as slaves. We tend to think of slavery as if it happened way back when but … no. It was actually quite recent.

Just thinking about how historically recent slavery was it’s pretty reasonable to assume that there would be some lingering health effects. But the other thing that it’s important to keep in mind when thinking about the health effects of slavery is that the Dutch famine was a winter. One winter. Slavery was centuries of basically genocide with a racist legacy that persists to this day. This is why I get so mad about racism. Racism isn’t just being mean to someone because their skin is darker, it’s about participating in and benefiting from a persistent and institutional power structure that dehumanizes and subjugates people based on no other aspect of their personality than their ancestry.

But if you’ve read this far, I’m preaching to the choir. So let’s talk about white supremacy and how it effects maternal mortality. I know. I’m just a ray of goddamn sunshine, aren’t I?

Firstly, we’ve got the intergenerational effects of slavery plus the continued culture of lynching which basically means black people don’t feel safe anywhere ever and historically haven’t for centuries. Remember my grandfather who faced a firing squad? If you were white you were probably like, “oh my god, that’s crazy!” if you were black you were probably like, “yeah, did that last Thursday.” Maybe not that dramatic but the culture of state sponsored violence against black people is pretty alive and well in America.

Then we’ve got a predatory food industry which — and I can’t even make this up — will place supermarkets in less affluent areas, drive out competition and then inflate the cost of healthy staple foods so that people start relying on packaged, processed, and less nutritional foods. Seriously. I used to live in a primarily Latino area so I stopped by a supermarket to pick up rice and onions. Rice and onions. And they were just absurdly expensive. But the point is that people aren’t getting appropriate nutrition or they’re getting unbalanced nutrition and have no convenient means of breaking out of it.

And then lastly there’s the access to healthcare issue. The UN weighed in on this. Well, they weighed into the whole culture of lynching thing as well. The GOP flipped their toupes over it but ultimately all the UN was actually saying is, “yeah this isn’t great could you maybe provide justice reform and healthcare to your citizenry?” But there is uneven and insufficient access to healthcare particularly for minority individuals. And if you’re suffering from chronic biological stress that is a huge problem whether you’re pregnant or not.

Each of these three things goes back to white supremacy and each of these things impacts maternal mortality in general but especially for African American women. So the obvious one is the continued culture of lynching and generalized violence towards communities of color. I’m not even really sure how to explain this one because it’s just so clear. Police relate to communities of color in an authoritarian manner as opposed to protecting and serving them because communities of color in white supremacist logic are meant to be kept down. If people are frightened and continually threatened they will not reach outside and take power. Michelle Obama wrote about how she wasn’t really more frightened that her husband would meet a violent end due to his involvement in politics because as a black man he already risked being shot every time he left the house. (For the record though, because he’s black, Barrack Obama faced considerably more death threats than most to all previous candidates for the Presidency.) This continual fear for your life is the level of psychological stress that results in dangerously elevated cortisol and can do things like increase your risk for preclampsia.

The food issue is a bit less obvious but has to do with white supremacy isolating and concentrating communities of color. This goes back to the whole “red-lining” thing and ghettoization of certain neighborhoods. This concentration of people of color is done intentionally to disenfranchise them. If you keep people of color concentrated and their food prices up then you can also lower the quality of their schools, make higher paying jobs effectively unavailable to them, force either poverty or diaspora, and …. it makes it super easy to “pack” and “crack” their districts. (For that last you can refer to the Brennan Center for Justice or my article on gerrymandering and the Electoral College.) So how does this effect mothers? Well, diet is crazy important during a human pregnancy for a number of reasons probably the biggest being that human brains are metabolically super expensive. Malnutrition during a pregnancy can have lasting effects and *sigh* there’s gestational diabetes. The risk factors for gestational diabetes are literally if you’re not white. I mean, I have a white relative who’s fit as hell and still had gestational diabetes so you’re never really safe, but everything we’ve been talking about before regarding health and racism contribute to a risk for gestational diabetes.

But concentration of communities of color also feeds into our final point regarding access to healthcare. This one should be obvious. If you don’t have access to good healthcare you are less likely to have a safe and healthy pregnancy and white supremacy has an invested interest in keeping communities of color in poor health. This is why white supremacists are so anti-abortion. They don’t really care about abortions at all, but if women have access to abortions they also have access to reproductive healthcare meaning they have control over their own health and bodies and rape becomes a less effective threat or means of control. Rape’s still pretty awful, but it carries a considerably larger sting if you can’t expect to get a plan B pill or get care for whatever nasty diseases your rapist might have given you. White supremacists count on that extra threat to maintain control. If on the other hand you can choose at what point you are ready to have children and have a doctor who’s happy to see you through your pregnancy and birth then you’re just going to have a better outcome.

