The Boundaries of Blackness: AIDS and the Breakdown of Black Politics (review)

Cathy J. Cohen. The Boundaries of Blackness: AIDS and the Breakdown of Black Politics. Chicago: University of Chicago Press, 1999. 394 pp. $18.00 paper.

Medical literature examines the specific health problems of African Americans or compares the disparity in health care opportunities between people of color and whites. The context is almost always economic without any consideration of the underlying political and cultural structures that influence health care. A book that dissects the lack of response to the AIDS epidemic in black communities without blaming the victims is a welcome addition to traditional clinical and economic approaches to the problem.

The central question addressed in The Boundaries of Blackness is: Why, when faced with a disease that was threatening significant numbers of African Americans, did black leaders and the black press not take action? Cathy J. Cohen systematically examines the roles that politics, attitudes, racism, and lack of leadership played in limiting the resources allocated to fighting AIDS in black communities.

This book provides a thought-provoking discussion of marginalization, meaning, in this context, the political, economic, and social "disempowerment" of African Americans in the United States. Cohen points out that a number of minority groups in addition to African Americans have been marginalized (37), such as blacks under apartheid in South Africa, undesirables in India, or Palestinians in the Middle East. Dominant groups in any society use established (government) institutions, laws, ideologies, and norms to control or oppress marginal groups. This inevitably leads to conflicts among the groups. Conflict, in turn, causes marginal groups to develop alternative or oppositional worldviews (49), to have limited resources (51), and to practice various forms of political resistance (53). The author concludes that understanding marginalization helps explain black community reaction to the AIDS epidemic.

Cohen contends that many of the institutions indigenous to black communities were unable or unwilling to make AIDS a major issue for African Americans and their politics. Their marginalization meant that resources and political attention were already in short supply. AIDS failed to gain a prominent place on the political, community, or media agendas for a number of reasons.

Cohen's most controversial assertion (at least for Republicans) is that "ideological" attacks during the Reagan administration resulted in the dismantling of social welfare programs and renewed support for states rights that many southern whites equated with "white supremacy" (82). She contends that these attacks focused black leaders' attention on large state and national programs and contributed to the underfunding of AIDS research. Cohen indicts the federal government on several levels for putting too little or the wrong emphasis on the demographic segments affected by AIDS. First, she says that the Centers for Disease Control (CDC), while illuminating the AIDS epidemic, erred in first focusing on only white gay communities and then overemphasizing AIDS in specific ethnic groups, such as Haitians. Statements and actions of other Reagan officials, who misunderstood AIDS in communities of color, compounded these problems.

Her indictment of the media's role in putting a white face on the AIDS epidemic is no less scathing. A substantial portion of the book is devoted to media content and how the epidemic was framed, especially by the black press. Her analysis reveals that "the number of print and television stories devoted to analyzing the spread of this epidemic in African-American and Latino communities lagged behind those stories in which gay men were central, and drastically lagged behind the number of stories examining the threat of AIDS to 'the general population'" (149). Because the media are the major source of information about HIV and AIDS for the American public, their attention to the disease as a white homosexual male problem meant that the public did not perceive the AIDS threat as a problem for minorities and women. The media coverage may, in fact, have influenced the CDC's decisions...