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The Myth of Meritocracy and African American Health Recent theoretical and

empirical studies of the so-

cial determinants of health

inequities have shown that

economic deprivation, mul-

tiple levels of racism, and

neighborhood context limit

African American health

chances and that African

Americans’ poor health sta-

tus is predicated on unequal

opportunity to achieve the

American Dream.

President Obama’s elec-

tion has been touted as

a demonstration of Ameri-

can meritocracy—the belief

that all may obtain the Amer-

ican Dream—and has instilled

hope in African Americans.

However, we argue that

in the context of racism

and other barriers to suc-

cess, meritocratic ideology

may act as a negative health

determinant for African

Americans. (Am J Public

H e a l t h . 2 0 1 0 ; 1 0 0 : 1 8 3 1 –

1 8 3 4 . d o i : 1 0 . 2 1 0 5 / A J P H .

2009.18644 5)

Naa Oyo A. Kwate, PhD, and Ilan H. Meyer, PhD

ON JULY 16, 2009, PRESIDENT

Barack Obama spoke at the NAACP at its centennial celebra- tion, articulating a common goal for the association and his admin- istration: ‘‘We want everyone to participate in the American Dream.’’ He argued that although poor and African American chil- dren face social challenges, these challenges need not stop their success: ‘‘No one has written your destiny for you. Your destiny is in your hands. . . . That’s what we have to teach all our children. No excuses.’’1 This notion—that through striving, anyone can achieve and create his or her own destiny—is central to American ideology. This ideology asserts that the United States is a meri- tocracy and that its citizens—re- gardless of the social stratum from which they start—should aspire to, and in fact can attain, the height of social and economic success described as the American Dream. American meritocracy, the claim goes, has liberated its citizens from old-world confines of class and heritage. President Obama per- sonifies the promise of American meritocracy—an African American man in a country with a long history of racism, rising from very modest means. His presidency seems to demonstrate that the American Dream is indeed within anyone’s reach.

But what if belief in the Amer- ican Dream can lead to poor health among African Americans? Compared with Whites, African Americans experience more mor- bidity and mortality resulting from economic and other inequalities.2

Moreover, upward socioeconomic mobility does not always lead to

better health for African Ameri- cans.3 We propose that in the context of strong social barriers to success, especially racism, belief in meritocratic ideology may be detrimental to African American health.

We do not suggest that believ- ing in the American Dream is ineluctably detrimental to all Af- rican Americans, nor do we sug- gest that such beliefs should be eradicated. Certainly, belief in meritocracy and the possibility of success through hard work and effort undergirds American opti- mism and attempts to achieve. In- stead, we hope to problematize how public health researchers and policymakers understand meri- tocracy by looking at some of the less visible ways in which merito- cratic ideology may jeopardize health and well-being. We intro- duce our ideas about the potential pathogenic effect of meritocracy and briefly discuss two mecha- nisms: individual, through the im- pact of stress and coping on health, and structural, through the impact of beliefs and values on policies. Figure 1 depicts some mechanisms through which meritocratic ideol- ogy may lead to poor health.

THE NATURE OF MERITOCRACY

Meritocracy has been described as America’s dominant ideology.4

Indeed, it is so dominant as to be hegemonic—to eschew it is un- American.5 America’s history and folklore are replete with ideas re- lated to meritocracy, suggesting that individual agency and resil- ience will lead to economic success. For example, novelist Horatio

Alger’s stories envisioned America as a meritocratic republic where all personal and societal rewards were equitably bestowed. The rags-to-riches life trajectories enjoyed by his characters remain a seductive and affirming narra- tive in American culture. The American Dream is salient in our national consciousness,6 and for many, it serves as a powerful motivator to strive for success. Moreover, for African Americans, meritocratic ideology can lower perceived vulnerability to preju- dice,7 providing a sense of hope. It is difficult to argue with the mes- sage of hope inherent in merito- cratic ideology that is reflected, for example, in President Obama’s message to African American schoolchildren that they can cre- ate their own destinies.

