Mistrust in Medicine: The Impact of Racism on Healthcare Today

I can remember, when I was very new to chaplaincy, being shocked by the amount of mistrust that patients verbalized towards the healthcare system. It was surprising to hear patients and families question the way in which hospitals operate, let alone the motives of their nurses, doctors, and other members of the healthcare team. My experience of hospitals had always been positive, in the sense that when I was hurt, I went there, and they made me better. Growing up, I had quite a few run-ins with the hospital, and I never once questioned the treatment, the doctors, the nurses, or other staff.

Your experience may be similar to mine, but it is not shared by all. Over time, I noticed a distinct pattern: those patients and families that expressed the most fear and mistrust, while not universally so, were, the vast majority of the time, Black. One encounter, in particular, brought this observation to a tipping point. As a patient who was Black died, a family member became irate and yelled accusingly at the nurses that they had killed the patient. He could not be consoled and eventually left the floor followed by another chaplain and security.

I’m not going to go into more specifics, but the encounter left me and others reeling and questioning the intensity of his accusation. How could he think that those meant to care and comfort would do harm? In processing this situation with my manager at that time who is Black and the other chaplain involved who is Black, they provided more context for the fear and mistrust that exists among Black Americans. There was no excuse for the family member’s actions, and they did not seek to fabricate one; however, my conversation with them provided additional context about how and why that mistrust, fear, and anger could exist. I left that meeting and did a little looking around for more information. I ended up finding Medical Apartheid by Harriet Washington; with the subtitle The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present, it appeared to be the comprehensive book for which I was looking. I had no clue what I had gotten myself into.

In the far recesses of my mind I had heard of the Tuskegee Syphilis Study. I didn’t know much about it; just that it was a massive injustice and that it probably accounted for the mistrust that exists among Black Americans in regard to the medical establishment. For those that don’t know, here’s a recap: The U.S. Public Health Service Syphilis Study at Tuskegee took place between 1932 and 1972. In this study, researchers set out to study the course of syphilis in untreated Black patients. They chose 400 patients, lied to them about the nature of the study, and asked them to go under invasive procedures about which they also lied. As medicines developed that would have treated their syphilis, the unknowing participants were denied them, so that researchers could watch the disease progression.[1] Within the medical community this was no secret and multiple articles were published in medical journals while it occurred.[2] The study ended when a social worker in the CDC provided a journalist with details of the study. The journalist took it public, and the swift public outcry led to the end of the study.[3]  

The details of the Syphilis Study at Tuskegee are included in Medical Apartheid, and are about a quarter of the way through the book.[4] It is incredibly heartbreaking and disturbing to read about the racism that fueled it, as well as, the level of deceit perpetuated by those involved. It has taken me a long time to get through Medical Apartheid because it is so disturbing to read about the incredible cruelty that has been inflicted upon Black Americans throughout American medical history. The Tuskegee Syphilis Study is one painful episode of that long and unjust history. I believe it is important to know this history and understand it because of its impact on our society today.

Today, studies show that Black Americans do mistrust the medical establishment, and a significant contributing factor of this mistrust is this history of race-based exploitation and abuse.[5],[6] Tuskegee often gets a lot of the focus, but these studies indicate that the mistrust is rooted in the historic pattern; Tuskegee was not just a one-off incident of abuse, it was a part of a larger racist system that enabled these incidences of cruelty, injustice, and mistreatment. As the authors of an article in The Journal of Medical Ethics state, the “…victimisation of African Americans by professional medicine was largely a pervasive outgrowth of structure, not the idiosyncratic work of particular individuals.”[7]

Furthermore, I may not have known about this troubling past until reading Medical Apartheid, butthe stories of injustice are passed down in family histories. This is documented in the book The Immortal Life of Henrietta Lacks.[8] It is the story of Henrietta Lacks, a Black woman whose genetic material was taken during treatment for cervical cancer, replicated, and used to make all sorts of lifesaving treatments, allowing corporations and researchers to make billions of dollars. Her family was given nothing, lived in poverty, and had no idea the extent of their mother’s contribution to science and medicine until a journalist established a relationship with them. In a poignant section of the book, one of the family members consistently refuses to seek medical treatment because he has heard that Black people tend to disappear when they go around hospitals. This very thing is documented in Medical Apartheid.[9] So while I may have been unaware of such horrible incidents, they are known amongst portions of Black America, and they have impact.   

I’ve written elsewhere about how this history built upon racist ideas may have an impact upon how Black Americans are treated to this day in healthcare,[10] but it also leads Black Americans to have resistance to participating in research,[11] a refusal to seek treatment,[12] and greater skepticism about interventions when prescribed.[13] In the long run this leads to greater burdens on patients, families, the healthcare team, and the healthcare system as a whole.

