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For the past two days on our podcasts, Bakari Kitwana has raised the question of Black-specific issues and, specifically, their omission from Democratic National Convention proceedings this week. Obama is making history as a Black political candidate, but he’s also been doing an interesting dance around issues of race.

On the one hand, and I mentioned this in a piece I wrote for Giant Magazine during the Iowa caucuses, Obama uses race to describe the obstacles he’s over come, to define a personal narrative, rather than to “communicate an indelible experience informing a sense of injustice about what it still means…to be Black in America.” On the other hand, he’s largely shied away from the issues that seem more pressing to Blacks, like affirmative action, poverty, the break up of two-parent families, the devastation of many urban Black communities.

Now, some might argue that advocating for affordable health insurance, regardless of whether it’s framed in racial terms, is clearly important to African Americans, who lack access to affordable health care at higher rates than other Americans. But still there is a distinction to be drawn, as national statistics on health always indicate.

But, I’ve been thinking about Kitwana’s admonition in light of Obama’s own celebrated words from the 2004 convention speech that put him on the map as a national candidate. You see it all the time—Obama intoning that there’s no red America, or blue America, no liberal America, or conservative America, no Black America or White America, there’s just the United States of America. It’s a compelling line, and a big part of his appeal. The vision that that sentiment underscores is not just of a post-racial America, but also of a post-conflict, harmonious country.

And, in a compelling recent review in The Nation of Shelby Steele’s latest book, Ta-Nehisi Coates argues that the reason the debate about whether Obama was “black enough” was always silly was because it was based on a misunderstanding of Black America itself. Coates rejects as outdated and absurd Steele’s claim that Obama can’t win because Blacks will not vote for a man who doesn’t “yell ‘white supremacy’ whenever he’s presented with an open mike.” (Steele’s book was written just prior to the start of the primary season). By contrast, Coates argues, African Americans are not primarily concerned with issues like affirmative action and welfare reform. Instead, Iraq and universal health care predominate. In this context, Obama’s support among African Americans makes all the sense in the world.

But, is it really true that race is, in a sense, beside the point, as a recent New York Times Sunday Magazine article suggests?

From where I sit, there are a few problems with this line of thinking. Senator Obama is a smart man, and a cleared-eyed one, and surely he knows that he’s being more visionary than descriptive when he says there’s no Black America or White America. There are two ways in which I have been thinking about that sentiment lately—one more arguably superficial, the other more serious.

On the first score, when I tell people I am covering the convention for Radio One/News One, I am getting a now very predictable reaction: white people have never heard of Radio One. African Americans have. To take this a step further—as I’ve been getting more familiar with Tom Joyner and his eight-million strong audience—I’ve been asking people whether they’ve heard of him. Now there’s probably scarcely a person in America who hasn’t heard of Howard Stern or Don Imus. The former has as an audience about Joyner’s size and the latter doesn’t come close.

When I ask about Tom Joyner, however, whether people have heard of him breaks down almost completely by race. Blacks know him. Whites, for the most part, don’t. Tom Joyner is neither a celebrity, nor a firebrand. And also, he is not a conservative—so he fits none of the categories of African Americans seemingly worthy of attention in white media. But, it’s hard to come away from asking people about their radio preferences and conclude that there’s only one United States of America.

The second dimension is more serious. Earlier this year, the AMA issued an unprecedented apology for over a hundred years of discrimination against Black doctors. That admission has accompanied a steadily gathering drumbeat about the massive differences in health between Black America and White America.

In a recent article in Salon, Rahul Parikh noted that “the medical community has known for a long time” that African Americans are “not as healthy as whites. They suffer from higher rates of cardiovascular disease, diabetes, HIV, cancer, asthma and other chronic illnesses.” They have less access to health care, are more likely to “show up in an emergency room because they don’t have anywhere else to go” and are more likely to see low quality or non-board certified doctors.

All of this remains true, to varying degrees, when one controls for income, age, insurance status and disease severity. In other words, race alone accounts for a significant portion of the health disparity.

One especially disturbing example comes from a recent report by the Black AIDS Institute, widely publicized when it was released in late July. If Blacks were considered as constituting a country in their own right, according to the report, their population of 39 million would make them the 35th largest country in the world. And, the prevalence of HIV among adult African Americans would rank this country 16th highest in the world in infection rates, with only four countries outside of Africa ranking higher.

And, though the gap in life expectancy between African Americans and other Americans has been closing in recent years, it is still substantial, at five-plus years, and if the trends in HIV infection continue, especially in conjunction with inadequate treatment, it could widen again.

I looked around Barack Obama’s website earlier today. The site lists about two dozen issues categories, including on health. The health page makes no mention of race, or Blacks or African Americans. And, I don’t expect the issue to receive any meaningful attention this week. But, it’s disturbing to consider that, for example, The New York Times Magazine article is correct in its proposition that Obama’s candidacy could spell the “end of Black politics.” Many Americans will find succor in a vision of a post-racial America, an end to our enduring “dilemma.” But, concrete realities will persist and run the risk of continuing to be ignored.

Martin Luther King, Jr. once said that “of all the forms of inequality, injustice in health care is the most shocking and inhumane.” And, Obama is surely making health care an issue, at least to some degree. He’s also, naturally, going to pursue a politically pragmatic course until election day and, in that vein, will almost assuredly steer clear of issues like health disparities, especially since so much of his appeal is premised on the promise of racial transcendence. But, when it comes to health and race, at least, it’s hard to argue that we are, or are likely soon to become, one America.

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