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.

 

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The Most Important Questions We Won’t Answer For You

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My fellow pediatrician and friend Nia Heard-Garris and I wrote a piece on medium about how White Supremacy and anti-Blackness show up in medicine and how to start the conversation.

Check it out here and let me know what you think!

Viral Violence and the Challenge for Public Safety

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As the screens we carry narrow our proximity to random and targeted acts of violence, many parents and families are rightfully questioning the impact viral violence has on shared perceptions of public safety and child health.

In pediatrics, we have long considered the link between media, violence and health.

We know kids who watch fake violence in movies or play violent characters in video games show signs of increased aggression. But what happens when the violence kids watch is real? Or when the cameraperson is only a teenager?

Today, youth can easily capture and consume real violence, in real-time, as a part of their daily routines – from snapping school violence, live streaming police violence, recording sexual violence, or sharing images of political violence. This is the new normal* and it’s more complex than the simple relationship between simulated exposures and aggression.

A child watching real violence from their cell phone now understands something tangible about the world; and a kid who records or shares violent imagery online can contribute to others understanding of the world. That elevation of the voices and experiences of youth can be extremely valuable. Indeed, in terms of activist’s movements like Black Lives Matter, the perspective of youth, magnified by social media, has become a national catalyst for police reform, criminal justice reform, and racial equity.

Yet, perpetual exposure to viral violence takes its toll – often manifest in feelings of victimization, grief, fear, intimidation, anger and sadness. And kids and teenagers may be most vulnerable to this kind of trauma because they are still developing the emotional and intellectual maturity to process troubling events. What is more, they rely on trusted adult figures to provide safe spaces in their life.

As we face these harrowing challenges, consider two thoughts:

1. While it’s okay to be protective, thoughtful and proactive regarding how youth experience and contribute to violent images online, we, as parents, caregivers, or providers, cannot simply turn a blind eye. While distressing, some images of violence advance our collective understanding, compassion, and empathy for the suffering that exists outside the walls of our private communities or our segregated social groups, and the privileges those spaces confer. In this way, confronting the visual of violence with a particular effort to center the interpretation of the events around the marginalized populations disproportionately affected, is the first step towards collective healing. And that healing begins with rigorous and vigilant public exploration of the ways systemic racism, sexism, Islamophobia, homophobia, xenophobia and intolerance threaten public safety.

2. As we live-stream our lives, we open windows to the neighborhoods we live in, the spaces where our kids learn and play, and the ways we perceive and are perceived in the world. When we don’t like what we see on the other side of that window, it can be easy to hide discomfort or insecurity with blame or shame or to create narratives that distort the humanity we witness. But each time one of us resists the opportunity to understand the burdens or experiences of another, we all move further from the co-existence necessary to bring peace.

*This is a piece I wrote with my friend and colleague, Dr. Wendy Sue Swanson, that was published in the July 2016 Pediatrics. It is available for free online for the first week of publication.