Significant strides have been made within the healthcare system to bridge the gap between Black Americans. Nonetheless, a gap remains. Studies cited above still show mistrust, and I believe that a contributor is many within healthcare not knowing and, therefore, not acknowledging the depth of the historic racism and injustice that has occurred. Equal Justice Initiative often writes on social media, “To overcome racial inequality, we must confront our history.” To effectively care for all Americans, those in healthcare (myself included) have to work to overcome the part of American medical history that could be, and has been, easily swept aside and ignored. In working to establish trusting relationships, exhibiting empathy and compassion, and educating Americans about the checks and balances that now exist in the medical system to prevent abuses that occurred in the past, we can create a healthier and more equitable American medical system. We’ve definitely made some progress, and have the opportunity to continue this work now.   

[1] “Race and U.S. medical experimentation: the case of Tuskegee,” https://pubmed.ncbi.nlm.nih.gov/28492710/

[2] “The Tuskegee Study of Untreated Syphilis and public perceptions of biomedical research: a focus group study,” https://pubmed.ncbi.nlm.nih.gov/15303410/

[3] “Race and U.S. medical experimentation: the case of Tuskegee,” https://pubmed.ncbi.nlm.nih.gov/28492710/

[4] Medical Apartheid, Harriet A. Washington, pp.155-185.

[5] “The Legacy of Tuskegee and Trust in Medical Care,” https://pubmed.ncbi.nlm.nih.gov/16080664/

[6] “Distrust, Race, and Research,” https://pubmed.ncbi.nlm.nih.gov/12437405/

[7] “Rasing the ivory tower: the production of knowledge and distrust of medicine among African Americans,” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2598256/

[8] The Immortal Life of Henrietta Lacks by Rebecca Skloot

[9] Medical Apartheid, Harriet A. Washington, pp.115-119.

[10] https://americanhistoryhope.wordpress.com/2020/08/06/american-medicine-and-systemic-racism/

[11] “Perceptions of Clinical Research Participation among African American Women,” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1994515/ & “More than Tuskegee: understanding mistrust about research participation,” https://pubmed.ncbi.nlm.nih.gov/20693733/

[12] “The Legacy of Tuskegee and Trust in Medical Care,” https://pubmed.ncbi.nlm.nih.gov/16080664/

[13] “Understanding African Americans’ Views of the Trustworthiness of Physicians,” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1924632/

We Aren’t Finished Yet; A Response to First Things’ “Another Narrative

This is a response of sorts to a recent article that I read online entitled, “Another Narrative”[1] from the site “First Things.” The article “Another Narrative” is a jumping off point, for me to dive into today’s societal issues and to try to grapple with all of the complexity surrounding them. Thanks to feedback I received, I have edited my writing to soften the tone and to do more justice to my own journey in trying to wrestle through these issues. I believe that the initial draft came across as confrontational and was directed far too much at the author, which was not my intent. I simply use “Another Narrative” as a framework to push back against ideas that I frequently hear.

“First Things” is “an interreligious, nonpartisan research and educational 501(c)(3) organization.” The title – “Another Narrative” piqued my curiosity and so I was interested to know what narrative this piece was hoping to challenge.

The author, Robert Benne, begins by discussing a conversation that he had with a mentor. In the conversation his mentor warns him that the goal posts have moved; people are no longer interested in equality of opportunity, rather, now people want “equality of results.” He goes on to say that he should have taken the advice of his mentor more seriously. Interestingly, he does not provide an example of people asking for “equality of results.” I would like to know more about this idea. Who is articulating that equal opportunity is not enough and now people are demanding “equal results”? Where is he observing this and how is it manifesting itself in the public discourse? This is not mentioned, but has prompted further exploration.

He continues by talking about America’s quest to ensure that Black Americans, women, and other underrepresented populations, are represented in proportion to their population at large. He writes, “…we feel guilty if our achieved percentages are not high enough.” I’ve been fortunate enough to work in two medical institutions, both of which acknowledge the need for diversity and inclusion and who work towards that end. I have never been made to feel guilty for being white or been asked to repent for being white. I have also never heard leadership articulate feelings of guilt when goals are unachieved. Even in the modern day quest for equality, Black thought leaders have spoken and written about their desire for action and allies, not guilt.[3] [4] To me, guilt seems to be a refrain used to divert attention away from the issues of racial inequality. If looking at systemic racism and under-representation makes one FEEL guilty, does that mean they are actually guilty of something? Or should that lead to deeper reflection about why that feeling arises and what can be done about it? I would think the latter.

