Let's Stop Only Naming Racism in Healthcare, Let's Cancel It
By Ashlee Wisdom
For a long time we’ve been trying to get healthcare institutions to name racism. To call it exactly what it is. To call out what so many of us knew to be true, to be a reality--our reality. It’s great we’ve finally stopped focusing only on socioeconomic status, and started talking more candidly about racism’s role in the health disparities we see. In fact, I must confess that i’m relieved that the growing health disparities, made evident by indisputable research data, have exposed the US healthcare system enough to have it reckon with the harsh reality of its even harsher history and contemporary shortcomings. But naming racism is only a half step in the right direction. We can’t just name racism, we have to, as the folks on twitter would say, cancel it. And that takes more than nomenclature; it takes more than just pontificating about social determinants of health. At this point, we don’t need anymore people who are only willing to understand but aren’t willing to do anything about structural racism.
While I would love to wax-poetic about why naming racism is an obvious important first step, I refuse to. I refuse to use this piece to engage in public health pleasantries, because people are literally dying-- people who look like me and the people I love. And as they’re dying, many of us are spending too much time trying to inform systems of power of how racist they are when we already know they were built to be that way. At the risk of sounding like Jay Z, I'd like to ask the question, what’s next? How do we move beyond naming racism to doing something about it? I am challenged by public health champions like Dr. Camara Jones and Dr. Mary Bassett to not only name racism in healthcare, but to call it out, and do the work required to tear it down.
In the Trump era, telling racist systems that they are racist isn’t profound nor is it game changing. If history hasn’t taught us anything else, it certainly should have taught us that American systems are committed to the status quo until they are disrupted. The racism that is inherent in the American healthcare system is no different. However, healthcare is on the cusp of a disruption (some would argue in the midst of one) that is prime for the dismantling of broken structures--the racist kind. But, again, we can’t just name racism, or we stand the risk of racism becoming embedded in emerging systems and new structures.
Are we spending time thinking and talking about how we can use technology to disrupt and dismantle racism in the healthcare system? If not, why aren’t we? If yes, how do we bring these ideas to the forefront, to get implemented and funded? Instead of becoming complacent with naming racism, we need to spend more time finding innovative ways to dismantle current systems and structures that are, at worst, failing the most vulnerable patients and, at best, costing us too much money. One of my favorite activists and thought leaders Brittney Packnett spoke at a conference I attended and said, “changing systems and structures so people can live equitable lives is more powerful than creating some charitable action.” When I heard her say that, it made me imagine a world where we wouldn’t have to rely so heavily on safety nets because we were able to change the system and structures that made them necessary in the first place. Brittany went on to say, “we need two hands: one hand to build and one to battle. One to tear bad things down and one to build new, good things in its place.” That is what the US healthcare system needs and is more than ready for. It needs its bad, racist structures to be torn down and replaced with good, equitable ones.
As healthcare professionals, we need to resist the temptation to entertain the status quo by giving it academic terms that we turn into manuscripts, and comfy tenured positions that allow us to feel a sense of contentment as people die from preventable diseases, and as inequities widen. The data indicates that we have much more work to do after the peer reviewed article is published (first author and all). We have much more work to do once the dissertation is defended, and after the speaking engagement honorarium hits our bank account. And trust me, I know many of us are not to blame for the dire circumstances we are in; but if we chose a career in healthcare, we are certainly not off the hook. So let’s keep working, because as long as we do, change is imminent.
Ashlee Wisdom, MPH is a writer, public health professional and challenger of the status quo. She is the Founder & Publisher of the Health In Her HUE platform. She enjoys traveling the world, writing, a good brunch, and hosting epic game nights for her friends. You can read more of her personal writing on her Blog Growing Into Wisdom, and you can follow her on Twitter @AshleeWisdom for great laughs and insightful commentary.