Ideas

Kansas City and the case for restitutional medicine

How one U.S. city is looking at using reparations to redress structural racism and boost community health outcomes.

Filed Under

Equity

Written and illustrated by

Josh Neufeld

Published

October 12, 2022

Read Time

1 min

Featured In

Fall 2022

Comic title (handwritten): Kansas City and the case for resitutional medicine. A comic by Josh Neufeld. Image one: Multiple illustrations showing parts of a Kansas City, Missouri neighborhood. The illustrations are muted shared of green, brown, and orange, and depict single-family homes, empty lots, a liquor store, and only one person. In front of an abandoned house is accumulated trash and debris… Bottom right: An illustration of Ryana Parks-Shaw, Kansas City’s 5th district councilwoman and the city’s co-Health Chair Commissioner. She is a Black woman, and wears a purple turtle neck, gold hoops, a gold necklace and a black blazer. Her hair is shoulder length and curly. She says “In Kansas City, there are 18-year disparities in life spans between one zip code and another.” Parks-Shaw asserts “the core cause of the disparities is systemic racism, starting with redlining and other policies created to segregate people. This is what motivated me to run for office.”

Image three: Top panel: The word RACISM is visualized as giant, heavy, rocky letters, crushing silhouettes of people who are trying to hold them up. Text box reads: So can reparations be connected to health? The answer is yes. For one thing, numerous studies show that disease and death rates are elevated for marginalized racial and ethnic groups. Illustrations of scholars Derek Ross Soled, Avik Chatterjee, Daniele Olveczky, and Edwin G. Lindo, above a text box that reads: It’s well-established that there are health costs from just “being Black” in America. In a 2021 paper published in Frontiers in Public Health, the authors state (dialog box depicts them saying in unison): “When adjusting for other sociodemographic factors, being Black is independently associated with increased incidence of [a variety of] mental health conditions...Middle panel: Illustration of the silhouette of a Black man in a depressed pose (head in hands, stress emanates) surrounded by the words anxiety, depression, hypertension. Text box reads: “Research shows that they are not due to innate biological differences, but rather influences of chronic and unremitting stress caused by racism.”…Bottom panel: Text box reads: Compounding the issue, our country’s history of racist medical practices is long and calamitous, including pernicious ideas like Black people having a higher tolerance for pain, or being more resistant to certain diseases. Not to mention being FORCED into experiments during slavery. Illustration on left shows a white researcher drawing blood from a rural Black man in the Tuskegee syphilis study as another rural Black man with a sad expression watches. Illustration on right shows of an enslaved slave woman named Lucy kneeling on a table, as J. Marion Sims, a pioneering gynecologist in the 19th century, and two other white men stand around her. Two other slave women peer nervously from behind a nearby curtain…. Below is an illustration of Justice Gatson superimposed over an image of Henrietta Lacks’ HeLa immortal cells. Gatson says: “Or you talk about Henrietta Lacks and what her cells did for medical research. And yet her own family was denied what her cells did.”…

Image four: Top left panel: Gatson, gesturing with her hands palms-up at chest height, looks out at the reader and says “You can’t just ignore all the things that have happened to the bodies of black people for research. It has a big part to play in restitution.” Top right panel: Ryana Parks-Shaw illustrated in her council office, with a family photo visible on the wall behind her. She says “The state of Missouri has third-world numbers in terms of maternal mortality and infant mortality. In Missouri, Black women are three times as likely as white women to die of maternal mortality. And double the amount of infant mortality compared to white babies.” Middle panel: Illustration of a Black mother and father coming out of a maternity clinic, sobbing. Woman wears a yellow shirt and bracelets, her face covered with her hands. Her male partner wears a red shirt and is holding her with tears on his face. A close-up of Parks-Shaw’s face looking sad is superimposed to the right of the image. She says "The systems in place are what create this disparity.”… Bottom left panel: Illustration of Justice Gatson saying “I am a doula, and I have seen things at hospitals that were definitely race-related—” Bottom right panel: Illustration: The interior of a hospital emergency clinic. Seen from behind, a Black woman with her head bandaged, her hands up in a pleading gesture. A white doctor stands in front of her with an unsympathetic expression, arms crossed. Text box reads: “—Such as Black patients not being listened to and their pain being ignored, to care being denied for the very same condition a white person is being treated for.”

