By Kathryn Stroppel
In 2018, the CDC found a 16 percent difference in the mortality rates of Blacks versuswhites across all ages and causes of death. This means thatwhiteAmericans can sometimeslivemore than a decadelongerthan Blacks.
In 2020,due tothe COVID-19 pandemic,the discrepancy in health outcomes has only grown. Michigan’s population, for instance,is 14 percent Black, yet near the start of the pandemic, African Americans made up 35 percent of cases and 40 percent of deaths.
Because of thisdiscrepancy in health outcomes, many scientists and government officials, including former American Public Health Association President Camara Jones, MD, PhD, MPH; more than 50 municipalities nationwide; anda handful of legislatorsare attempting to root out this inequality and call it what it is: A public health crisis.
Dr. Jones,a nationally sought-after speaker and the college’s2020 Bray Health Leadership Lecturer, has beenengaged inthis workfor decadesand says the time to act is now.
“The seductiveness of racism denial is so strong that if people just say a thing, six months from now they may forget why they saidit. But if we start acting, we won’t forget why we’re acting,” she says. “That’s why it’s important right now to move beyond just naming something or putting out a statement making a declaration,butto actually engagein some kind of action.”
Synergies editor Kathryn Stroppel talked with Dr. Jones about this unique time in history, her work, racism’s effects on healthand well-being,andwhat we can all do about it.
Let’s start with definitions. What is racism and why is important to acknowledge ‘systemic’racismin particular?
“Racism is a system of structuring opportunity and assigning value based on the social interpretation of how one looks, which is what we call race,that unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities and saps the strength of the whole society through the waste of human resources.
“The reason that people are using those words‘systemic’or‘structural racism’is that sometimes if you say the word racism, people think you’re talking about an individual character flaw, or a personal moral failing, when in fact racism is a system.
“It’s not about trying to divide the room into who’s racist and who’s not. I am clear that the most profound impacts of racism happen without bias. The most profound impacts of racism are because structural racism has been institutionalized in our laws, customs and background norms. It does not require an identifiable perpetrator. And it most often manifestsasinaction in the face of need.”
Why did you want to give the 2020 Bray Lecture?
“I’ve been doingthiswork for decades, andall of a sudden,now that we are recognizing the disproportionate impact of COVID-19 on communities of color, and after the murder of George Floyd andall oftheotherhighly publicized murders that have been happening, more and more people are interested in naming racism and asking how is racismisoperating here and organizing and strategizing to act.I wish I could accept every invitation.”
What do you hope people take away from your lecture?
“When I was president of the American Public Health Association in 2016, I launched a national campaign against racism with three tasks: To name racism;to ask, ‘how is racism operating here?’;and then to organize and strategize to act.
“Naming racism is urgently important, especially in the context of widespread denial that racism exists. We have to say the word ‘racism’ to acknowledge that it exists, that it’s real and that it has profoundly negative impacts on the health and well-being of the nation. We have to be able to put together the words ‘systemic racism’ and ‘structural racism’ to able to be able to affirm thatBlack lives matter. That’s important and necessary, but insufficient.
“Ithenequip people with toolsto address how racism operatesby looking at the elements of decision making, which are in our structures, policies, practices, norms and values, and the who, what, when and where of decision making, especially who’s at the table and who’s not.
“Afteryou have acknowledged that the problem exists, after you have some kind of understanding of what piece of it is in your wheelhouse and what lever you can pull, or who you know, you organize, strategize and collectively act.”
You’re known for usingallegory to explain racism.Why is that?
“I use allegory because that’s how I see the world.There are two partsto it. One isthat I’m observant.If I see somethingand if it makes me go,‘Hmm,’I just sort of store that away. And the second part is that I am a teacher.I’ve been tellingagardeningallegorysincebefore I started teaching atHarvard, but Ilaterexpanded that in order to help people understand how to contextualize the three levels of racism.
