told the story of Clyde Murphy,

耶魯大學的校友雜誌中，

a black man who was a member of the Class of 1970.

敘述了克萊德．漠菲的故事，

Clyde was a success story.

他是在 1970 年畢業的一個黑人。

After Yale and a law degree from Columbia,

克萊德是一個成功的案例。

Clyde spent the next 30 years

從耶魯大學畢業後， 他順利取得哥倫比亞大學法律學位，

as one of America's top civil rights lawyers.

接下來三十年，

He was also a great husband and father.

他成為了一名美國頂尖的民權律師。

But despite his success,

同時，他也是一位很好的丈夫與父親。

personally and professionally,

雖然克萊德的私人生活以及事業

Clyde's story had a sad ending.

都算是相當完美成功，

In 2010,

但他的生活最後卻以悲劇告終。

at the age of 62,

在 2010 年，

Clyde died from a blood clot in his lung.

克萊德 62 歲，

Clyde's experience was not unique.

死於肺血栓塞。

Many of his black classmates from Yale

克萊德的案例並不獨特。

also died young.

許多跟他一起 從耶魯大學畢業的黑人，

In fact, the magazine article indicated

都很早過世。

that 41 years after graduation from Yale,

雜誌中曾有文章指出，

the black members of the Class of 1970

從耶魯大學畢業 41 年後，

had a death rate that was three times higher

1970 年畢業的黑人其死亡率

than that of the average class member.

比同期班上其他同學的平均死亡率

It's stunning.

還要高三倍。

America has recently awakened

太驚人了。

to a steady drumbeat

美國最近

of unarmed black men being shot by the police.

持續發生令人警醒的事情，

What is even a bigger story

許多未武裝的黑人被警察射殺。

is that every seven minutes,

更嚴重的是，

a black person dies prematurely in the United States.

每七分鐘

That is over 200 black people

就有一個黑人比預期中提早死亡。

die every single day

每一天都有超過 200 多個黑人，

who would not die if the health of blacks and whites were equal.

因為其與白人之間的 健康條件不平等而死亡。

For the last 25 years,

過去 25 年來，

I have been on a mission

我一直肩負使命

to understand why does race

努力去了解為什麼一個人的種族

matter so profoundly for health.

會如此影響他的健康。

When I started my career,

當我剛開始我的工作時，

many believed that it was simply about racial differences

許多人認為那只是因為不同種族

in income and education.

有著收入與教育程度之差別。

I discovered that while economic status matters for health,

我發現雖然經濟處境 會影響一個人的健康，

there is more to the story.

但是事實遠不止於此。

So for example, if we look at life expectancy at age 25,

比如說，我們來看看 年輕人的預期壽命，

at age 25 there's a five-year gap between blacks and whites.

25 歲的白人預期 可以比同年齡的黑人多活五年。

And the gap by education for both whites and blacks

受教育程度不同所造成的 死亡年齡差距

is even larger than the racial gap.

比種族鴻溝造成的更大。

At the same time, at every level of education,

同時，每一個教育階段的白人，

whites live longer than blacks.

都比黑人活得久。

So whites who are high school dropouts

高中輟學的白人

live 3.4 years longer than their black counterparts,

比高中輟學的黑人 還要多活 3.4 年，

and the gap is even larger

來比較大學畢業生的話，

among college graduates.

差距則更大。

Most surprising of all,

最讓我驚訝的是，

whites who have graduated from high school

只有高中畢業的白人

live longer than blacks with a college degree

比起有大學以上學歷的黑人

or more education.

活得更久。

So why does race matter so profoundly for health?

到底為什麼一個人的種族 會如此影響他的健康？

What else is it beyond education and income

除了教育程度與收入之外

that might matter?

還有什麼原因呢？

In the early 1990s,

1990 年代早期，

I was asked to review a new book

有人請我複審一本

on the health of black America.

關於黑人健康的書。

I was struck that almost every single one

我發現書中的 25 個章節裡，

of its 25 chapters

幾乎每一個章節

said that racism

都提到種族歧視

was a factor that was hurting the health of blacks.

