Confronting Structural Racism

The following originally appeared on the Drivers of Health blog.

Earlier this month, I participated in a plenary panel on confronting structural racism in health services research at the AcademyHealth Annual Research Meeting. I believe most of what I said generalizes outside of this field of research. My opening comments are below, and I was joined on the panel by Don Taylor and Sherilynn Black (Professor and Associate Vice Provost for Faculty Advancement, respectively, at Duke University), Linda Blount (President and CEO of the Black Women’s Health Imperative), and Steven Brown (a Research Associate at the Urban Institute).

As a discipline, health services research is in its sixth decade. That means it grew up in the context of racist laws, practices, and policies. It is not possible for HSR’s institutions and scholarship to have avoided racism’s influence. Let us at least accept this fundamental truth.

Structural racism is all around us, even if we are blind to it. It used to be popular to say one is color blind. But, at least for me, that equated to a lack of attention to racism. I didn’t see it because I didn’t look for it. For a long time I was satisfied with that. But it’s not satisfactory.

There is an unsatisfactory complacency that emerges from believing not being racist is adequate. It’s not adequate. In truth, it’s a passivity that tacitly supports structural racism everywhere, including in HSR. That I was not racist was merely a story I told myself. It didn’t have any impact on my community or the institutions where I work.

This reflects the unjustified and unjustifiable privilege of whiteness. As a white person, I have a privilege to be able to walk away from racism, to not think about it, to not have it contribute to my daily life — in a way that my Black colleagues cannot.

Change for myself, for HSR, and other areas, will require rejecting this privilege. I and my white colleagues have to find ways to challenge ourselves daily in the project of anti-racism. There’s a reason we’re doing this now — we’ve been shocked by videos of Black people being murdered by police. But we must remain motivated without another Black person being killed by racism. We must find a way to make anti-racism critical to our own humanity.

One, of several, ways I’m approaching this is through public writing, including at the New York Times. Each time I write about racism it’s a big effort. I have to face my fears about miscommunicating or being misunderstood. It’s important to push through those fears. With each piece I’ve received feedback — solicited and not — about how I can make improvements. This is challenging to hear when you’ve tried so hard! But this is also part of the necessary work — to listen, to hear, to accept the challenge, and, most importantly, to not walk away.


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