Questions and answers on racism in health care and beyond

In June, we held an online conversation with Denise Smith, Dr. Julian Nieves, and Asher DeLerme. Denise, Asher, and Julian are all front line health workers. They discussed with us the disparities that have long existed in the health care field and beyond for Black folks and other people of color. Here, Asher and Denise are revisiting some of the questions audience members had that we did not have enough time to respond to.

Racism, anti-Blackness, and how they play into our social systems is an ongoing conversation. We will be discussing racial injustice and health equity in an upcoming conversation with Stephanye Clarke and Tekisha Everette, which you can register for here.

To watch our full conversation with Asher, Denise, and Julian, follow this link.

These answers have been edited for length and clarity.

We have extreme disparities in wealth, housing, education, health care, law enforcement, etc. Where and how do we begin?

Asher Delerme: Those of us who work within these domains must continue to advocate for processes and policies that root out and address inequalities. Especially since we lack a powerful coordinating body that can address the impacts of inequality in our society.

It is important to keep in mind that for systemic change to be successful, it should occur across the spectrum of our social systems. As we work within our domains, it is important to be involved in or at least aware of advocacy efforts in other social sectors and understand the connections of disparities among them.

With that said, I personally believe education is essential in this systemic change process. Education can help mold and propel communities towards increased awareness of ourselves and others as we strive for a higher state of human consciousness, whether by:

  • Curriculum development
  • Teaching humanitarian core values in early childhood education
  • Expanding multiple pathways and opportunities for human growth and prosperity
  • Improving community and self-awareness
  • Dispelling historical myths.

Denise Smith: The first requirement is to determine who the “we” is. Historically, communities who experience these disparities are not the same people who are leading the work to evaluate, monitor, and develop interventions and policies to end these disparities.

Leadership and accountability of our public and private systems by the communities most impacted is essential. To ensure that these communities have the ability to fully participate in these activities, they should receive authentic engagement, payment for their time and expertise, and decision making power — not token advisory power.

Why is it important to use the following words every day, in all spaces if we want to see change: structural racism, institutional racism and white supremacy?

Asher: These words help us to describe the negative forces that are experienced by people of color. Often times those of us having conversations within the larger community use these words to convey our righteous rage at what we know to be evil.

Of course there are other words that can be used to describe our indignation toward moral injustices in our social system, but those may not have the value of helping people to participate in a constructive conversation about some of the undeniable legacies of American history: Racism and White supremacy.

We will continue to maintain a social system of inequalities and plunge deeper into social unrest so long as we fail to use these words in our conversations.

Denise: Without proper diagnosis, there can be no effective treatment.

If there was one thing you could change or create to making this an equitable world, what would it be?

Asher: As was noted in my response to a previous question, I believe education, whether formal or grassroots, is an area that can have a transformative effect on the state and health of our country. This would include a deeper understanding and appreciation for the experience of being a person of color within a culture that can be indifferent, fearful, and at times hateful (resulting in deadly consequences).

Further, an understanding of the concepts of marginalization as it applies to communities of color. There are too many open social wounds in American society today that stem from racism and are tied to wealth, housing, education, and criminal justice. All of us have a responsibility to apply our understanding and awareness of socio-cultural issues to elect leaders who will enact policies and processes that will create a more equitable world.

Denise: Give Indigenous Americans their recognition, their land and their sovereignty. Give Black Americans their reparations.