Anyone still there?

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Blog Fam –

You were the first platform that welcomed my critical analysis on the intersections of racism, health, and justice. You helped me hone my voice and you watched me grow. I’m so grateful for this little blog in my tiny corner of the internet and all it has taught me. And I wanted to let you know I’m still here. But lately, I’ve been fortunate to be invited to share my voice on bigger platforms and sometimes even in front of a live audience(!) So I just wanted to pop up and say, thank you for rocking with me and in case you’re still following (thanks Ma and Pops for always following!) here’s a rundown of some of the things I’ve been up to.

1. In June 2018, I wrote a commentary for The Lancet on a landmark study exploring the mental health impact of police violence. If you haven’t read this study, read it! It provides rare causal evidence that police killing unarmed Black Americans caused poor self-reported mental health in Black Americans who live in the same state. This effect did not require Black Americans to witness the event, live in the same neighborhood, or be a close relative to victim(s). Black people merely had to live in the same state as victims to experience the mental health impairment. The researchers estimated the magnitude of the mental health impairment was so high, it was comparable to the mental health burden of having diabetes. Meaning, Black Americans are so affected by policing killing unarmed Black Americans in their state, they have almost as many poor mental health days as individuals who actually have diabetes! I wrote a twitter thread that summarizes the paper’s major takeaways, in case you are short on time. Anyways, here’s a link to my commentary entitled, Police Violence and Built Harm of Structural Racism (and it is still free to view!)

2. In June 2019, I wrote an essay for The Lancet entitled, The Case for Desegregation, (which is free to view!) that essentially offered that the US health care system doesn’t have a problem with diversity, it has a problem with segregation. I also wrote a twitter thread on the topic for those who like short summaries.

3. In July 2019, the American Academy of Pediatrics (AAP) released it’s first policy statement on racism’s impact on child and adolescent health! To mark the historic occasion, I was honored to be among those asked to write a blog on the topic. I chose to write on what it means that a policy statement like this was published in 2019 and where pediatricians and child health advocates have to sprint next (spoiler: to address the child health impacts of police violence). Here’s a link to my piece on the AAP’s Voices Blog The Weight of the Little. And my twitter thread on it.

4. Last month (October 2019), I was invited to be the keynote speaker for the Data-Across Sectors for Health (DASH) All-In Conference. DASH is apart of the growing data infrastructure in health care that is also focused on equity and public health. So it was a real honor and dream to be invited. But it was also a real challenge. It’s one thing to talk about racism and health in my tiny corner of the internet. But it’s quite another to get up in front of a room of people, look them in the eye, and say let’s talk about white supremacy and how it hurts people (which is one of the many points I made in the talk). So here’s a link to the video of the presentation and slides. And no, it doesn’t have a twitter thread 🙂

Okay, those are some of my recent highlights. Thanks again for rocking with me on here and more soon!

Rhea

 

 

White People… What Say You?

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White friends, colleagues, peers, and neighbors –

White people who played with me as a child and sent well-wishes to my parents –

White people who invited me to your homes and welcomed me at your tables –

White people who were friends with my sister and had drinks with my Dad –

White people who prayed beside my Grandmother and worked beside my Mom –

White people who voted for Obama and voted for Trump –

White people who made room on public transit and held open elevator doors –

White people I know and white people I don’t –

White people who have power and white people who won’t –

White people in general –

What. Say. You.

What say you?

As the President of the United States wages verbal and political violence in your name, what say you?

As he reorders our democracy to enshrine white nationalist power, what say you?

As he retells a story of America that places you, and you alone, in positions of moral and political authority, what say you?

And what are you doing?

Are you silent and on the sidelines, unscathed by the vitriol because you are unsupportive of its arbiter?

Do you grapple with this violence, both rhetorical and physical, meted for your racial advancement or is your struggle brief?

How does it feel to be white in the midst of a white supremacist insurgence in America?

Do you hope to passively benefit from language that resurrects a nation where only white people belong or hold political power?

How are you making sense of the ways hateful, racist words make it fundamentally easier for people who look like you to move in this country and feel free?

