One night, just before bed, my husband and I were watching evening news anchors talk about recent police shootings of black people. As we turned off the TV, he asked me, “How do you cope in this country knowing that you are never completely safe?”
My husband grew up in Nigeria, in a country where nearly everyone is black and having lots of melanin in your skin is not a de facto offense.
“How do you cope with the fact,” he said, “that so many people hate us?”
I’m Irish by birth and Nigerian by heritage. But I came to the United States when I was 6 years old, so I grew up American. Like many African-Americans, I remember the moment I realized I was black. But more importantly, I remember the moment I learned that being black in this country carried a heavy burden. My skin color precedes anything I do or say. With that comes possible prejudice.
Martin Luther King Jr. once said, “The arc of the moral universe is long, but it bends toward justice.”
In the last year, those words have been tested.
On Friday, the Department of Justice released its findings that Chicago police too often use force, including deadly force and that force is disproportionately used against blacks and Latinos in the city. Police brutality against communities of color is not a new phenomenon, but video and live-streaming have forced this issue to the front of our national consciousness and inspired divisiveness rather than productive dialogue. All of this is happening as I’m coming of age as a physician.
As I learn to care for all of my patients and carry their trust, I also wonder, who cares for black America? Who carries the trust of people who look like me?
Systemic racism is a chronic disease and it is ubiquitous. Police violence is a noted determinant of public health. Its impact is more heritable than cancer and more contagious than bacterial disease. And as my husband pointed out, discrimination and bias haunts us everywhere, from our highways to our hospitals. We can’t cure it with pills, but I’ve come to believe that we can solve these problems with philanthropy, that MLK Jr.’s arc bends more urgently and intentionally towards money.
In September, Dr. Priscilla Chan and her husband, Facebook CEO Mark Zuckerberg, announced a $3 billion investment into curing chronic disease, focusing on “connecting people and building strong communities.” Chan, a pediatrician, cried as she expressed how hopeless and helpless she felt in caring for children with chronic diseases.
I feel the same, but also for children affected by the chronic disease of racism and the vicious symptoms of police violence. My heart breaks when I think of the young Tajai Rice who witnessed her 12-year-old brother being shot and killed by a Cleveland police officer in 2014. She’s “lost more than 50 pounds from stress and has missed about 100 days from school,” reported Yamiche Alcindor for the New York Times. Another child carrying the burden of police brutality: “the daughter of Oscar Grant III, killed by a transit officer while lying down on a California train platform in 2009, who as a 5-year-old would ask playmates to duck when she saw the police.”
In order to achieve their ambitious goal, I think the Chan Zuckerberg Initiative will have to grapple with racism, its role in entrenching chronic disease and the ways that it tears our communities apart.
Money has lessened health discrimination before.
While in medical school, I took a course that not only traced the history of African-American physicians in the United States but also focused on efforts to reverse discrimination in health care. This course was a blessing because I drew inspiration from the resilience of black physicians, but when I learned that the majority of hospitals in this country desegregated only because they had to in order to receive federal funding, I was devastated.
Hospital desegregation happened not because the medical system cared for and respected the humanity of black patients, but because money was at stake.
I told one of my mentors how frustrated I felt that diversity and inclusion never seem to happen for honorable reasons. When it comes to fighting for equality, he asked, “Does it really matter if you do the right thing for the wrong reason?”
This makes me wonder if we can buy our way out of racism: fund solutions to the hilt. Would health follow? One way we could do this would be to fund public health departments to look at the data they gather on injuries and deaths, and see if they can use that data to prevent police violence.
Or, like in Pittsburgh, philanthropy can fund community policing in the hopes of reducing violence.
We can end institutional racism that drives health disparities. We cannot erase the memory of racism, but we can eradicate its continued contribution to chronic disease in this country. Like being a physician, being a police officer is undoubtedly hard work. Both professions must not only protect the health and well-being of the communities we serve, but also confront any obstacles that undermine that fundamentally earnest mission. Our professional obligations compel us to see the blood on our hands, and wash them clean by working together to restore the trust eroded by generations of injustice.
In the same way hospitals were desegregated overnight, I believe with financial support we can bend the modern day moral arc in our favor.
My husband asked me that night before bed how it felt to know that so many people harbored both explicit and implicit ill will for black America.
I answered, “I don’t know.” It’s easier not to know.
But as African-American writer James A. Baldwin has said, “To be a Negro in this country and to be relatively conscious is to be in a rage almost all the time.”
It’s time to put that rage to use to solve the moral crisis of health disparity. To convince those with the dollars that in order to solve illness, you have to solve othering, dismissing, and discrimination.
“Curing disease will take time. Over short periods of five or 10 years, it may not seem like we’re making much of a difference,” said Zuckerberg and Chan at the launch of their initiative. “But over the long term, seeds planted now will grow.”
Philanthropy can make this happen. A world without disease. One day, maybe my future children and I will see what Zuckerberg and Chan imagined and live what Martin Luther King Jr. dreamed.
Good, thought provoking article. Thank you for writing. I like this line of thinking since as philanthropy continues to rise to fund medicine as public funds like NIH diminish, it would be great to think about race or equity in every gift. There should of course be dedicated gifts to tackle institutional racism and structural violence, but this framework could help the gift where the philanthropist or the receiver(health researcher, doctor, nurse, public health expert, etc) think their work has nothing to do with race or class or haven’t thought about it deeply. How will this gift tackle institutional racism or access for all to the fruits of the money invested? I wonder if others or you have fleshed this out in a way that may provoke philanthropists to think of these issues when they make their gift to ensure relevance to everyone. Like a checklist? Or something else since I think many of the wealthiest Americans or medical foundations don’t usually think deeply about structural violence, poverty, institutional racism, etc
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