Decompiling Oppression #43
Sam McVeety
This week, I wanted to revisit structural oppression in the medical arena, and connect it to current events across COVID-19 and Seattle Children's Hospital (more on that in a bit, for those who are unfamiliar). As a quick reminder, we've talked about medical racism before in this space (mostly focusing on reproductive justice), and many of the materials there (especially Medical Apartheid) are equally applicable here. Credit to King County Equity Now and Tubman Health for inspiring this topic.
We'll take a local focus today, looking at the past and present here in Seattle. First, at Seattle Children's, the high-profile resignation of Dr. Ben Danielson marked the escalation of a long series of community complaints regarding harmful practices at the institution. In commenting on his departure, Dr. Danielson discussed the individual and systemic racism that he encountered -- both overt personal animus (racial slurs) as well as systemic issues (notably, staff calling the police on Black families at vastly higher rates). Dr. Danielson is a leading voice for trying to transform potentially harmful systems from the inside, and his departure from Seattle Children's sends a strong message about the barriers to making such changes.
If we look backwards in time, we can see that this isn't a new issue. Responding to community needs for respectful, responsive medical care, the Seattle chapter of the Black Panther Party founded medical programs (one of which persists today) as a mutual aid project. We've looked at the BPP's free clinics before, and the needs that drove those projects are (unfortunately) still alive and well in 2021.
It is with this historical context that we're encountering the COVID-19 pandemic, and the massive project to vaccinate as many people as possible (in the United States, anyway -- internationally probably merits another post). Given both the covert and outright hostility experienced by the Black community in the medical realm, for some, it is understandably hard to square the competing messages "vaccinate now" vs. a government that initially seemed to care very little about Black health outcomes (recall from #8 that COVID prevalance among non-white Americans was initially blamed on "comorbidity" factors rather than the racialized root causes). It's also worth noting that there is also an entire economic discussion around employment security for vaccinations and possible side effects (will I get fired if I call in sick?) that we won't have time to go into this week.
This is all to say, when it comes to building programs for mass vaccination, it's complicated. It's understandable that there may be some cognitive dissonance going on (especially for white observers) in the differences between unvaccinated populations. Why would some of the most marginalized groups not rush to get vaccinated? Often, skepticism in the Black community around medicine is oversimplified into looking at single incidents (like the Tuskegee syphilis study), but as we can see in Seattle, the reality is much more pervasive than that. For many white people, this might not be obvious, because it runs so counter to our individual experiences. Personally, my interactions with the medical system have been generally positive, and there's a learned deference to medical authority, underwritten by a general trust that a physician has your best interests in mind. You might find yourself chided for browsing WebMD and trying to self-diagnose, but the relationship is generally cordial and mutual.
For many people of color, particularly Black (and Native) people, that relationship is not mutual at all, and is instead characterized by anything from indifference to outright condescension and hostility. For members of the LGTBQ+ community (particularly trans people of color), many people have to specifically seek out a respectful medical provider. All of this against a backdrop where people of color (especially Native and Black Americans) have demonstrably worse health outcomes, and thus on average, have every reason to be skeptical of the "first opinion" that they get from a medical provider. It is therefore wholly inappropriate to pathologize this doubt, often in racialized terms (with an implication of ignorance or superstition, also tinged with saviorism -- "how dare they reject our aid") from communities that historically have every reason to be skeptical of the medical establishment.
Fundamentally, condescension and ridicule is not a recipe for building or rebuilding trust, when that trust has not been earned. When we create group-based distrust or even outright hostility in our medical system, not only does it harm the individuals that would otherwise seek care; it causes harm to all of us, through our interconnections. There are amazing people working to change this narrative, but it is hard, labor intensive work, and it requires some (white-led) historical institutions giving up some of their power to allow for systems of care that are accountable to the communities that they serve.
Here are this week's invitations:
Personal: If you've gotten the vaccine, what are all the economic and cultural factors that made you more or less likely to do so?
Communal: Talk to friends and family about their experiences with the medical system across the intersection of their identities. What can we do to create a more inclusive experience for everyone?
Solidarity: Support Tubman Health and their mission to advance health justice, culturally appropriate care, and integrative medicine through programs like #Blaxinate.
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