Are you comfortable in spaces at home, in community, at work, school, and church where only people who look like you can be safe and thrive?

What do you see as your responsibility, right now, in this very moment, as the President of the United States articulates and executes a political agenda that limits the rights and protections of all kinds of people, simply because they are not you?

And what do you say to other white people, especially those who will never ascend to the  power or wealth that Trump’s whiteness promises? What do you say to those whom whiteness is failing?

White people, what, if anything, in these dire political times, do you feel compelled to say or do?

I ask these questions honestly and earnestly and with a bit of impatience. I ask them with the full intent that at least some white people will respond.

If you would like to respond publicly, I invite you to my twitter thread in which some white folks have already spoken. Or if you feel so inclined, sound off in these comments below.

And if you know me in real life, I invite you to call me. Text me. Email me.

Say. Something.

Whether I see you in clinic, in the grocery store, or in my gym, I need to know where you stand.

Where Implicit Bias Fails

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The implicit bias frame does not offer equity. It offers absolution from complicity in systems that harm people. And yet, individuals, organizations, and institutions continue to use the implicit bias frame to make sense of inequity and to address it.

Take police violence, for example. In the face of the devastating and disproportionate toll police violence takes on Black and Brown people in America, policymakers have responded by offering local law enforcement implicit bias training. The underlying assumption is, police violence is an interpersonal problem that takes place between an individual “bad” officer with bias and the civilian on whom their bias is projected. In this framing, the solution then requires an interpersonal remedy to address unconscious racial stereotypes that must drive racial inequity in police violence.

But this limited reading of the problem and solution, rooted in individualized and unconscious judgement, ignores the collective impact of police violence and the explicit choices that structure, authorize and weaponize police-community relations.

Police violence is also, and I would argue, largely, a structural problem, whose effects extend beyond individual civilians to the communities and populations who directly and indirectly suffer the burden of the disproportionate risk of this form of violence. This community and population-level impact is driven by intentional human design.

Police violence must be understood as the predictable by-product of policies that introduce militarized weapons into local precincts and permit use of force in the absence of a lethal threat. Racial inequity in police violence is then incentivized by “tough on crime” and “zero tolerance” politics that penalize poverty and Blackness. This inequity is exacerbated by municipal procedure to use petty offenses to generate city revenue. And it is perpetuated by law enforcement culture that fails to demand officer accountability.

Each of the preceding system-level factors are determined by explicit human choices, not implicit beliefs. Therefore, attending a training on implicit bias or simply substituting a Black or Brown officer for a white one, because they presumably harbor less anti-Black bias, does not address the systems-level choices at the core of police violence or the racial inequities those choices create.

Similarly in medicine, implicit bias training will not help institutions unpack their problematic relationship to entrenched local poverty and racial inequity – both drivers of racial health disparities. Those relationships, between hospitals, poverty and racial inequity, are structured by intentional business models and tax designations, not unconscious preferences or prejudices. And diversifying the physician workforce without disrupting the various manifestations of white hegemony that currently set clinical priorities, research agendas, and promotional criteria, will not magically narrow racial disparities in health outcomes.

One cannot simply change a cog in an assembly line and expect the line to produce a new product. Systems function as they are designed to. To get a new outcome, it requires building a new system or transforming the existing one – each of which relies on humans making different explicit choices, regardless of their implicit leanings.

Advocates, we can no longer afford to use an individual or interpersonal analysis of harm, like that offered by the implicit bias frame, to understand and confront inequity. It fails to capture the collective experience of harm and works to conceal the ways explicit choices encoded in process, reproduce harm, across systems and populations.

While the implicit bias frame may have gained traction because the solutions it offers are relatively simple, like admitting unknowing harm in one on one interactions. The frame ultimately fails where it absolves us from confronting our knowing role in maintaining systems that inequitably distribute harm among populations. That task is more complex and requires us to challenge our individual, organizational, and institutional choices to create and uphold legacies of oppression and privilege. We all must be accountable – to each other and to ourselves, for the systems we create, the systems we protect, and the systems we participate in that harm others. Because ultimately, the goal is not to simply adjust the ratio of good to bad apples, but to change the kinds of trees we are planting.