The article continues: “Since the 70’s our country has been working to ensure that women, blacks, and other minorities are represented in every facet of our society….” He then points out, “Even Wall Street is concerned: Fifteen percent of the overall population is black, but only 10 percent of Wall Street operatives are black.” As is pointed out, for 50 years the US has worked towards equal representation, and yet that equal representation has not occurred; the example of this is provided by looking at Wall Street. No doubt there are many reasons for this, and one of the big ones is that Affirmation Action has been fought tooth and nail since its inception.[5][6][7] Despite the consistent pushback towards affirmation action, studies do show that it has increased opportunities for Black Americans, among others.[8][9][10]

He goes on to say that these results, as well as, the push for diversity and inclusivity within “nearly all institutions,” including academia should be more satisfying. “But the recent protests have led to wholesale amnesia about the past fifty years of affirmative action. The hysteria ignores the fact that we have had a half-century of ‘systemic affirmative action’ rather than ‘systemic racism’” I find this truly bizarre. First, today’s protests are completely mischaracterized. They are specifically related to systemic racism in policing and the criminal justice system. This has little to do with affirmative action, but it seems like the argument is that because there has been a drive for greater representation in the criminal justice system, this systemic racism should have gone away. To think that the damage caused by hundreds of years of disenfranchising Black Americans through enslavement, violence and intimidation, and explicit and implicit racist policies, can be undone after 50 years of a policy that has been regularly fought and undermined, seems to underestimate the extent of the problem.

In addition, the argument is presented as if because there is affirmative action, all systemic racism has gone away. Greater representation in the work force is not the only area of bias and racism, and neither has affirmative action even solved that problem. Again there have been gains, but there are still very real issues with representation within important institutions in America:

  • Black Americans are underrepresented in journalism[11]
  • Black Americans are underrepresented in medicine (both as doctors and acceptance to med school)[12] [13]
  • Black Americans are underrepresented in corporate American, particularly in leadership roles [14]
  • Black Americans are underrepresented in law enforcement[15] [16]

To this day, the quest for equal representation is challenged throughout the country. This is true especially in the realm of academia. No case highlights this better than Abigail Fisher’s lawsuit against the University of Texas which made its way up to the Supreme Court in 2016. Fisher’s case was bankrolled by a man named Edward Blum, whose hobby is challenging affirmative action in academia.[17] In the Fisher case, her team alleged that she was denied a spot at UT because she is white and others less qualified were granted access to the University. The problem is, it’s not true. She was denied because of her academic performance. There were 49 provisional applicants offered admission with lower grades than Fisher. “Five of those students were black or Latino. FORTY-TWO were white.” In addition, there were “…168 black and Latino students with grades as good as or better than Fisher’s who were also denied entry into the university that year. Also left unsaid is the fact that Fisher turned down a standard UT offer under which she could have gone to the university her sophomore year if she earned a 3.2 GPA at another Texas university school in her freshman year.”[18] The Fisher case is a wonderful example of how equal representation continues to be fought to this day and it’s not a one-off example.[19] [20]  Despite the best efforts to paint affirmative action as a cure-all, this conclusion does not stand up to the statistics nor the continued battle against it.

This is not the only area where the on-the-ground issues in America seem to be mischaracterized. He writes, “Racism is called out and denounced when made public. In recent months we have seen exaggerated sensitivity to acts and words that are not likely racist at all. They just don’t fit into the current narrative.” I’m sure that there are examples of this, but I think that, on the whole, racism has been given a fresh platform. No greater example of this is the person who sits in the White House, President Donald J. Trump. President Trump has a well-documented history of racism.[21][22] Not to mention his unwillingness to separate himself and denounce white supremacists until there is intense outside pressure. Or his casual retweeting of a video of one of his supporters shouting clear as day, “White Power.”[23]

The impact of this racism in seen in many of his followers who have been emboldened and frequently invoke his name in their own racist diatribes. The videos of this are replete.[24] [25] Videos of a white woman questioning a landscaper and asking for his papers,[26] a video of Trump supporters telling a Latinx person in their video that “Trump is going to take care of you[27],” a white supremacist yelling for people trying to control him ‘To call Donald Trump’ before slapping a woman and being tackled.[28] One only needs to watch footage of “BLM counter-protests” to hear racism alive and well. And while it’s true that when these videos are made public there are often consequences for the people involved, how many of these acts occur out of the view of cameras? Dr. Benne seems to drastically underestimate the extent of the racist ideas in this country, and how those ideas have been given new license in the words and deeds of our highest office holder.

The article continues by discussing several of the problems facing Black communities and how equal representation through affirmative action (the focus of this article) is ineffective. “Poverty, crime, poor schools, single-parent families, gangs, and neighborhood decay are far too often the plight of that portion of our black population.” How these issues have developed and why they seem to disproportionately affect Black Americans is left unaddressed. No doubt the causes of “Poverty, crime, poor schools, single-parent families, gangs, and neighborhood decay…” are complex, but there can be no doubt of the impact of structural and systematic racism on creating many of the problems faced by Black Americans. It also goes unmentioned that the ‘Great Society programs’ as well as affirmative action resulted from analyses which showed the impact of racism on Black communities.[29] One such analysis, The Kerner Commission[30], highlighted many of our current issues. Sadly, it was written in 1968 and the recommendations, that may have circumvented our modern problems, were ignored.