Still, as Merton8 noted, there is often a disjuncture between America’s meritocratic values that promote aspiration for success and the opportunity structure—the social, economic, and political structures that make success possible. The problem is that op- portunities are not equally dis- tributed, and they are not allotted solely by meritocratic criteria. For example, racism serves as a strong barrier to African Amer- ican’s achievement. Even if unin- tended, the promise of equality inherent in meritocratic ideology serves to elide racism. Indeed, Geronimus and Thompson viewed meritocracy as part of a broader set of racialized ideolo- gies that undergird health dispar- ities. They argued that ideologies that laud equality and personal responsibility imagine a ‘‘commu- nity of virtuous seekers of the

COMMENTARIES

October 2010, Vol 100, No. 10 | American Journal of Public Health Kwate and Meyer | Peer Reviewed | Commentaries | 1831

American Dream, people who work hard, play by the rules, and suffer the consequences if they don’t.’’5(p252)

Within this context, African Americans’ demands for economic justice can be seen as unwar- ranted5; their lower economic and social standing is explained as in- dividual failure rather than the effects of long-standing racism. These views are represented among some civil rights theorists. Traditionalists contend that post– civil rights African American cap- ital deficiencies reflect African American cultural deficiencies, such as the rejection of main- stream culture, victimhood, and other self-defeating behaviors.9

They therefore eschew govern- mental remediation, essentially calling on African American peo- ple to ‘‘overpower strong envi- ronmental headwinds by dint of willpower.’’9(p34)

MERITOCRATIC IDEOLOGY AND SOCIAL INEQUALITY

Meritocratic ideology imbri- cates the moral economy—the norms that govern economic ac- tivity and society’s protections and privileges.10 Americans are con- flicted about the inequality in their society and, hence, the need for and urgency of political action to promote equality.11 When in- equalities can be rationalized as inevitable outcomes of lack of talent, skill, or work ethic, in- equalities in wealth and health can be justified as reflecting individual, not societal, failings.10

System justification theory il- luminates the relationship be- tween meritocratic ideology and political inaction, showing why even the most disenfranchised citizens view inequalities as nec- essary and even fair.12 The the- ory, and related research, shows

that although the system is char- acterized by inequalities in ac- cess to resources, life chances, and life outcomes, believing that this is a just arrangement can be palliative. This reduces anxiety, dissonance, and perceptions of unfairness.12 Among the disad- vantaged, who bear the brunt of inequalities, system-justifying at- titudes are often the strongest.13

Because meritocratic ideology promises everyone the chance to succeed, it diverts attention from structures and conditions, such as those related to racism, that make it impossible for many to succeed. This is not to say that individuals believe everything is fair; rather, they hold attitudes that are more positive toward the system than are warranted.14

Meritocratic ideology can obfus- cate features of the opportunity structure that erect barriers to success.

A political climate guided by meritocratic ideology is related to general lack of support for social programs that assist those most in need. The American public’s and policymakers’ belief in mer- itocratic ideology catalyzes oppo- sition to policies that contradict the idea that individuals deserve what they get and get what they deserve. For example, research shows that meritocratic ideolo- gies influence opinions about how much governmental assis- tance should be provided to low- income women.15 Ironically, it is among the disadvantaged, who bear the brunt of inequalities, that system-justifying attitudes are often the strongest.13 In some studies, poor Southern African Americans were more likely than were their higher-income coun- terparts to endorse meritocratic notions that hard work leads to success.13 ‘‘Individuals who do not recognize that they are treated un- justly will not protest,’’4(p342) mak- ing agitation for equality less likely.

Thus, meritocratic ideology leads to policies that advance fewer allocations to help the disadvantaged, such as health care and welfare. Indeed, merit- ocratic ideology is associated with the endorsement of income inequality,13 which in turn is not only strongly associated with health but also associated with ‘‘the heart of problems which beset our societies and are con- stantly in the news.’’16(p1976) Al- though meritocratic ideology may exert subtle and pervasive influence on American politics, support for social programs has varied across US history, and this variation is not necessarily coex- tensive with the cultural strength of meritocratic ideals. Strong social programs may be implemented even in a climate in which merit- ocratic ideologies are salient.