“As anassistant professor at the HarvardT.H. ChanSchool of Public Health, I developeditsfirst course on race and racism.AsI’m teaching students and trying to help them understand different elements, different aspects of race, racismandanti-racism, I found myself using these images naturally just to explain things, and then I recognizedthatallegory issort of a superpower.
“It makes conversations that might be otherwise difficultmoreaccessible because we’re not talking about racism between you and me, we’re talking about these two flower pots and the pink and red seed,or we’re talking about an openorclosed sign,or we’re talking about a conveyor belt or a cement factory. And so I put the image out theretosuggest the ways that it can help us understand issues of race and racism. And then other people add to it or question certain parts and it becomes ourcollectiveimage and our tool, not justmine.”
What shouldwhite people in particular see as their role and responsibility in this system?
“All of us need to recognize that racism exist, that it’s a system, that it saps the strength of the whole society through the waste of human resources, and that we can do something about it. White people in particular have to recognize that acknowledging their privilege is important–thatyourvery being gives you the benefit of the doubt.
“White people who don’t want to walk around oblivious to their privilege or benefitfrom a racist society need to understand how to use theirwhite privilege for the struggle.”
“An example: Aboutsix years ago now, in McKinney, Texas,outside of Dallas, we came to know that there was a group of pre-teens who wanted to celebrateabirthday at aneighborhoodswimming pool. The people who were at the pool objected to them being thereandcalled the police. And what we saw was awhite police officer dragging a youngBlack girl by her hair, and then he sat on her, andthe youngBlack boys were handcuffed sitting on the curb.
“The next dayon TV,Iheard a youngwhite boywho was part of the friend groupsaying it was almost as ifhewere invisible to the police. He saw what was happening to his friendsandhe could have run home for safety, but insteadhe recognizedhiswhite skin privilege. He stood up and videotaped all that was going on.
“So,the thing is not to deny yourwhite skin privilege or try to shed it, the thing is to recognize it and use it.Then as you’re using it, don’t think of yourself as an ally. Think of yourself as a compatriot in the struggle to dismantle racism.We have to recognize that if you’rewhite, your anti- racist struggle is not for ‘them.’ It’s for all of us.”
Why did you transition from medicinetopublichealth?
“Because there’s a difference between a narrow focus on the individualanda population-based approach.I started as a family physician, but then wanted to do public health because it made me sad to fixmy patientsup and then send them back out into the conditions that made them sick.
“Iwanted to broadenmy approach andreally understand those conditions that make people sick or keep them well.From there, the datadoesn’tnecessarily turn into policy. So,I sort of went into the policy aspect ofthings. Andthen you recognize that you can have all the policy you want, but sometimes the policy is not enacted by politicians. SonowI am considering maybe moving intopolitics.”
Speaking of politics, when engaging in discussions around racism and privilege, people will sometimestry toshut down the conversation for being ‘political.’ Is racism political?
“Racism exists. It’s foundational in our nation’s history. It continues to have profoundly negative impacts on the health and well-being of the nation. To describe what ishappeningis not political. If people want to deny whatexists,then maybe they have political reasons for doing that.”
What are your thoughts on COVID-19 and ourcountry’sapproachto dealing with the virus?
“The way we’ve dealt with COVID-19 is a very medical care approach.We need tohavea population view where you do random samples of people you identifyasasymptomatic as well as symptomatic.
“Whenyou have a narrow medical approach to testing, you can document the course of the pandemic,but you can’t do anything to change it. With a population-based approach we already know how to stop this pandemic:It’s stay-at-home orders, mask wearing,hand washingandsocial distancing. This very seductive, narrow focus on the individual is making us scoff at public health strategies that we could put in placeandis hamstringing us in terms of appropriate responses to the COVID-19 pandemic.
“In terms of race, COVID-19is unmasking the deep disinvestment in our communities, the historical injustices and the impact of residential segregation. This is the time to name racism as the cause ofthose things. The overrepresentation of people of color in poverty andwhite people in wealth is not happenstance.”
Watchthe full lectureathealth.oregonstate.edu/camaraor on the college’sYouTubechannel.