The Black-white health gap is one of the most striking examples of the depths of racial inequality in the United States. Why does it persist? A new paper from researchers at the Samuel DuBois Cook Center on Social Equity at Duke University investigates — and refutes — a popular argument for the causes of this disparity.
“How Epigenetic Inheritance Fails to Explain the Black-White Health Gap” explores the hypothesis that the trauma of slavery inflicted upon the enslaved population in the U.S. precipitated epigenetic changes that have been passed down and persist to the present.
This argument, labeled as Post-Traumatic Slavery Syndrome or Post-Traumatic Slavery Disorder, postulates that these inherited changes at the genetic level are negatively affecting the health of contemporary African Americans.
“Blaming the inherited trauma of slavery for modern health disparities is inaccurate, imprecise and irresponsible,” said public policy professor William A. Darity Jr., co-author of the paper who directs the Samuel DuBois Cook Center at Duke. “All that Black Americans have ‘inherited’ is a perpetual resource disadvantage in a society that refuses to enact policies to correct the condition.”
The paper will be published in the February 2025 issue of Social Science & Medicine and is now available online.
Many statistics underscore the depths of the racial health gap: Black life expectancy for many years has averaged four years less than white life expectancy, a gap that expanded during the COVID-19 pandemic. Black infant mortality is twice as high as that of white infants, and Black mothers are three times as likely as white mothers to die of pregnancy-related causes.
The consensus understanding of the cause of these gaps is they are the product of historical and ongoing systemic racial disparities. The
Black-white health gap stems, at least in part, from the racial wealth gap. The 2022 Survey of Consumer Finances, collected by the Federal Reserve, found that the average white household had more than a million dollars more in wealth than the average Black household — coupled with disparate access to land and housing, well-paid employment, quality education, adequate sanitation, nutrition and medical care.
However, in recent decades the transgenerational slavery trauma hypothesis has gained prominence. This argument suggests that the extreme injuries inflicted upon the enslaved in the United States have been transmitted across multiple generations, resulting in poorer mental and physical health for their living descendants.