是傷害黑人的健康的重要因素。

All of these researchers

這些研究者

were stating that racism was a factor adversely impacting blacks,

都指出種族歧視是負面影響 黑人生活的一個因素。

but they provided no evidence.

但他們沒有提出證據。

For me, that was not good enough.

對我來說，那是遠遠不夠的。

A few months later,

幾個月之後，

I was speaking at a conference in Washington, DC,

我在華盛頓發表演講，

and I said that one of the priorities for research

我提出我研究中的當務之急

was to document the ways in which racism affected health.

就是記錄種族歧視如何影響健康。

A white gentleman stood in the audience

一個白人男士站起來說，

and said that while he agreed with me that racism was important,

雖然他對我表示贊同， 認為種族歧視很重要，

we could never measure racism.

但是我們永遠無法衡量它。

"We measure self-esteem," I said.

我回答道，我們可以衡量自尊心。

"There's no reason

如果我們認真對待這件事，

why we can't measure racism if we put our minds to it."

那就沒有理由說 我們無法衡量種族歧視。

And so I put my mind to it

所以我全力以赴，

and developed three scales.

並發展出一個三步驟衡量法。

The first one captured major experiences of discrimination,

第一是對被歧視的經歷進行評估，

like being unfairly fired or being unfairly stopped by the police.

比如說，不公平地被辭職， 或是被警察攔著。

But discrimination also occurs in more minor and subtle experiences,

但是歧視通常發生在 更細小且不易察覺的層面上，

and so my second scale, called the Everyday Discrimination Scale,

所以我的第二步驟叫做 每日歧視比例尺。

captures nine items

它包含九項條目，

that captures experiences

比如體驗到

like you're treated with less courtesy than others,

你所受到的禮遇不如他人，

you receive poorer service than others in restaurants or stores,

在餐館受到其次的待遇，

or people act as if they're afraid of you.

或著是人們看到你會感到害怕。

This scale captures

這個尺很明顯地表示出

ways in which the dignity and the respect

一般社會人士瞧不起的人，

of people who society does not value

他們的尊嚴與自尊心會

is chipped away on a daily basis.

每一天一點一點地被侵蝕。

Research has found

我的研究指出，

that higher levels of discrimination

隨著歧視的惡化

are associated with an elevated risk of a broad range of diseases

更多的疾病會產生，

from blood pressure to abdominal obesity

從高血壓到肥胖症，

to breast cancer to heart disease

從乳癌到心臟病，

and even premature mortality.

甚至提早死亡。

Strikingly, some of the effects are observed at a very young age.

讓人驚訝的是，很多負面的作用 在年輕人身上就能發現。

For example, a study of black teens

比如說，一個研究 黑人青少年的研究指出，

found that those who reported higher levels of discrimination as teenagers

在青少年期受到越多 歧視的孩子們，在二十歲那年

had higher levels of stress hormones,

相對的有越多的壓力荷爾蒙，

of blood pressure

更高的血壓，

and of weight at age 20.

更重的體重。

However,

但是，

the stress of discrimination

受到歧視會有更大的壓力

is only one aspect.

只是許多問題的其中一個。

Discrimination and racism

不公平待遇與種族歧視

also matters in other profound ways for health.

還有更多不同影響健康的方法。

For example, there's discrimination in medical care.

比如說，醫療制度的不公平待遇。

In 1999, the National Academy of Medicine

在 1999 年，全國醫療協會

asked me to serve on a committee

請我在一個委員會中幫忙，

that found, concluded based on the scientific evidence,

過程中，我們藉由科學證明，

that blacks and other minorities

黑人與其他少數民族

receive poorer quality care than whites.

比白人還要受到更差的醫療服務。

This was true for all kinds of medical treatment,

各式各樣的醫療服務都相對更差，

from the most simple

從最基本的

to the most technologically sophisticated.

到最複雜的。

One explanation for this pattern

其中一個原因

was a phenomenon that's called "implicit bias"

是一個叫做「隱性偏見」的現象，

or "unconscious discrimination."

