We Can’t Ignore this Data

I very much support the nationwide protests against racism, because racism is very much a public health problem. Michelle Williams, Dean of the Harvard School of Public Health, explains:

“That reality is apparent not just in the police brutality that disproportionately claims the lives of Black Americans, but in the legacy of slavery and discrimination that persists in countless social determinants of health. To understand how this manifests today, one need only examine the disparities in health care, pollution exposure, and access to green spaces, nutritious food, and educational opportunities that have long harmed health—and prematurely ended lives—in marginalized communities. While the COVID-19 pandemic has newly laid these inequities bare for all Americans to see, the underlying injustices have endured for generations.“

We know very well that the COVID-19 pandemic is ridiculously, disproportionately impacting our communities of color. Studies show that Black and Latino patients are much more likely to die from COVID-19 than whites:

Racism is deeply ingrained in the social, political, and economic structures of our society, resulting in real, tangible discrimination. For minorities, this discrimination results in unequal access to quality education, healthy food, livable wages, and affordable housing.

And a greater risk of dying at the hands of law enforcement. Research shows that Black, Native America, and Latino males are far more likely than whites to die as a result of being killed by police:

And there’s more data on this, there’s full color video of George Floyd being murdered, slowly and surely, over a torturous eight minutes by a police officer’s knee on his neck. This video might be the data that does it. Yes, the numbers have been there. But that video, that is hard data, the hardest data there is, in so many ways. This is the data that no one can say was made up, no one can look away from, no one can ignore.

Ignoring the data, we’ve been good at that. We’ve been doing that for a long time. And that is wrong. On March 10, 1968, The Reverend Martin Luther King gave a speech in New York City, titled “The Other America”. It’s as relevant now as it was then, and well worth reading, or listening. On the protests and riots then:

“And the great tragedy is that the nation continues in its national policy to ignore the conditions that brought the riots or the rebellions into being. For in the final analysis, the riot is the language of the unheard. And what is it that America’s failed to hear? It’s failed to hear that the plight of the Negro poor has worsened over the last few years. It has failed to hear that the promises of justice and freedom have not been met. It has failed to hear that large segments of white society are more concerned about tranquility and the status quo than about justice, humanity, and equality, and it is still true. It is still true that these things are being ignored.“

It’s time to pay attention, to listen, and change. This is a job for all of us, no matter how we identify. It’s especially a job for all of us in medicine. Our medical system is so poisoned by structural racism, that both patients and providers are suffering. My colleague, physician Altaf Saadi wrote about her experience being harassed by patients, as a Muslim woman who wears a headscarf:

“We — as physicians and society more generally — must realize that the struggles of one marginalized community are struggles of all of us. My fight as a Muslim-American doctor to serve my patients without fear of racism, and the fight of an African-American patient to be treated with dignity and respect, should also be your fights.”

Her words echo the words of King in that same 1967 speech:

“Injustice anywhere is a threat to justice everywhere.”

This is absolutely true, and it’s why we need to all take this moment and run with it. Now is the time to make change stick.

So what’s next, how do we even begin to tackle the social inequities, the poverty, the disadvantages and discouragements of a hundred years? I was thrilled to hear from a real leader on this, someone who really knows what they’re talking about when it comes to racism. Former president Barack Obama wrote a powerful essay in Medium, pointing out that while protest (ideally peaceful protest) can successfully call attention to an issue, it’s not an effective solution in and of itself.

“If we want to bring about real change, then the choice isn’t between protest and politics. We have to do both. We have to mobilize to raise awareness, and we have to organize and cast our ballots to make sure that we elect candidates who will act on reform.“

He points out that the reforms then need to be specific and smart. He ends with a message of hope and action:

“I recognize that these past few months have been hard and dispiriting — that the fear, sorrow, uncertainty, and hardship of a pandemic have been compounded by tragic reminders that prejudice and inequality still shape so much of American life. But watching the heightened activism of young people in recent weeks, of every race and every station, makes me hopeful. If, going forward, we can channel our justifiable anger into peaceful, sustained, and effective action, then this moment can be a real turning point in our nation’s long journey to live up to our highest ideals. Let’s get to work.“

So what’s next?

What he said: Let’s get to work.