I found the concluding remarks of this article most troubling. How are we to overcome these challenges? “Renewal will also have to come from within the black community, aided heavily by private and public agencies that can wisely discern the genuine agents of renewal.” What have Black Americans been doing throughout the history of our country? They have been seeking this renewal! Many have put their well-being and even their lives on the line in the hopes of achieving this equality which even today remains elusive. To me this statement seems to presume that this activity does not already exist, which it very clearly does. And of course private and public agencies have a role, as does the government at all levels of society who have aided in creating a society that does not offer equal opportunity.

A perfect example of how challenging this actually is, is the Trump administration’s rescinding of the Affirmatively Furthering Fair Housing (AFFH) mandate.[31] This provision made it so that those seeking federal money for development and housing had to assess for discrimination and segregation, and, if it existed, put together a plan to address it. This is necessary because federal policy was housing discrimination through practices such as redlining and zoning. To ATTEMPT to rectify this, the AFFH came into existence. Much like affirmative action it has been fought tooth and nail, ignored, and finally rescinded by the Trump administration who then proclaimed that he was protecting the suburbs. The actions of the Trump administration were fought diligently by Black Americans, white Americans, Latinx Americans, as well as the civil rights community at large. Yet, their lawsuits, protestations, and data went unheeded. And this is the norm, the Voting Rights Act since its inception has been fought just as vehemently.[32]

Ultimately the article concludes by affirming that “… race is important. But the story of the last fifty years is a lot more complicated than the narrative of oppression and systemic racism.” This is particularly interesting because the entire article has painted an awfully simplistic (and rosy) picture of the past fifty years, especially in regards to affirmative action. Now, for the first time, the complexity of the American story is being articulated. However, it is not on these narratives that we should focus, “Instead of promoting these narratives [narratives of oppression and systemic racism], we need to build on the successes we have achieved and turn our attention to the formidable tasks ahead.” This closing sentence is problematic for two reasons:

First, I do not agree that we should not stop “promoting these narratives” because there is still a large part of the population who believe they are a myth, despite the data, evidence, and experience. Racial bias does indeed affect the medical system[33], the criminal justice system[34], and housing[35], to name a few. And we are just beginning to understand the extent of these problems, especially in the medical field. To say that we should shift gears and stop talking about these issues and instead focus “on the successes” seems premature and unwise.

Second, here the idea of narrative returns. In this concluding sentence, the author appears to be proposing that we lay down the other narratives [of oppression and systemic racism], for this narrative which will enable us “to build on the successes we have achieved.” The challenge for me is that I cannot figure out why these narratives are mutually exclusive. Why must we ignore the reality of systemic racism that still exists, to celebrate and build on the successes that have been achieved? Last year, I ran a marathon for the first time. This year, I’m training for a 30 mile trail run. I can celebrate my achievement of the marathon and have pride in that accomplishment, while pursuing the goal of a further distance. These two states of being are not mutually exclusive, yet this is representative of much of the discourse that takes place regarding race in America. The line of thinking seems to go, “Why can’t we just move beyond this topic, haven’t we done enough?” Well, we can’t move beyond this topic because it still impacts our society today. Certainly, we can celebrate and take pride in what has been accomplished, while simultaneously acknowledging that we aren’t there yet and continuing the fight for equality.

It seems like this alternative narrative wants to be done with all of this race talk. This despite the glaring disparities, despite American history, despite the racial bias that still exists in the foundational structures of our society. They are ready to move on to the “formidable tasks ahead.” Hopefully those tasks include fighting the “Poverty, crime, poor schools, single-parent families, gangs, and neighborhood decay…” that he mentions early in the article. If so, it will be tough to do so without addressing racism. As The Kerner Commission found in 1968, “What white Americans have never fully understood but what [Black Americans] can never forget–is that white society is deeply implicated in the ghetto. White institutions created it, white institutions maintain it, and white society condones it.” It was true in 1968 and it remains true today. Acting as if we’ve moved beyond systemic racism only assures that our problems today will be handed down to the next generation. This occurred in 1968, and we are at a similar crossroads now. This is why “Another Narrative” should be rejected in favor a narrative of racial equality that acknowledges progress WHILE living in the reality that there is still a lot more work to be done.

[1] https://www.firstthings.com/web-exclusives/2020/07/another-narrative

[3] https://www.theguardian.com/commentisfree/2015/apr/10/white-guilt-america-walter-scott-us

[4] https://www.sfchronicle.com/politics/article/Being-a-white-ally-of-African-Americans-means-15321365.php

[5] https://plato.stanford.edu/entries/affirmative-action/

[6] https://www.scu.edu/mcae/publications/iie/v5n2/affirmative.html

[7] https://www.washingtonpost.com/nation/2018/10/19/most-white-americans-will-never-experience-affirmative-action-so-why-do-they-hate-it-so-much/

[8] https://isps.yale.edu/news/blog/2017/01/what-are-the-effects-of-affirmative-action-regulation-on-workers%E2%80%99-careers#:~:text=There%20is%20substantive%20evidence%20that,between%20majority%20and%20minority%20workers.