Image five: Title: Why Kansas City needs Reparations. Top left panel: Text box reads: Residential segregation is considered the primary factor that influences health outcomes….An illustration of the Kansas City skyline. A legend provides this data: Kansas City, Missouri, Total population: 508,000, Black population: 152,000, 30 percent of total…. Top right panel: Return to an illustration from the distressed neighborhood seen at the beginning of the story, this time in front of a dollar store. Text reads: In Kansas City’s Black neighborhoods, this plays out in concentrated poverty, poor quality housing, endemic violence, and second-rate medical care… Illustration of Ryana Parks-Shaw is in the foreground, gesturing at the store. She says “In my district, there is limited access to healthy fruits and vegetables. There’s an overabundance of liquor stores, convenience stores, and dollar stores.”… Bottom left panel: Illustration of a simplified map of Kansas City as it was red-lined in the 1930s. Four different colors are used to depict the quality of the neighborhood. A key indicates the four zones: A: Best (designated green on maps) B: Still Desirable (designated blue on maps) C: Definitely Declining (designated yellow on maps) D: Hazardous (designated red on maps). The majority of neighborhoods given a “D” rating at the time form a red cluster on the east side of the city map. Text box reads: In the 1930s, in an attempt to shore up the country’s troubled housing/mortgage market, a federal government agency drew up maps of hundreds of U.S. cities that divided neighborhoods into four zones. In Kansas City, most Black neighborhoods were classified as D - “Hazardous”….Middle right panel: Illustrated map of Kansas City showing Troost Ave in red. The city is colored white on the left and black on the right. Text box reads: “The result was a city virtually split in half along Troost Avenue. Residential segregation worsened after 1954’s Brown vs. Board of Education Supreme Court decision sparked white flight to the suburbs. The subsequent construction of the U.S. 71 connector similarly divided the city.”…Bottom right panel: Illustration of Mickey Dean, retired civil servant and member of the Kansas City Reparations Coalition. Dean is standing on a street corner, saying says: “They cut a swath right in the middle of the Black community and displaced all of those folks.*” Text box reads: Mickey Dean, retired civil servant and member of the Kansas City Reparations Coalition, *as quoted in The Community Voice, November 4, 2021.

Image six: Top panel: Another illustrated map of Kansas City shows Troost Avenue marked red in the center. The left section of the map is shades of green and marked with dollar symbols of various sizes. The right section is shades of oranges and brown with cents symbols of various sizes and one green section with a dollar sign. Text box reads: “Some studies show that the areas of Kansas City designated as “A: Best” now produce 11 times more wealth than the redlined areas. And that’s just measuring things from a contemporary perspective -- this inequity now goes back more than eight decades”…. Middle panel: Text box reads: Remember Councilwoman Parks-Shaw’s comments about life expectancy by zip code? Let’s compare two regions within Kansas City… Illustrated maps of two zip codes, side by side: Left zip code map, colored green, is labeled “Zip code 64113: Population: 93 percent white, Avg. home value $305,000, Avg. life expectancy: 86.3 years (city’s highest)” Right zip code map, colored red, is labeled “Zip code 64128, Population: 86 percent Black, Avg. home value: $50,000, Avg. life expectancy: 68.1 years (lowest in the city)” Text box reads: “Looking at the two zip codes, it’s apparent that homes in the Black neighborhood are worth roughly 16 percent of those in the white neighborhood…” Bottom left panel: Text box reads: “Much more troubling is the 18-year difference in expected lifespans. And that gap is getting worse. Illustrated pink chart shows two cofins comparing life expectancy by zip code. The White tombstone, on left, for zip code 64113, reads “R.I.P. 86.3 years.” The Black tombstone, on right, for zip code 64128, reads R.I.P. 68.1 years.” Bottom right panel: Illustration of Ryana Parks-Shaw saying “The other component is violence in the communities — gun violence, homicides. Appropriating dollars for violence prevention ... could be huge. Illustration of a Kansas City street corner with a splotch of dried blood on the road. Tattered police tape blows in the breeze.

Image eight: Top left panel: Illustration of Mayor Lucas in blue suit and red tie in a meeting room with Justice Gatson and other Black community leaders. Lucas’s is standing while the rest of the group sits around him. His hands rest in an inquisitive gesture[FM1] . He says “How do I put this package together — how do I disburse it?" Top right panel: Justice Gatson waves her right hand and says “If we have this coalition together by the beginning of the fall, I will feel like our Mayor is very sincere. I don’t think he’s stringing us along. Because if he is, a lot of groups will come for him.” Middle panel: Text box reads “One hopeful sign for reparations happened this past summer, when the city won a $5 million grant to plan ways to restore Black neighborhoods severed by Highway 71.” Illustration of Mayor Lucas at an intersection, in front of several other men and women in official-looking dark suits. Speaking into a reporter’s microphone, Lucas, who is holding up his right hand, index finger pointed at the sky, says “You can’t go back to the past, but you can try to do better.” Bottom panel: Text box says: “That may not seem directly related to restitutional medicine, but healing a broken community sparks the imagination. Illustration in softer tones of what the Kansas City neighborhood from the start of the story might look like after reparations: a farmer’s market with fresh produce, Black families and couples, including a man in a Kansas City Royals baseball cap, examining fresh apples, clean streets and sidewalks, and in the background various people out and about. The liquor store is imagined as being replaced by a maternal health clinic next to a market. Inset illustration of Gatson, arms crossed, looking determined. She says “We know what we need, but there’s a huge gap. Reparations are in order.” Text box reads: “Never the end.”

The illustration on the third page depicting J. Marion Sims and Lucy, an enslaved woman, was modeled after the painting Marion Sims: Gynecologic Surgeon, circa 1952, from Great Moments in Medicine by Robert Thom. This illustration and that of the Tuskegee syphilis experiment originally appeared in “A Tale of Two Pandemics” in The Journalist’s Resource.

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Equity

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