又稱「淺意識歧視。」

Research for decades by social psychologists

十多年來，社會學家的研究指出

indicates that if you hold a negative stereotype

如果你對某些人種

about a group in your subconscious mind

有負面的刻板印象，

and you meet someone from that group,

當你遇到一個那個種族的人，

you will discriminate against that person.

你會對那個人有歧視。

You will treat them differently.

你會不公平的對待他。

It's an unconscious process. It's an automatic process.

整個過程是淺意識的。 是自動化的。

It is a subtle process, but it's normal

是個微妙但也正常的的過程，

and it occurs even among the most well-intentioned individuals.

連最善意的人也可能會犯的錯誤。

But the deeper that I delved

我越是更深層地

into the health impact of racism,

研究種族歧視，

the more insidious the effects became.

我越發現它的隱患。

There is institutional discrimination,

我發現連最基本的

which refers to discrimination

社會制度都有

that exists in the processes of social institutions.

嚴重的歧視存在。

Residential segregation by race,

社區因為不同種族而隔離，

which has led to blacks and whites living in very different neighborhood contexts,

造成白人與黑人 住在非常不同的社區，

is a classic example of institutional racism.

是最典型的社會制度種族歧視。

One of America's best-kept secrets

美國最大的一個秘密，

is how residential segregation

就是社區的隔離

is the secret source

是造成種族不平等的秘密來源。

that creates racial inequality in the United States.

在美國，你住哪

In America, where you live

會影響一個人的

determines your access to opportunities

教育與工作機會，

in education, in employment,

連醫療制度與找房子都會受到影響。

in housing and even in access to medical care.

有一個研究指出 美國前 171 的大城市當中，

One study of the 171 largest cities in the United States

沒有一個城市是

concluded that there is not even one city

白人與黑人的居住環境是平等的，

where whites live under equal conditions to blacks,

而且當中住在最爛的環境的白人

and that the worst urban contexts in which whites reside

都還是比一般的黑人住的還要好。

is considerably better than the average context of black communities.

另外一個研究指出，

Another study found

如果我們能夠在統計上排除

that if you could eliminate statistically

社區隔離，

residential segregation,

我們就能夠排除黑白種族在

you would completely erase black-white differences in income,

收入、教育、

education and unemployment,

失業率、單親媽媽等等的差別，

and reduce black-white differences in single motherhood

拉近三分之二的差距，

by two thirds,

這些都是因為隔離造成的。

all of that driven by segregation.

我同時瞭解到

I have also learned

我們對黑人的

how the negative stereotypes

負面的刻板印象，

and images of blacks in our culture

確實地造成

literally create and sustain

制度與個人的偏見。

both institutional and individual discrimination.

一群科學家收集了一批數據，

A group of researchers have put together a database

裡面有大學畢業的普通美國人

that contains the books,

一輩子下來會閱讀的書本、 雜誌與報刊，

magazines and articles

收集起來研究他們的內容，

that an average college-educated American would read over their lifetime.

我們藉此找出

It allows us to look within this database

美國人在長大的過程中

and see how Americans have seen words paired together

讀到某些詞彙時，聯想到什麼。

as they grow up in their society.

當美國人看到「黑人」這個字時，

So when the word "black" appears in American culture,

他們通常同時看到的字是什麼？

what co-occurs with it?

「窮苦」、

"Poor,"

「暴力」、

"violent,"

「有虔誠信仰」、

"religious,"

「懶惰」、

"lazy,"

「開心」、

"cheerful,"

「危險。」

"dangerous."

當 「白人」 出現時，

When "white" occurs,

經常發生的詞彙是

the frequently co-occurring words

「富有」、

are "wealthy,"

「先進」、

"progressive,"

「常見」、

"conventional,"

「固執」、

"stubborn,"

「成功」、

"successful,"

「有受教育。」

"educated."

因此當一個警察

So when a police officer

看到一個未武裝的黑人，

overreacts when he sees an unarmed black male

卻緊張地以為他是危險人物，

and perceives him to be violent and dangerous,

我們面對的不見得是 一個不好的警察。

we are not necessarily dealing with an inherently bad cop.

他只不過是一個顯現出

We may be simply viewing

受到這個社會

a normal American

長期薰陶而長大的

who is reflecting what he has been exposed to

普通美國人而已。

as a result of being raised

我的經驗告訴我，

in this society.