Another notable thing is that for women fertility and the chance of a healthy pregnancy drops off pretty rapidly. Now, some of this is statistical nonsense. One of the scare tactics is that this one study with a really small sample size showed that women’s fertility decreases and that they have a doubled risk of becoming pregnant with a fetus that has congenital issues. The “doubled” risk is something like from 2% to 4%. It’s technically correct, but it doesn’t mean that if you get pregnant after forty your child is definitely going to be severely disabled. But it is true that with age fertility does drop off and risk does increase and this is particularly pronounced … among black women. What’s really notable is that it’s particularly pronounced among black women regardless of affluence or education.

Yeah. It’s racism. Black women are having trouble with fertility and pregnancy because of lifetimes of dealing with racism.

I’m going to go back once again to Michelle Obama’s memoirs. Now, honestly, I am not equipped to say exactly where her fertility issues came from but she did have fertility issues. And it is also definitely true that while her childhood and life were hardly poor in terms of love she did experience institutionalized racism in her childhood, during her years at Princeton, and during her young adulthood. She continues to experience it to this day. She relates her struggles with fertility and that she wanted her babies so bad that she was willing to undergo some pretty difficult treatments to have them. Notably, Michelle Obama by the time she was looking to get pregnant was extremely well educated and solidly middle class. She’s now rich. My point is that affluence and education does not protect people of color from the ravages of racism.

And these effects are additive over time. Stress is additive over time. It’s entirely possible that Michelle Obama would have had the same issues if she were white but statistically speaking it is less likely. If she were white she would not have experienced the thousand little stabs of institutional racism that gnaw at people’s families and security and lives and wear them down over time. Even if she were white and super poor, well poorer than she was growing up the likely scenario is that it would have been easier for her to conceive.

I really like Michelle Obama as an example for all this because she’s basically a unicorn. She’s intelligent, determined, fierce, compassionate, organized, she’s done everything right, made all the right choices, planned ahead like crazy and was super super lucky. The thing about her though is although her trajectory is absolutely unprecedented and although she does deserve a lot of credit for the success in her life the flip side of this is there are plenty of black women out there every bit as smart and determined and fierce and organized as she is who will die young. And it is crucial to remember that not only is that not their fault and not anything that they had any control at all over but even Michelle Obama, our tall unicorn in the black and white gown, experienced a lot of this adversity in her life and is still not immune to it.

She credits a lot of her success to the actions of women and people of color in the past which — fair enough — we all stand on the shoulders of giants, but her example is often used in an attempt to prove that racism or sexism no longer exists even as she continues to suffer from it. Remember, Michelle Obama was First Lady. She wasn’t President. And she and her family dealt with absolutely unprecedented and truly violent racism throughout Barrack Obama’s candidacy and Presidency. Even now the entire country is paying a price for the “Audacity of Hope.” I call Donald Trump an “anthropomorphic fart,” because I have no respect for him but he’s also white supremacy in the form of a man. Donald Trump is currently President because of white supremacy.

So yeah, racism, white supremacy, sexism and everything that goes along with them are immediately present in our society and they have a deleterious and increasing effect on our health. This is not something that can be fixed with tax relief or student loan relief. This is a legacy of colonialism and a culture of racism that has persisted and really not even weakened over time. There are people who tell me now that it’s a shame I’m not a man because women are just dumb. They have no evidence for this. And they think they’re giving me a compliment. And keep in mind I’m a pretty little white girl and at present I know where my next meal is coming from. White supremacy does aim to control me as a white woman, but it aims to destroy people of color. And it is succeeding.

To sum up there’s several things I hope you take from this. Firstly white supremacy is genocide. Secondly white supremacy continues to this day. Thirdly a lot of what you might consider just normal cultural debates or things are the underpinnings of white supremacy. Fourthly, racism is not just overt expressions of enmity but insidious propagation of inequity in all aspects of life. Fifthly, that inequity in and of itself leads to deleterious health problems which loops about to our first point that white supremacy is genocide.

Doctor of Palaeopathology, rage-prone optimist, stealth berserker, opera enthusiast, and insatiable consumer of academic journals.

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