July is Minority Mental Health Awareness Month and this year’s focus is particularly relevant. Minority populations have had significant stressors this year. The coronavirus pandemic, the national focus on race and systemic racism, and the economic fallout from an unstable economy have created a storm of emotions and concerns.
The National Alliance on Mental Illness (NAMI) and the U.S. Department of Health and Human Services Office of Minority Health (OMH) are particular champions of Minority Mental Health Awareness Month. Mental illness and mental health challenges can impact anyone with no regard to race, location, socioeconomic status, or gender. But how mental health is regarded and treated can vary greatly. So many factors significantly impact how someone seeks, has access to, receives, and talks about mental health.
This month is devoted to spreading awareness about the particular challenges minority populations face when thinking about mental health.
The OMH reveals some startling information from the Substance Abuse and Mental Health Services Administration (SAMHSA) and the CDC:
- In 2017, 10.5% (3.5 million) of young adults age 18 to 25 had serious thoughts of suicide including 8.3% of non-Hispanic blacks and 9.2% of Hispanics.
- In 2017, 7.5% (2.5 million) of young adults age 18 to 25 had a serious mental illness including 7.6% of non-Hispanic Asians, 5.7% of Hispanics and 4.6% of non-Hispanic blacks.
- Feelings of anxiety and other signs of stress may become more pronounced during a global pandemic.
- People in some racial and ethnic minority groups may respond more strongly to the stress of a pandemic or crisis.
Because of the vast gaps in health equity and access, many minority populations have trouble finding high-quality mental health care providers and/or a means of getting to a provider to receive care. The pandemic has created a unique situation that can actually be a benefit for some people who have trouble finding good care or getting to an office. Because so many healthcare appointments are now virtual, that could remove one barrier to receiving care, but is wholly dependent on access to reliable technology to be able to connect virtually.
Increased access also depends on changing much deeper levels of the healthcare system. Many mental health providers are overwhelmed with the increased demand for their services during the pandemic. And many providers choose to skirt the often tedious and time consuming insurance process and have opted not to accept insurance and are private pay only. Those two issues can actually create even steeper burdens for those already marginalized by the healthcare system.
MentalHealth.gov offers resources to help families, individuals, educators, and faith and community leaders to begin conversations around mental health among minority populations. Talking about mental health in a normalized and compassionate way can help reduce some of the stigma around mental health issues. People who feel like they can ask for help are often able to then take the steps to get the help they need. If they feel like they are not alone and they are not the only ones who might be struggling, then they will find that getting help is less of a burden. If they feel supported by their community, they feel less need to hide or even deny what they are feeling and experiencing.
Although July calls attention to minority mental health, the issue is one that needs constant attention, but particularly during this time of tremendous and chronic upheaval.
COVID-19 is hitting minorities harder than other communities. According to the Centers for Disease Control, as of June 12, 2020, the age-adjusted hospitalization rates were reported highest among non-Hispanic American Indian or Alaska Native and non-Hispanic black persons, followed by Hispanic or Latino persons. The CDC clearly states that such racial and ethnic minority groups are an increased risk of the getting COVID-19 regardless of age due to long-standing systemic health and social inequities. It has been found that non-Hispanic American Indian, Alaska Native, and non-Hispanic black persons are hospitalized for COVID-19 at a rate 5 times that of non-Hispanic white persons. Hispanic or Latino person have a rate approximating 4 times that of non-Hispanic white persons.
Why are minorities at increased risk during the COVID-19 pandemic?
For decades, health differences among racial and ethic groups have arisen due to living, working, health, and social conditions. During this pandemic, such conditions have not disappeared but work against minorities by isolating them from the resources they need to cope with such outbreaks.