[9] https://drive.google.com/file/d/0B7gXilvu7Y8AUDBfTXNGWi1XUjA/view

[10] http://people.umass.edu/fidan/Kurtulus_AffirmativeAction_AEJSubmission_06_26_2012_web.pdf

[11] https://www.pewresearch.org/fact-tank/2018/11/02/newsroom-employees-are-less-diverse-than-u-s-workers-overall/

[12] https://www.usatoday.com/story/news/health/2019/02/28/medical-school-student-african-american-enrollment-black-doctors-health-disparity/2841925002/

[13] https://www.texmed.org/Template.aspx?id=50657

[14] https://www.cnn.com/2020/06/02/success/diversity-and-black-leadership-in-corporate-america/index.html

[15] https://www.brookings.edu/blog/the-avenue/2016/07/14/minority-under-representation-in-city-and-suburban-policing/

[16] https://www.governing.com/topics/public-justice-safety/gov-police-department-diversity.html

[17] https://www.reuters.com/article/us-usa-court-casemaker/special-report-behind-u-s-race-cases-a-little-known-recruiter-idUSBRE8B30V220121204

[18] https://www.propublica.org/article/a-colorblind-constitution-what-abigail-fishers-affirmative-action-case-is-r

[19] https://www.vox.com/2018/3/28/17031460/affirmative-action-asian-discrimination-admissions

[20] https://www.propublica.org/article/another-race-case-for-a-hostile-court

[21] https://www.theatlantic.com/magazine/archive/2019/06/trump-racism-comments/588067/

[22] https://www.vox.com/2016/7/25/12270880/donald-trump-racist-racism-history

[23] https://www.bbc.com/news/world-us-canada-53212685

[24] WARNING STRONG & OFFENSIVE LANGUAGE: https://www.youtube.com/watch?v=R9YPYRaeTW0&list=LLw9GZkXEB8wNEJQnDX99d0A&index=92

[25] https://www.nbcnews.com/news/asian-america/asian-american-woman-harassed-self-identified-trump-supporter-thanks-bystanders-n1201261

[26] https://abc7.com/rancho-mirage-video-landscaper-show-me-your-papers-riverside-county/6326623/

[27] https://twitter.com/fb_illini/status/1287772604988710919?s=20


[29] https://www.blackpast.org/african-american-history/moynihan-report-1965/

[30] http://www.eisenhowerfoundation.org/docs/kerner.pdf

[31] https://allthingsofflimits.wordpress.com/2020/07/30/housing-discrimination-systemic-racism-and-the-shaping-of-american-cities/

[32] See Ari Berman’s Give us the Ballot and Dr. Carol Anderson’s One Person, One Vote.

[33] https://allthingsofflimits.wordpress.com/2020/07/23/american-medicine-and-systemic-racism/

[34] https://www.washingtonpost.com/opinions/2019/04/09/more-studies-showing-racial-disparities-criminal-justice-system/

[35] https://www.propublica.org/article/trump-financial-regulator-quietly-shelved-discrimination-probes-into-bank-of-america-and-other-lenders and  https://projects.newsday.com/long-island/real-estate-agents-investigation/

Housing Discrimination: Systemic Racism and the Shaping of American Cities

Housing discrimination has existed, and was allowed by law, at every level of American society. I don’t believe an honest discussion about how cities developed and why they developed the way they did, can take place without acknowledging the profound impact of biased mandates and practices.

One such practice was ‘redlining’ which refers to the color coding of neighborhoods by the Federal Housing Administration and later the Veterans Administration. Neighborhoods comprised mainly of Black Americans were color coded red. This meant that the inhabitants of that area were deemed too risky for mortgage insurance and therefore, could not be approved for a mortgage. This policy was laid out in the FHA’s Underwriting Manual, so it was not a secret. This manual also made it clear that neighborhoods should stay comprised of the same groups. Again, this was a widely acknowledged and followed federal guideline that prohibited many Black Americans from accumulating wealth and moving out of the inner city. (1,2,3) You can still see the impact of ‘redlining’ by looking at modern maps. (4, 5)

In addition, the National Association of Real Estate Boards forbade its members from selling to Black Americans and other people of color.  “A realtor should never be instrumental in introducing into a neighborhood a character of property or occupancy, members of any race or nationality, or any individuals whose presence will clearly be detrimental to property values in that neighborhood.” This was not profitable, however, so real estate agents practiced something called “blockbusting.” Where they would convince homeowners in white neighborhoods to sell because a Black home-buyer would soon be moving into the neighborhood. The homeowner would sell below market value, and the real estate agent could then sell to a Black American far above market value. (6,7)

After protracted legal battles and through the Fair Housing Act of 1968 (8,9), these practices were outlawed and oversight was put into place to protect the public from them (blockbusting actually continued into the 80s). A continuation of this oversight was a rule put in place by President Obama. In 2015, President Obama enacted a rule for the implantation of Affirmatively Furthering Fair Housing, or AFFH, which was a part of the 1968 Fair Housing Act. The Obama rule made it so that areas that received federal money had to do an assessment of racial discrimination, and, if discovered, develop a plan to correct it. (10,11) This was meant to correct the historic wrong caused by discriminatory housing policies.