FIGURE 1—Structural and individual pathways through which meritocratic ideology may harm African

American health.

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1832 | Commentaries | Peer Reviewed | Kwate and Meyer American Journal of Public Health | October 2010, Vol 100, No. 10

Often, however, in the context of meritocratic ideology, social programs reproduce extant in- equalities. For example, Franklin D. Roosevelt introduced the GI Bill (i.e., the Servicemen’s Read- justment Act of 1944) to provide returning veterans unemployment pay while they looked for work; tuition allowances; and loans for homes, farms, or to start a business.17 Today, the program is hailed as legislation that trans- formed the United States by dramatically expanding higher education, housing and highway construction, and small businesses and, most important, by provid- ing a gateway to the middle class for thousands of Americans.18

Supposedly, the GI Bill made good on core meritocratic ideals:

All those promises that brought people to our shores from the very beginning, that in this country there was opportunity to extend yourself to the limits of your ability. Education provided that opportunity for millions of people, made the promise of America real.18

But for African American vet- erans, the promise of the GI Bill was largely foregone. African American GIs were dispropor- tionately and unfairly given dis- honorable discharges, making them ineligible for GI Bill benefits. Those who were eligible were unable to translate their benefits into education or housing oppor- tunities because the program operated through federal (e.g., Federal Housing Administration, Veteran’s Administration) and private institutions (e.g., colleges, banks) that actively discriminated against them.17 Resultant inequal- ities in African American wealth and education levels are in turn used as evidence that African Americans are unable to compete in a meritocratic system.

Public discourse on home own- ership and neighborhood quality has been punctuated by assertions that African American residents lack appropriate values, reflecting and reinforcing meritocratic ideology. Although some Whites agree that some individual dis- crimination exists, many remain skeptical that macrolevel policies and choices are discriminatory or that they harm African Americans. Contrary to evidence,19 they be- lieve that the passage of civil rights laws has eradicated institutional level and systemic bias in the housing market.20 Thus, Whites argue that negative features, such as crime, in predominantly African American neighborhoods reflect character deficits. As one White respondent said,

I think the majority aren’t en- thused, not motivated, and don’t care. . . . The opportunity is there if they want to take advantage. I don’t think most Blacks want to work for anything.21

Described as the cornerstone upon which African American– White health disparities are founded,22 racial residential seg- regation is a critical structural pathway through which merito- cratic ideology harms health. Pre– civil rights bias continues to undergird stark differences in Af- rican American–White wealth,23

but the US polity has been reluc- tant to recognize or remediate segregation and housing discrimi- nation. The US Supreme Court ruled in 1992 to end a court- ordered integration program, holding that if resegregation was the result of private individual choices and not state action, there were no constitutional implica- tions.21 Thus, meritocratic ideolo- gies legitimize existing status differences and policies that harm health by locating the

responsibility for social status within individual characteristics.

MERITOCRATIC IDEOLOGY AND STRESS

Stress theory has been one of the core theoretical approaches to the study of health disparities in the United States, arguing that social and psychological demands can be taxing and lead to adverse health outcomes.24 Meritocratic ideology may be a source of stress. If social status tends to be attrib- uted to individual responsibility, meritocratic ideology may be as- sociated with adverse health out- comes among African Americans by increasing the risk of internal- izing negative self-attributions for failure to obtain the American Dream. To endorse meritocratic ideology—as most Americans do—means to be at risk for the psychic toll borne from percep- tions about not measuring up. Alford Young’s ethnography of poor African American men from Chicago’s near west side25 is par- ticularly instructive in this regard. When asked if race was an im- portant issue in American life, one participant responded, ‘‘It ain’t important. . . . To me it’s within the individual to get along. To me it’s up to the person, you know. I don’t think it’s a racial thing.’’25(p143)

This exemplifies both meritocratic ideology and related system justi- fication. If it’s up to ‘‘the individual to get along,’’ then society is ex- empt from the responsibility to remediate racial inequities.