Living conditions contribute to an increased risk of COVID-19 for minority groups. Many minorities live in highly populated communities due to institutional racism. Such institutional racism occurs through residential housing segregation. An example of this can be seen in the overcrowding in tribal reservations and Alaska Native villages. As a result of such densely populated areas, it acts as a barrier to social distancing. Racial housing segregation is all linked to several health conditions such as asthma which increases the risk of becoming severely ill or death from the virus. Also, certain communities with higher minority populations also have increased exposure to pollution and environmental hazards. The reservation homes of non-Hispanic Native Americans also have been found insufficient in plumbing when compared to the rest of the U.S. As a result, it proves a challenge for handwashing to occur regularly. Some members of minority groups also rely heavily on public transportation, making it difficult to follow through with social distancing. Minority groups also more commonly have multigenerational and multi-family households, which makes it harder to protect older adult family member or isolate sick household members in such limited space available. Minority groups are also over-represented in congregate environments such as jails, prisons, homeless shelters, and detention centers, which again presents a challenge for social distancing as they engage in activities of daily living in group settings.
Certain work conditions and policies also put workers at an increased risk of being infected with COVID-19. Certain minorities are more likely to work under such conditions. Being an essential worker in essential industries like health care, meat-packing, grocery stores, and factories put minorities at risk. This is because they are required to still work despite outbreaks occurring in their communities and some may need to work such jobs due to economic circumstances. They also may not have sick leave so such workers are more likely to work despite being sick. Income, education levels, and unemployment are other factors that must be considered. When considering the average earning of minorities compared to non-Hispanic whites, minorities earn less, possess less accumulated wealth, have lower levels of education, and higher rates of unemployment. All such factors contribute to the social and physical conditions of minorities which also affect health outcomes.
Lastly, the health circumstances of minorities play a major role in their being at increased risk of COVID-19. The issue of being uninsured is one of the highest concerns. Hispanics are about 3 times more likely to be uninsured than non-Hispanic whites. Whereas, non-Hispanic blacks are about twice as likely to be uninsured when compared to non-Hispanic whites. Minorities report cost as a barrier to seeing a doctor as well as distrust of the health care system, language differences, and losing wages due to missing work. Minorities also suffer from certain health conditions at higher rates than non-Hispanic whites. Black have higher rates of chronic conditions and at earlier ages with higher death rates than non-Hispanic whites. Non-Hispanic American Indian and Alaska Native adults are reportedly experiencing higher rates of obesity hypertension, and smoking then non-Hispanic white adults. Such health conditions put minorities at increased risk of severe illness. Racism, stigma, and systemic inequalities also contribute to health circumstances that increase the risk of COVID-19 in minorities. Such factors undercut prevention and increase the levels of stress in such communities, therefore, continuing health and healthcare disparities.
What can we do as health care providers and organizations?
As health care providers we must first understand this novel virus and how to best prevent, intervene, and treat it. However, in order to combat the health disparities in minorities, health care systems should offer providers training on how to identify their implicit biases. Providers must understand how implicit bias affects the way they communicate with their patients and how their patients will react to such communication. They also should be trained on how bias can affect their decision-making. Medical interpreters should be available in health care systems. Health care systems should work on community outreach projects in an effort to reduce the cultural barriers to care. As providers, we need to connect our patients with community resources that can help them manage underlying conditions. We should encourage our patients of all backgrounds to ask questions and promote a trusting relationship. All of these strategies could combat the distrust minorities may experience of health care in general. The starting point for all these forms of action is to learn more about the socioeconomic conditions that put certain patients at risk for getting sick with COVID-19. It is my hope that this essay is only the starting point for all health care providers and administrators who read it to aggressively protect the lives of racial and ethnic minority groups during this grueling pandemic.
Nurses have had a particularly challenging year. This year, we’ve seen an intense pandemic strain healthcare workers while simultaneously experiencing a powerful social uprising against racism in the United States. The two major events have some common touchpoints where social, health, education, and economic disparities intersect and are highlighted.
Minority Nurse recently spoke with Lillian Pryor MSN, RN, CNN, and president of the American Nephrology Nurses Association (ANNA), about how this year, in particular, could cause a sea of change across the nation. The process isn’t going to be easy, she says, and it’s only the beginning. But it’s needed, necessary, and long overdue.
“This is a very unprecedented, pivotal kind of moment,” Pryor says. It’s not just one event or even a couple that have brought the nation to this point, she says. “The emotional and physical impact of a pandemic is universally affecting all nurses, although studies have shown that COVID-19 is disproportionately affecting our Black and brown patients. There are social determinants of health that are disproportionately egregious against people of color. You have to think about poverty. It’s not just racism—it’s poverty and not having equitable access.”
