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In Cuba, Being Black Is a Mortality Risk Factor

Afro-Cubans die more than whites from diseases of a wide variety of types, as well as from violence, accidents, and complications from medical care.

La Habana
Mortality and race in Cuba.
Mortality and race in Cuba. Diario de Cuba

During the first decades of the Revolution —when Fidel Castro placed Cuba on the vanguard of Marxism/Leninism— speaking of racism was inconceivable. Class struggle was dismissed as something typical of bourgeois societies, and inadmissible for the new Cuban man, with the country pretending not to see its obvious social differences related to skin color.

For many years distinguishing between whites, mestizos and blacks in official Cuban documents was taboo, which made it impossible to statistically record this variable in order to gauge each social group's particular needs.

It was not until 2003 that death certificates began to specify skin color, making it possible to study whether this was a relevant, differential variable impacting causes of death, something that was presumed plausible taking into account the marked socio-class differences originating in slavery, but that persist to this day.

What Juan Carlos Albizu-Campos Espiñeira and Fabián Cabrera Marrero, authors of Mortality in Cuba According to Skin Color, a key reference for this article, could hardly foresee was the extent to which "not being white means an additional risk," since, according to the researchers, the Cuban health system has been characterized since 1960 by the population's unrestricted and free access to health services, a reduction in interprovincial and urban/rural disparity in terms of access to health services and levels, especially for mothers and children, and the consideration of health as a state responsibility.

Despite this health infrastructure, the in-depth analysis carried out by Albizu-Campos Espiñeira and Cabrera Marrero found that, based on all the indicators used, and for all age groups, the black population suffered higher mortality rates, save only for late maternal mortality.

Cuban blacks and mestizos die more than whites from heart and cerebrovascular diseases, bacterial meningitis (except meningococcal), malignant and non-malignant tumors, violence, accidents, self-inflicted injuries, mental disorders, alcoholism, cirrhosis and other chronic liver diseases, diabetes mellitus, digestive system diseases, intestinal infectious diseases, tuberculosis, septicemia, viral meningoencephalitis, malnutrition, anemia, viral hepatitis, influenza, pneumonia and chronic respiratory diseases.

The same is true in the case of mortality from AIDS, complications from medical and surgical care, adverse effects to medications and drugs, sequelae of treatments, and incidents in medical attention.

Also affecting this population more severely are glomerular and other kidney diseases, systemic connective tissue disorders, diseases of the arteries, arterioles and capillaries, prostatic hyperplasia, acute pancreatitis and other diseases of the pancreas.

In addition, mestizos and blacks under one year of age suffer more mortality than whites due to congenital malformations, deformities, chromosomal abnormalities, hernias, intestinal obstructions and low weights.

Black and mestizo women of reproductive ages also die at higher rates due to direct maternal death and obstetric complications.

This higher mortality, more than discrimination in health services, is due to an accumulation of bio-psycho-social factors resulting from the marginal position that the Afro-Cuban population still generally occupies, which leads to lifestyles and forms of consumption degraded by their surroundings, poor water quality, disjointed reproductive health, and the late securing of medical services, among other factors.

Although it has yet to be statistically calculated, it is already known that during the current pandemic there has been an increase in mortality from causes not directly associated with the coronavirus, because, for mixed reasons, related to health and Castroism's political choices, Covid patients have received priority treatment, at the expense of patients with other diseases, since the scant resources generated by the inefficient economic system are not enough to cover everything.

In light of the grim trend described above, which reveals a dismaying generalized fragility in the black and mestizo population relative to the white one, it is foreseeable that both the meteoric increase in mortality not related to the coronavirus, and deaths directly related to Covid- 19, asymmetrically affected the Afro-Cuban population.

More than differences in causes of death, the data here indicates dramatic differences in quality of life between Cubans, depending on the color of the skin they were born with, and this inequality cannot be approached exclusively from a medical point of view.

Improving these shamefully disproportionate indices, indicative of the disadvantages suffered by mestizos and blacks, depends on generating sustained economic growth at a rate that is impossible to achieve under the Castro model. Therefore, it is not unreasonable to assert that for blacks in Cuba, dismantling Castroism is a matter of life and death.

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