• An open letter to White people

    This is a letter to White people, as well as a letter to myself.

    Like you, I am White. You and I don’t have the lived experience of racism that Black people in America do (or indigenous people or other people of color). But we do have a relationship with racism.

    Racism kills Black people, but White people are its source. It’s a problem of our making or perpetuation. This is so obvious that to deny it would be racist in the extreme.

    We don’t act like racism is our problem, certainly not with the requisite urgency. You would think that being a source of death would motivate more action.

    I’m sure many readers are thinking, “I’m not the source. I’m not racist. I’m not the problem.” I get it. These are thoughts I’ve had too.

    They’re wrong. Hear me out.

    To be White in America (and, yes, male, high income, able bodied) is to be the beneficiary of policy-driven privilege. By privilege, I mean power. Policy and institutions have been shaped over time to promote and codify White power. That power is evident in government, in finance, in industry, in education, in technology, in culture, in all things, everywhere. This is not to say an individual Black person cannot be powerful, nor is it to say that all White people are powerful. It is just to say that the vast majority of those holding the reins of power are White — disproportionate to our representation in the population. It has always been this way in America, and it remains so today.

    Power is the ability to influence and affect change, including to reduce or eliminate racism. Because we hold power (and, again, not just political power, but power in all things), White people are uniquely positioned to affect change. This is why racism is White people’s problem. Though Black people have worked and are working themselves to death trying to address it, it is our problem.

    Now, suppose we tell ourselves that we are not racist, therefore we are not part of the problem. But are we therefore part of the solution? Let’s see how that’s going.

    Has our belief that we are not racist spared the life of George Floyd?

    Has our belief that we are not racist spared the life of Ahmaud Arbery?

    Has our belief that we are not racist spared the life of Eric Garner? Of Travvon Martin? Of Breonna Taylor? Of Tamir Rice? (The list is very long.)

    Has our belief that we are not racist closed the gap in mortality rates between Black and White Americans?

    Has it allowed Black people to shop without suspicion? To obtain equivalent opportunities for education or jobs? To have the same access to and receive the same quality of health care as White people? To drive or walk the streets without harassment?

    No. None of these things. Our belief that we are not racist is not enough. It has only allowed us to feel absolved our responsibility to address racism. It is what we tell ourselves to justify sitting on the sidelines as racism kills and oppresses Black people (and indigenous people and other people of color).

    There are people in America who intentionally engage in racist behavior. It would be wonderful to change their hearts and minds. I believe, in time (generational time), the tide will turn. But my contention is that, in the shorter term, change will come another way. It will come from motivating White people who want to not be racist, who already believe they are not racist, to actually join in the work to eliminate racism, to be anti-racist.

    There are many sources to learn how to be anti-racist. It’s White people’s responsibility to do some reading, to educate ourselves. Then, there is work to be done. Education is a beginning, not an end. We cannot be satisfied with a belief that just because we know what anti-racism is, that we are therefore anti-racist. We have to actually do some things, make some changes.

    Ideas are out there. We need to work alongside Black people in implementing them. We need to listen and really hear what they are telling us about their experience in America, to what White people and American institutions and policies have done and are doing to them, to what we need to do to change. As Bryan Stevenson said,

    We need people to vote, we need people to engage in policy reform and political reform, we need people to not tolerate the rhetoric of fear and anger that so many of our elected officials use to sustain power. We need the cultural environments in the workplace to shift.

    There is work to do at all levels of government and in all sectors of the economy. There are behaviors that need to change and people to hold accountable, including in our own circle of friends, in our communities, even within our own families.

    Who should do this work? We, White people who believe we are not and do not want to be racist, should do it. We should join Black people (and indigenous people and other people of color) already in the struggle. Feeling we’ve done enough just because we believe we are not racist is insufficient.

    This is you and me. Not every White person is like us in this way, but there are a lot of us, and a lot of us who aren’t doing enough, myself included. What are we waiting for? Another Black person to die?

    @afrakt

     
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  • Cost shifting update

    Truth be told, I sat down early this morning to write another post about racism, but I needed to clear this out of the way. I’ve been remiss in not posting some cost shifting claims, counter-claims, and related. Here’s the long awaited update. For anyone new to my writing on cost shifting, see these ~80 […]

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  • A precision public health approach to preventing the next COVID-19 surge: it’s time to talk about surveillance

    Meredith Matone, DrPH, MHS, is the scientific director of PolicyLab at Children’s Hospital of Philadelphia (CHOP). Deanna Marshall, MPH, is a clinical research coordinator at PolicyLab at CHOP. As communities reopen across the country, strategies for preventing another wave of widespread COVID-19 transmission are top of mind. Arguably, contact tracing is the approach receiving the […]

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  • Do JUUL and e-cigarette flavors change health risk perceptions of adolescents?

    Nambi Ndugga is a policy analyst at Boston University School of Public Health. She tweets @joerianatalie. Despite decades of progress in reducing the prevalence of tobacco smoking, we are now facing a new e-cigarette epidemic among youth in the United States. The prevalence of e-cigarette use among school-aged students has substantially increased between 2017 and […]

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  • Coronavirus and Immunity, MIS-C, and Hydroxychloroquine: COVID News Roundup 5-27-2020

    If you’ve had coronavirus, are you immune or can you catch it again? What’s this I hear about Multisystem Inflammatory Syndrome in Children? And does hydroxychloroquine work or not? Aaron talks you through some of the latest coronavirus news.   @DrTiff_PhD

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  • COVID-19 Update: May 26 Edition

    Sources of COVID-19 information and updates, including on epidemiology, treatment, and policy responses.

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  • Keep our people safe

    Two and a half months ago, I asked what each of us could do about the coronavirus. My answer was that we should talk to the people we are closely connected to and give them our best guidance on how to stay safe. That’s still my advice. The hard question is, what is the best […]

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  • Four ways COVID-19 has exposed gaps in the US social safety net

    A deep look at how difficult it is for people to navigate their way through the U.S.‘s patchwork of social safety net measures as they try to stay afloat during the pandemic and economic downturn.

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  • Indiana’s COVID-19 Testing Study and What it Means for Reopening

    What’s the true infection rate of COVID-19? So far, we’ve had no real idea, which means most states are flying blind into reopening. But not Indiana, where a new statewide study is the first to provide the kind of data we’ll need to make safe decisions moving forward.   @DrTiff_PhD

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  • Off-Label Prescribing With Limited Evidence: What We Have To Lose

    Randomized clinical trials are the core of how government regulators prevent dangerous drugs from reaching patients. That’s for good reason. Though some prescriptions can be made ethically without the backing of a placebo-controlled, double-blind randomized control trial, these situations are and should remain the exception, not the rule.

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