Such denial of racism can have a harmful impact on health. Among working-class African American women and men, re- spondents who denied experienc- ing discrimination had higher blood pressure than did those who reported discrimination.26 Simi- larly, denial of racial discrimination

vis-à-vis self-report and implicit assessment was associated with hypertension among African American respondents with less than a college degree.27 These paradoxical findings may indi- cate that individuals who can express their experience with racism face lower health risks than do individuals who inter- nalize it.26 If meritocratic ideol- ogy subverts the recognition and articulation of racial inequality, rather than acting as a source of uplift, it may in fact place indi- viduals at risk.

Meritocratic ideology may also be associated with adverse health by increasing health-damaging, high-effort coping to overcome adversity. Evidence suggests that in low status groups, the endorse- ment of meritocratic ideology can lead to self-blame for failure to reach a goal instead of attribution of discrimination. Research on John Henryism, a term inspired by the story of John Henry, the steel- driving man who collapsed after competing with a high-powered machine, shows that persistent high-effort coping in the face of impediments to success can lead to hypertension among African Americans from low socioeco- nomic backgrounds.28 Merito- cratic ideology may be an impor- tant catalyst for John Henryism by increasing the propensity for sin- gle-minded determination to suc- ceed and increasing self-blame and demoralization.

CONCLUSIONS

The association of meritocratic ideologies with poor health for African Americans has implica- tions for public health and health policy. The World Health Organi- zation sees health equity as ac- tionable through social and eco- nomic policy interventions.29

COMMENTARIES

October 2010, Vol 100, No. 10 | American Journal of Public Health Kwate and Meyer | Peer Reviewed | Commentaries | 1833

Three overarching recommenda- tions are to (1) improve daily living conditions; (2) tackle the inequi- table distribution of power, money, and resources; and (3) measure both the extent of health inequities and the impact of policy and action. At the heart of the second aim is a call to address inequities in the way society is organized.29 To do that requires recognizing that societal structure is not simply the reflection of variation in individual talents and effort, as suggested by meritocratic ideologies.

To accomplish significant changes, we must broadly define health policy as encompassing a range of governmental policies, including labor, education, and transportation.30 For example, educating American youths about inequality—given that many Americans are not aware of social disparities and the means by which they are per- petuated11—is not just good ped- agogy, it is indirectly health pol- icy. African American parents socialize their children to nego- tiate their social world from a position of psychological strength, self-efficacy, and opti- mism while remaining cognizant of the inequality they are likely to face. So too must the United States socialize children to attend to long-standing disparities in the distribution of resources and life chances. Again, the goal is not to quash the American Dream for US youths but to discourage uncritical acceptance of a deeply held but vexed cul- tural value. A steadfast belief in the United States as the land of opportunity may be as hazardous as it is inspiring. The American Dream remains central to Amer- ica’s sense of self, but as Langston Hughes asks, ‘‘What happens to a dream deferred?’’31(p426) j

About the Authors At the time of writing, Naa Oyo A. Kwate and Ilan H. Meyer were with the Department of Sociomedical Sciences, Mailman School of Public Health, Columbia University, New York, NY.

Correspondence should be sent to Naa Oyo A. Kwate, PhD, Associate Professor, Department of Human Ecology, School of Environmental & Biological Sciences, Rutgers, The State University of New Jersey, 55 Dudley Rd, Cook Office Building, New Brunswick, NJ 08901-8520. Reprints can be ordered at http://www.ajph.org by clicking the ‘‘Reprints/Eprints’’ link.

This commentary was accepted March 31, 2010.

Contributors Both authors conceptualized and wrote the article.

Acknowledgments An RWJF Investigator Award (award 66488) in Health Policy Research from the Robert Wood Johnson Foundation, Princeton, New Jersey, provided support for this article.

We would like to thank Ayana April and Anjali Dixit for their assistance with the article’s preparation.

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