Yesterday, the Trump administration did away with this provision because, according to President Trump, it led to lower property values and crime. (12) There is absolutely no evidence that the AFFH led to increased crime or lowered property values. Unfortunately, the AFFH was never enforced by the Trump administration even after states and cities sued HUD and HUD Secretary Ben Carson for their unwillingness to enforce the mandate. (13, 14) It is consistent, however, with the Trump administration’s desire to ignore continued housing discrimination (15) and a continuance of President Trump’s own history of discriminatory practices in his businesses (16).

The AFFH was a rare occurrence in which the impact of systemic racism was acknowledged and some sort of a plan was put into place to try to overcome it. This by no means stopped housing discrimination (17), but it was a step in the right direction. Unless we acknowledge our past, even though uncomfortable, we cannot move forward in a manner consistent with our Constitution’s values of liberty and justice for all.  

1 – https://www.npr.org/2017/05/03/526655831/a-forgotten-history-of-how-the-u-s-government-segregated-america

2 – https://www.npr.org/sections/thetwo-way/2016/10/19/498536077/interactive-redlining-map-zooms-in-on-americas-history-of-discrimination

3 – https://www.theatlantic.com/business/archive/2014/05/the-racist-housing-policy-that-made-your-neighborhood/371439/

4 – https://dsl.richmond.edu/panorama/redlining/#loc=10/41.49/-82.007&city=cleveland-oh&area=D20

5 – https://www.arcgis.com/apps/Cascade/index.html?appid=5ccb9580d7a9489c918d57ab04af7296

6 – https://www.thoughtco.com/blockbusting-definition-4771994

7 – https://www.bloomberg.com/news/articles/2015-03-03/a-new-paper-examines-blockbusting-and-how-real-estate-brokers-can-benefit-from-stoking-racial-fears-in-white-neighborhoods

8 – https://web.archive.org/web/20130809022759/http://lamar.colostate.edu/~pr/redlining.pdf

9 – https://www.hud.gov/program_offices/fair_housing_equal_opp/fair_housing_act_overview

10 – https://www.housingwire.com/articles/hud-to-abolish-obama-era-affh-fair-housing-rule/

11 – https://www.housingwire.com/articles/pelosi-calls-out-trumps-repeal-of-obamas-fair-housing-rule/

12 – https://twitter.com/realDonaldTrump/status/1288509568578777088

13 – https://www.housingwire.com/articles/43362-new-york-suing-hud-ben-carson-to-enforce-obama-fair-housing-rule/

14 – https://www.housingwire.com/articles/43624-coalition-of-states-cities-join-fight-to-force-hud-to-enforce-obama-fair-housing-rule/

15 – https://www.propublica.org/article/trump-financial-regulator-quietly-shelved-discrimination-probes-into-bank-of-america-and-other-lenders

16 – https://www.publicbooks.org/the-big-picture-americas-real-estate-developer-in-chief/ 17 – https://projects.newsday.com/long-island/real-estate-agents-investigation/

“Voter Fraud”: A Simple Phrase Used to Disenfranchise

“Do we need to start messaging ‘widespread reports of election fraud’ so we are positively set up for the recount regardless of the final number? I obviously think we should.” — Steve Baas, a lobbyist for the Metropolitan Milwaukee Association of Commerce and former Republican legislative staffer, floated an idea on the email thread.

“Yes. Anything fishy should be highlighted. Stories should be solicited by talk radio hosts.” — Scott Jensen — the former GOP Assembly Speaker turned lobbyist for American Federation for Children, a private school voucher advocacy group — quickly responded.

In another email, Jensen writes that [Judge] Prosser “needs to be on talk radio in the morning saying he is confident he won and talk radio needs to scream the Dems are trying to steal the race.”

