The preceding chapter referred to the Institute of Medicine's (IOM) 2002 groundbreaking report that documented poorer well-being and health outcomes for African Americans and other ethnic and racial minorities relative to Whites.

The IOM report noted that African Americans are sicker and have shorter life spans, and this is not simply a result of income or access to insurance. Instead, what the report made painfully clear was that “racial and ethnic minorities receive lower-quality health care than white people—even when insurance status, income, age, and severity of conditions are comparable.” According to the IOM report, Black people within the United States were less likely than White people to be given appropriate cardiac care, to receive kidney dialysis or transplants, and to receive the best treatments for stroke, cancer, or AIDS. According to the report, “Some people in the United States were more likely to die from cancer, heart disease, and diabetes simply because of their race or ethnicity, not just because they lack access to health care.”

Within the United States, structural inequities that exist result from the various systems of oppression that have ensured the continued maintenance of the status quo. The status quo in the United States is one that has historically privileged Whites relative to all others, men relative to women, the rich relative to the poor and working class, and the able-bodied relative to the disabled. Although the definition of who is considered White has varied over the centuries of America's existence, far less mutable has been the belief in White superiority and the right to White privilege. Current discourse about White privilege has focused on inequity in healthcare, racism and justice, education, employment, intimate partner violence, and wealth.

Most people today who are inclined to think about these issues accept this as a reality. In many ways, it has come to be viewed as a part of the “tax” of being a person of color and, in particular, a Black person in the United States. Much like the “tax” that is a part of law enforcement traffic stops for Black drivers, the healthcare and well-being tax is another given.