Healthcare, we have a problem.
This guest blog post is by James Bell III, Equity Strategist, Founder, CEO for Just Solutions, LLC.
It was a hot day in July when I decided to go in for my standard physical. I noticed my doctor continually checking her watch, as I was just one of many appointments for that day. I wanted to talk to her about how the latest string of police brutality was starting to impact me. Overall, my health is fine, but as of late I had trouble sleeping or my mind feels like a marathon with no finish line. She checks her watch again.
My doctor is a petite White woman, and I’m your average sized Black man. In no way do I feel like I intimidate my provider, but I don’t always believe she’s as invested in my health as I am. The way our sessions feel hurried, or even the questions I’m asked. As person-centered as healthcare claims to be it just doesn’t feel specific to me. And because it’s just a physical, she encourages me to schedule a follow up appointment and says she can’t offer much recommendation other than to limit my screen time. Well, yes. Thanks Doc. I'd love to not see young black boys murdered for carrying a toy gun on my television. I'd also like to not see it happen, ever.
This brief description is just a snapshot of the problem. I have never had a primary care physician that looks like me by race or by race and gender. I’ve never completed a questionnaire that asked about how I respond to racism. Just if my parents’ parents were diabetic or have high blood pressure. Never about the fact we lived in the inner city, in a grocery desert, and the nearest grocery store was miles away limiting our food choices. The social determinants of health look great in presentations, but nowhere to found in my health assessments.
How is it that the place I should be going to be healed, isn’t equipped to handle discussions on racism and its impact on my health? Well, because it is hard to be honest and say, I helped to create this problem. Or help to perpetuate this problem. Or even further, I benefit from this problem. So how do we fix it? How do we put a band-aid on this problem that is bigger than my doctor and me? The response is simple, but the implementation is not – equity.
I’ve spent a lot of time in public health and in non-profits. We are aspirational because we have no other choice but to be. It is essential to our mission and to our sustainability. It is essential to the people we serve. They often say you don’t go into the human service or public health sector for the money, but for the reward. I am looking to cash in my reward.
First, let’s get comfortable talking about racism and how the stress associated with racism is making us sick. There is more to the relationship of Erica Garner, daughter of Eric Garner having multiple heart attacks before the age of 30. I can't imagine what damage racism did to her heart and to her health. Let's make it plain: racism is making us sick. Racism is paralyzing us with illness. And not acknowledging racism as the culprit is the reason we are afraid to change the system.
This is not rocket science, but it is racism. We’ve seen success in creating strategies to advance equity. There is a surplus of frameworks touching on how to take on an anti-racist mission or how to eliminate institutional racism from your organization. But who is willing to change, and who is willing to try?
I am pleading with leadership and decision makers to reconsider their approach to healthcare. I need you to be bold. I need you to acknowledge the elephant in the room. And know that your impact is just as important as your intent. I’ve always meant well, even when things didn’t end well. But the conversation does not end there. Many of us know, this is in fact where the conversation begins. Equity is not a sexy topic, and not a revenue generating one (at least not immediately). But it is the right one if we want everyone to have a fair chance.
I want my healthcare system to be aspirational too. And until we aspire for the same things, we have a problem.
James is a doctoral candidate at the University of Southern California Suzanne Dworak-Peck School of Social Work studying social innovation and racial health inequities, with an anticipated graduation in May 2021. James has nearly a decade of experience in building relationships/creating partnerships between diverse stakeholders around critical issues and a strong background in assembling and managing diverse teams to meet client needs.