In medicine, the people who know the least about structural racism have the most power to control how our field understands and addresses racism's impact on health. These folks are hospital executives, NIH leaders, journal editors, and chairs. They are also mostly white (men).
As a result, the medical canon remains in this perpetual cycle of racism 101, where scholars are asked to simply explain racism. So rather than funding, publishing, and implementing critical work that might address (or even eliminate) racism and its impacts, we just describe it.
Imagine if a cure for kidney disease was developed. But every article on the cure had to begin with a review of basic kidney anatomy, "because some people just aren't comfortable enough with the basics to talk about cures." There would be an outcry! And rightfully so.
And yet we continue to center those least informed about racism in our field's approach to addressing its impacts. Scholars have to answer editors' questions about readers' "comfort" and teach basic history and definitions before imagining new systems to end health inequities.
This centering allows ignorance about structural racism, which germane to white racial dominance, to shape our field's science and interventions. So if you are a leader in healthcare - challenge your own ignorance. Teach yourself. Do the work. So the field can advance.
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Spending my adult life in large cities has taught me how to assess the level of neighborhood tension based on the position of clothes in and near laundry mats. Based on my experience, here is how to recognize brief insults, signs of escalation and when folks are all out BEEFING.
If you see an entire load of laundry on the floor, this is probably a one-off offensive, the kind that transpires in response to someone removing their things from machine before they returned. This brief insult may not escalate beyond this load. Proceed with your washing.
Once I saw wet clothes thrown into the tree just outside the laundry mat. And I'm not talkin gently placed in the tree to dry, I'm talkin aggressively thrown with mad disrespect. That was an absolute escalation and a sign I should change my wash day. Crisis averted.
Just reviewing some of the national vaccination data by race and ethnicity and WOW the inequities are alarming!
Look @KFF data for Black folks as of March 3. In Washington DC, Black folks make up 45% of the population, 76% of COVID deaths (!!), and only 26% of those vaccinated.
You see similar, but not as striking, racial inequities in states like Alabama, Mississippi, Delaware, North Carolina, and Maryland. These states have sizable Black populations who have suffered disproportionate rates of COVID deaths and yet have lower COVID vaccination rates.
States that are vaccinating Black residents commiserate with their percentage of the population and rates of COVID deaths are: Colorado, Massachusetts, Oregon, Utah, Vermont, and West Virginia. However, these states overall have much smaller Black populations (less than 5%).
The truth is, Black people don't hate vaccines. We hate exploitation, experimentation and neglect. And many of us, need not resurrect the ghosts of Tuskegee to recall moments in which we’ve endured such abuse.
As a result, Black folks are some of the most discerning healthcare consumers in the US. That discernment often manifests in LEGITIMATE questions & concerns. Mislabeling those concerns as "vaccine hesitancy" is dismissive AND tacitly blames Black folks for their undervaccination.
Hello Black America! Black health care workers across the country and I hear your questions and concerns about the COVID vaccines and we're bringing the information right to you. It's time for us to have a conversation Between Us About Us. Watch and share now! #BetweenUsAboutUs
Today's launch is just the beginning of our commitment to ensure every Black person in the country has the information they need to make the critical choice about receiving the COVID vaccines. Shout out to @wkamaubell who has been working with us to bring these facts to you!
The very first Black doctors, back in the 1800s (!!), argued that racial health disparities were driven by racism (and more precisely racial capitalism).
That I have to argue this same basic fact in 2020, doesn't make me my "ancestors wildest dreams." My ancestors already knew.
And you don't need to be a doctor to know racism harms Black folks' health. Black people who are not doctors, know too!
Here is recent data from the @KFF and @TheUndefeated poll asking Black folks how racism shapes their outcomes. They know.
And yet here we are in healthcare, year after year, CENTURY AFTER CENTURY, asking the same essential question when the answer HAS BEEN clear.
RACISM MAKES PEOPLE SICK.
RACISM KILLS PEOPLE.
This is true despite one's income or education status.
I'm going to say something that might be hard to hear, but I'm going to say it anyway.
To those who continue to decry the thin margins in this election, you need to de-center whiteness in your analysis.
Brief thread.
These takes, that lament "how close this presidential race is" as some referendum on the nation and it's progress effectively ignore the populations for whom this election was not close at all.