你的種族

From my own experience,

並不一定要註定你的終身。

I believe that your race

我在 1970 年代末，

does not have to be a determinant of your destiny.

從加勒比海小島聖露西亞

I migrated to the United States

移民到美國

from the Caribbean island of Saint Lucia

來念大學，

in the late 1970s

接下來 40 年，

in pursuit of higher education,

我混得不錯。

and in the last 40 years,

我有個支持我的家庭，

I have done well.

我努力地工作，

I have had a supportive family,

我得到了許多。

I have worked hard,

但是那還不夠讓我成功。

I have done well.

密西根大學給了我 少數民族的獎學金。

But it took more for me to be successful.

是的。我是一個平權措施的寶寶。

I received a minority fellowship from the University of Michigan.

沒有平權措施，

Yes. I am an affirmative action baby.

我不可能有今天。

Without affirmative action,

但是以往 40 年來，

I would not be here.

美國的黑人沒有我成功。

But in the last 40 years,

在 1978 年， 白人家庭每賺一塊錢，

black America has been less successful than I have.

黑人家庭只賺 59 分。

In 1978, black households in the United States

在 2015 年，

earned 59 cents for every dollar of income whites earned.

當白人家庭賺一塊錢美金，

In 2015,

黑人家庭仍然只賺 59 分，

black families still earn 59 cents

而且種族差別造成的 貧富懸殊更加嚴重。

for every dollar of income that white families receive,

白人擁有的每一塊錢，

and the racial gaps in wealth are even more stunning.

黑人家庭只有 6 分， 中南美的家庭只有 7 分錢。

For every dollar of wealth that whites have,

實話說，

black families have six pennies and Latinos have seven pennies.

種族歧視

The fact is,

造成了一個不公平的系統，

racism

一個徹底損害某些美國人種的系統。

is producing a truly rigged system

改述一下柏拉圖曾經說的，

that is systematically disadvantaging some racial groups in the United States.

世界上沒有比平等對待 不平等的人民，

To paraphrase Plato,

還要更不平等的事情了。

there is nothing so unfair

因此我這麼投入地

as the equal treatment of unequal people.

想要拆除種族歧視。

And that's why I am committed

我深刻領悟到我能夠有今天，

to working to dismantle racism.

是因為有許多前人犧牲自我，

I deeply appreciate the fact

替我們打造了一條通路

that I am standing on the shoulders

好讓我們通過。

of those who have sacrificed even their lives to open the doors

我希望這條通路繼續維持暢通，

that I have walked through.

讓更多人通過。

I want to ensure that those doors remain open

羅伯特甘迺迪說：

and that everyone can walk through those doors.

「每當一個男人」 ──我還要加上或是女人──

Robert Kennedy said,

「為了理想而奮鬥，

"Each time a man" -- or woman, I would add --

或者是為了大眾的利益

"stands up for an ideal

而與不公平打鬥，

or acts to improve the lot of others

小小的希望之波浪 就會慢慢地前進，

or strikes out against injustice,

小小的波浪聚集 在一起變成大急流。

he sends forth a tiny ripple of hope,

沖倒壓制與抵抗的高牆。」

and those ripples can build a current

今天我非常的樂觀，

that can sweep down the mightiest walls of oppression and resistance."

因為在全美國，

I am optimistic today

我都有看到希望的小波浪。

because all across America,

波士頓醫療中心，

I have seen ripples of hope.

請了律師加入他們的醫療團，

The Boston Medical Center

所以當醫生在治療病人的過程中，

has added lawyers to the medical team

律師可以順便處理病人 跟醫療無關的問題。

so that physicians can improve the health of their patients

羅馬林達大學在聖貝納迪諾附近

because the lawyers are addressing the nonmedical needs their patients have.

蓋了一間技術學院，

Loma Linda University has built a gateway college

所以當他們提供醫療服務的同時，

in nearby San Bernardino

他們可以教導工作技能，

so that in addition to delivering medical care,

給弱勢團體，

they can provide job skills

與低收入的人們，