These quotes are taken from an email exchange during an election for Wisconsin Supreme Court in 2011, and show that claims of ‘voter fraud’ are generally nothing more than attempts to manipulate the public. (1)

No widespread voter fraud was ever discovered in Wisconsin in this election or any other, although, in 2012 a Republican voter did manage to cast a ballot for Gov. Scott Walker FIVE times. (2)  

In Missouri it was alleged that a tight race was decided by the illegal voting of 50 Somali nationals. This claim was proven FALSE, but this did not stop members of the Republican Party from publishing the lie in various columns in 2011, 2012, and 2013. (3)

Republican Kris Kobach, who was Secretary of State in Kansas, had prosecutorial powers to stop thousands of illegal immigrants from voting in Kansas elections. After two years, he had nine prosecutions most of them older Republicans. One was a 20 year old who voted for Trump twice. (4,5)

Study after study after study shows that WIDSPREAD voter fraud is a MYTH, and while there are instances of occasional voter fraud, it is RARE. (6) Yet voter-fraud is the alarm bell that allows legislators to pass stringent voting laws that disenfranchise large numbers of voters, many of whom are Black, Latinax, young, Native American, and/or under the poverty line (7,8,9). These laws do nothing to actually stop the few instances of voter fraud which typically occur due to administrative error or honest mistake (which is what the young lady who voted for President Trump twice said she made). Ultimately modern day voter suppression is the continuation of a heritage of voter suppression that goes back to the end of the Civil War, and it is just another example of systemic racism.  

1 –  https://madison.com/news/local/govt-and-politics/in-newly-released-emails-critics-see-proof-of-political-motive/article_140c898e-2c28-5e0c-ad4e-aa8fdf61cc8c.html

2 – https://www.cbsnews.com/news/scott-walker-supporter-claims-amnesia-in-voter-fraud-case/

3 – https://www.propublica.org/article/kris-kobach-voter-fraud-kansas-trial

4 – https://www.politico.com/magazine/story/2017/05/21/kris-kobach-voter-fraud-investigation-prosecution-215164

5 – https://www.vice.com/en_us/article/xw73j4/kris-kobach-wanted-this-20-year-old-to-go-to-jail-for-accidentally-voting-twice

6 – https://www.brennancenter.org/our-work/research-reports/resources-voter-fraud-claims

7 – https://www.brennancenter.org/our-work/research-reports/new-voter-suppression

8 – https://www.npr.org/2020/02/14/806083852/north-dakota-and-native-american-tribes-settle-voter-id-lawsuits

9 – https://www.theatlantic.com/politics/archive/2020/06/voter-suppression-novembers-looming-election-crisis/613408/

American Medicine and Systemic Racism

WARNING: GRAPHIC CONTENT, some of the quotes and information may be upsetting. I share it to shed light on our past and the way it affects our society today.

A 2016 study revealed that half of the medical residents surveyed believed that African Americans felt less pain. (1)

WHERE could this idea have come from?

From the earliest days of modern medicine:

“[blacks] bear surgical operations much better than white people and what would be the cause of insupportable pain for white men, a Negro would disregard…” – Dr. Charles White

“When we come to reflect that all the women operated upon in Kentucky, except one, were Negresses and that these people will bear anything with nearly if not quite as much impunity as dogs and rabbits, our wonder is lessened.” – Dr. James Johnson

Dr. James Marion Sims, who is the “father of modern gynecology” and who had a statue in Central Park until 2018, also believed that African-Americans felt less pain, and so he perfected his surgical interventions on enslaved women and refused to offer them the most basic anesthetic of the day. When he performed the surgeries on white women, he, of course, utilized pain medicines to keep them comfortable. (2)

We may live in a different time, but foundational biases still impact our healthcare system today as the 2016 study mentioned above shows. These biases have consequences:  

  • A 2019 Meta-Analysis showed that African-Americans were less likely to receive pain meds in the ED than white people (3)
  • A 2019 study showed that racial biases in pain perception led to biases in pain treatment decisions (4)
  • A 2013 study showed that African-American were less likely to receive pain medicines when presenting to the ED with abdominal pain (5)

When a racial bias leads to a diminished outcome for a certain race within a certain system, we call that institutional racism. We are a part of a culture that transmits ideas to us, both implicitly and explicitly, and these ideas have real-world consequences. To overcome these biases, we have to expose their origins, recognize their impact on us and the systems of which we are apart, and pursue equality. Continued denial is not an option because it only leads to more suffering.   

1 – https://www.pnas.org/content/early/2016/03/30/1516047113.abstract

2 – Quotes and info taken from “Medical Apartheid” by Harriet A. Washington

3 – https://www.ajemjournal.com/article/S0735-6757(19)30391-2/fulltext

4 – https://pubmed.ncbi.nlm.nih.gov/31070440/

5 – https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4074647/

The Kerner Commission: Part 1 – Background

Have you heard of ‘The Kerner Commission’ from 1967-1968? I had not until I saw a random comment on Twitter that mentioned it. At this point, I’ve read through it multiple times, and I have been blown away by the insights it provides into our current situation. I believe that it shows that our current issues surrounding racial justice and equal treatment before the law are not new and have been explored in the not too distant.

In response to inner-city riots that rocked America in 1967, President Lyndon Johnson commissioned THE NATIONAL ADVISORY COMMISSION ON CIVIL DISORDERS (which became known as ‘The Kerner Commission’) (1). Over a six month period the members of this committee visited the sites of the civil unrest, interviewed witnesses and citizens of the affected communities in 23 different cities, and “sought the counsel of experts across the country.” They also brought with them social scientists to collect data and compare across populations.

