As it became clear that Covid-19 was disproportionately infecting and killing people of color in the U.K., just as it was in the U.S. and elsewhere, a new group tackling disparities and systemic racism within health care saw its mission crystallize.
The group — called Race and Health — was first envisioned at the start of the year as an academic project among public health researchers in the U.K. Once the pandemic hit shortly after, the researchers knew that publishing a series of papers on the impact of systemic racism on health disparities, as the initial project was intended, was “no longer an option,” said Sujitha Selvarajah, an OB-GYN and one of the core organizers of Race and Health. The group formally launches Thursday with a webinar that will be livestreamed around the world on the impacts of racism, xenophobia, and discrimination on health beyond the pandemic.
Now the group’s focus is broadening beyond academic circles to work with people all over the world from multiple fields — not only medicine but also art, architecture, and social justice — toward dismantling systemic racism and discrimination in health.
STAT spoke with Selvarajah to learn more about the genesis of the organization, its official launch, and the urgent need to keep addressing racism in health beyond the current pandemic. This interview has been lightly edited and condensed.
What is Race and Health?
Race and Health is a collective of a wide range of people. We range from public health academics to activists, artists, grassroots organizations, all the way down to individuals who have an interest in what we do and share our vision.
Our main aim is to address, tackle, and minimize the effects of racism, xenophobia, and discrimination on health. Looking at those three things and how they affect health in particular we feel sometimes gets missed in public discourse. Even things that are linked to racism that are out there, the overt link to how that affects health is somehow missed. And we look at discrimination that’s based on race, on ethnicity, skin color, caste, Indigenous status, religion, migratory status, and how that discrimination can adversely affect health all across the world.
Who is behind the team, and are you funded?
We have 30 members, three quarters of whom identify as women, 12 of whom are Black. The countries represented in the collective: Zambia, Nigeria, Sri Lanka, Brazil, India, Mexico, Italy, Indigenous Australian, South Africa, Kenya, Korea, Iran, Germany, Canada, Turkey, St. Lucia.
At the moment, we are completely unfunded and it’s all volunteer-led. We’re seeking funding at the moment. The fact that people who are working on dismantling racism, dismantling discrimination, are volunteers is part of the problem itself. We’re hoping that as the world tunes in to just how deeply embedded racism is, we can attract funding to sustain our work. If we’re centering the people who are most marginalized, then we need to pay them for their work.
What inspired you to start this group?
It started off as a very academic project at the start of this year. We came together as people who had interest and experience in clinical medicine and public health and academia. Our first academic synthesis will be coming out later this year — and it will be the first global synthesis of academic literature that looks at how racism and discrimination affects health.
But as we started to do the work, we started to realize that it’s going to take a lot more than just academia to dismantle these systems that are so deeply embedded in our society. What really changed the trajectory was the start of the pandemic. I was working [in emergency medicine] and before any of the data were coming out, I was treating more Black and brown people, who were coming in way more sick.
And as we started to see the pandemic unfold, we realized the pandemic is only making social vulnerabilities worse. It became clear to us that the initial idea [of having academic work out there and then disseminating information] was no longer an option. We had to become a lot more dynamic — we launched our online presence as the pandemic began to unfold here [in the U.K.]. [And then] we started collaborating with other organizations, artists and that’s how Race and Health was founded.
You’re not the first ones to try and tackle this. So what do you see as missing in the current landscape of the conversations surrounding health disparities?
The issues that Race and Health are tackling are long-term, global health, they’ve been around for centuries, but the organization itself is very young. [That] means we’re open and receptive to what people want from us and how they want us to achieve the change that we all want.
We do think that the health lens is often neglected. A timely example is that there’s literature that shows that just witnessing police brutality has poor mental health outcomes for Black Americans who just watch it on TV. Often people don’t think about it from the health perspective and that’s what we’re trying to address here.
When we think about diseases or health outcomes that minority people face, there’s a level of reasoning that’s often missed out. Go-to examples are chronic conditions like high blood pressure and diabetes that are more common in Black and brown people. We’ve got evidence telling us that the racism and constant stress that’s experienced by these marginalized groups, of being discriminated against, can actually bring about these [health] conditions. And we have to address that.
Just saying that more Black and brown people are likely to die from Covid-19 because they have high blood pressure is actually lazy thinking, and perpetuates the thinking that is racist. The reason is not really straightforward, and it’s a lot more complicated than a genetic predisposition. It can perpetuate racial inequality to leave it at that. There’s no biological basis for race, so saying that there’s predisposing conditions for those disparities is lazy and doesn’t address structural racism.
What are you hoping to achieve with Thursday’s webinar?
We’ve got four panelists — and it’s entirely a Q&A-based webinar. All of the questions have come from grassroots organizations and individuals that have reached out to us — we currently have representation from every continent, besides Antarctica. [We want] people to leave feeling like something can be done, and the focus is going to be on what can be done right now, what can be done before the end of this month and what can be done by the end of this year, to really make our vision a reality.
The webinar is just the start of the conversation, and absolutely will just be an introduction to what we’re hoping to achieve.
Why is this important beyond Covid-19?
It’s very important that we look at what we can do long-term. So even if you even look at health, the structures within health are part of structural racism and perpetuate inequalities. For example, if you live in a country that is predominantly English-speaking, but you have communities that don’t speak the language, then there are significant barriers to them accessing the health care system. It’s unsurprising, if you’re involved in this work, that Black and brown people are more likely to turn up more unwell. It’s issues beyond just the pandemic: Black and brown people are dealing with problems with employment, problems with education, structural racism at work. It’s short-sighted — and misses the point — to only focus on the pandemic.
I’m starting my training in obstetrics and gynecology, and so much of what we know about medicine and the human body was built on the awful treatment of Black people, of minority groups. J. Marion Sims, who is considered the godfather of gynecology — you’ll see his name on hospitals and buildings — but so many of his experiments were done on Black women without their consent and based on this false pretense that they don’t experience pain without any anesthesia. And often those who are involved in health have no idea that so much of what we know is due to sacrifices made by those who have been sidelined. So, I think we don’t really have any option but to look beyond the pandemic.
What else will Race and Health be doing?
We’re opening up our global consultation process, which will be open until July 11. Any organization, any person across the world who is interested in this can tell us what they want from the organization and how they want to collaborate. We want our work to be quite participatory and dynamic. We want this process to be a conversation rather than us kind of teaching how to do it.
So, this next month is going to be this consultation process. I think the first thing we’re going to be doing is building a database of everyone who’s interested and seeing if we can link up groups and start up projects. One of the things that people have asked us [about] is organizing a conversation just among grassroots organizations — often conversations about larger issues happen at a level that those working at the grassroots level are not involved in.
Often, many of these conversations are had in silos and different groups — artists, startups, etc. — talk amongst themselves. So we want to see what we can do to bridge that gap.
We’re also considering creating a roadmap to changes that can feel a bit more concrete, and more than just discussions and reports, for example. One of the groups that have inspired a lot of the members of Race and Health is a group of Black activists at the University of Washington, who recently campaigned and removed the category of race from evaluating kidney function. So we’re hoping to produce a roadmap of things you can achieve like that — so that you feel like you’re actively dismantling the systems that allocate privileges to some and oppression to others.