President Johnson handpicked the members of this commission, and he intentionally did his best to include as many moderates as possible. After-all, this was after his Great Society initiatives, the Civil Rights Act of 1964, and the Voting Rights Act of 1965. President Johnson did not want to rock the boat anymore and was hoping for an easy solution to the problems facing the inner city. (2) That’s not what he got.  

As opposed to a simple solution, Kerner Commission CONCLUDED, “What white Americans have never fully understood but what [Black Americans] can never forget–is that white society is deeply implicated in the ghetto. White institutions created it, white institutions maintain it, and white society condones it.”

REMEMBER this was 1967. The report continues:

“White racism is essentially responsible for the explosive mixture which has been accumulating in our cities since the end of World War II. Among the ingredients of this mixture are:

  • Pervasive discrimination and segregation in employment, education and housing, which have resulted in the continuing exclusion of great numbers of [Black Americans] from the benefits of economic progress.  
  • Black in-migration and white exodus, .which have produced the massive and growing concentrations of impoverished [Black Americans] in our major cities, creating a growing crisis of deteriorating facilities and services and unmet human needs.  
  • The black ghettos where segregation and poverty converge on the young to destroy opportunity and enforce failure. Crime, drug addiction, dependency on welfare, and bitterness and resentment against society in general and white society in particular are the result.”

As I will discuss in other posts, the Kerner Commission goes on to discuss these factors in greater detail, citing a history of racism and racist policies. It also gives policy recommendations to help with the problems affecting the inner city. The recommendations were IGNORED by President Johnson, and then the report was lost in the shuffle when Dr. Martin Luther King Jr was assassinated.

There is a current stream of thought which tries to deny that systemic racism is real. It’s tempting to believe this narrative, especially if we are detached from the FULL SWEEP of American history. When we investigate our history – often times the history not taught in school or widely publicized – we find that much of what is affected our society is nothing new. The need for racial equality, in particular, is simply something that is regularly deferred to the next generation; in essence the can is kicked down the road. Then comes a moment, like that moment in 1968 when President Johnson was given the report or like the moment we find ourselves in now, when we can take decisive action and truly live into the ideals laid out in our Constitution. It becomes our choice to act with empathy, justice, and equality, or kick the can to the next generation.  

1 – http://www.eisenhowerfoundation.org/docs/kerner.pdf

2 – https://www.jstor.org/stable/10.7758/rsf.2018.4.6.01#metadata_info_tab_contents

3 – https://www.ncjrs.gov/pdffiles1/Digitization/8073NCJRS.pdf

The Kerner Commission – Part 2: The Inner City and Policing

Systemic Racism: Overt to Abstract

In reading through the history of racism in America, I was surprised to learn that there was a conscious decision to make racist ideas “abstract.” A very basic outline of how that occurred follows:

President Nixon recorded everything. As such, we have his recorded views on the superiority of the white race over other races. Incidentally, the War on Drugs began under Nixon in the 1970s.

Here’s what John Ehrlichman, Assistant to the President for Domestic Affairs said about the War on Drugs, “You want to know what this was really about? The Nixon Campaign in 1968 and the Nixon White House after had two enemies: the antiwar left and black people. You understand what I’m saying? We knew we couldn’t make it illegal to be either against war or black, but by getting the public to associate the hippies with marijuana and blacks with heroin and then criminalizing both heavily we could disrupt those communities. We could arrest their leaders, raid their homes, break up their meetings, and vilify them night after night.”

The hippies might have disappeared, but black citizens did not have this luxury. Surely though, these laws were scaled back and corrected since institutional racism is a myth, right? Wrong. These policies were ramped up in the 1980s and it was a coordinated strategy rooted in racism. 

Lee Atwater, a Republican strategist that worked on the Reagan campaign gave in an interview in 1981 that was recorded and can still be listened to today. He said:

“You start out in 1954 by sayin, ‘[n-word, n-word, n-word].’ By 1968 you can’t say ‘[n-word]’ – that hurts you. Backfires. So you say stuff like forced busing, states’ rights and all that stuff. You’re getting so abstract now, you’re talking about cutting taxes, and all these things you’re talking about are totally economic things and a byproduct of them is blacks get hurt worse than whites.”

So, at the highest levels of our government, when it was no longer acceptable in the public sphere to use racial slurs, turn fire hoses on protestors, and lynch, politicians became more “abstract,” and used their power to further target black citizens. That is exactly how institutional racism works, and nothing has ever been done to roll back these laws. In fact, they have continued and been strengthened.

The story of our nation isn’t finished though. It is within our power to work towards liberty and justice for all. It starts with awareness of our own prejudices and biases (more on my own in later posts) and of awareness of our history and its impact. Then, with the problem in sight, we can work towards reform by supporting local organizations and political action.