And while COVID-19 dominates the lives of healthcare workers, the Black Lives Matter movement has continued to grow, evolve, and impact different people—from those who have grown up with the impact of systemic racism on their own lives to those who have never given racism much thought because it never impacted their lives in a negative and direct way. “I’ve talked with my colleagues about this, and it’s something we’ve had to deal with for a long time,” says Pryor. “I think that Black nurses have always had to face racism and yet continue to function in a manner that embodies the true meaning of nursing.”
As nurses, their job is to help people, and they do that even with patients who are openly racist, she says, but that takes an emotional toll. Sometimes the interactions can lead to something more meaningful—especially if the nurse is able to call attention to the action. A patient who didn’t realize a comment was racist, may be able to hear how it impacted the person it was directed at. In those cases, Pryor says she calls on her ability to be forgiving. But sometimes, it’s intentional, she says. “For so many of us, that’s what we’ve been doing for a while—we just keep going,” she says. “As long as I’m not threatened, I’m going to keep taking care of you because that’s what I’m here to do. Sometimes you get angry.”
What’s happening with the Black Lives Matter movement right now seems to have started a new opportunity. “I believe we just have to start the conversations,” Pryor says. “For sure, education needs to happen, but more than just education; intentional, meaningful awareness of ‘unconscious bias,’ the realities of racism, those written and un-written ‘rules’ that continue to perpetuate systemic inequality to disrupt and then transform this into action.”
Pryor is encouraged by what she sees, even as she knows it’s not going to be immediate. Black nurses need to feel they are able to speak up when something is wrong without being concerned about repercussions—emotional, physical, or professional. They also shouldn’t shoulder the responsibility to correct the wrongs, and that’s where organizations can begin to lead the way by implementing the training and ongoing conversations that will begin to make a change. “You have to be aware and you have to pay attention to it,” she says.
“I believe nursing, will, as the most trusted profession, use our voice to speak out about health inequality, advocate for fair and just health policy, point out institutional racism in our schools, places of work, etc.,” she says. “Then we must promote safety where racism and inequality can be challenged so that equity, inclusion, and diversity can be the experience of all. ANNA recently released a statement against racism pledging to do our part to create systems that support advancement and equality for all.”
When thinking of what nursing can do and continue to do, Pryor recalls the words of ANA president Ernest Grant who stated, “Commit to sustainable efforts to address racism and discrimination…and hold ourselves and our leaders accountable.”
Those words resonate for Pryor. “It’s the time to do this and everyone is willing,” she says, “and that encourages my heart. I’m hopeful it will get better. Never give up hope.”
In 2001, Noriyuki Matsuda, CEO of Sourcenext, realized a need—people wanted to be able to understand others when they didn’t speak the same language. He wanted to create a mechanism that could do this. But at the time, the hardware and software to make this happen didn’t exist. What he envisioned would eventually be known as Pocketalk.
By early 2020, Pocketalk launched their latest device. When COVID-19 hit the United States, the company started a relief program that donated 850 Pocketalk devices to first responders and health care providers on the front lines.
Matsuda talked with us about their relief program and how Pocketalk has helped so many across the country during this stressful time.
Why did Pocketalk feel it was needed to come up with a relief program?
Creating connections and enabling conversations is at the heart of why I founded Pocketalk. Before coming to the U.S., I saw people firsthand in Japan using Pocketalk to hold conversations in different languages and break down cultural barriers, reaffirming our need to take Pocketalk to the rest of the world.
Japan was one of the first countries affected by COVID-19. I started to think about the true mission of Pocketalk, after witnessing the impact the pandemic was having on our communities. And then, I saw the Diamond Princess cruise ship quarantined at Yokohoma, where Pocketalk helped staff members provide information and updates to concerned passengers quickly and accurately.
I wanted to—we had to—do more to help others during this time of need, and that is what led to the creation of our relief program.
We initiated the Relief Program in the U.S. in March because we knew we had the resources to be helpful for hospitals and first responders, and we wanted to give back during this global health crisis by providing translation services to those in most need. We set out to donate 600 Pocketalk Classic units to qualifying medical facilities, first responders, testing sites, and those in need of translation services. Units were given out on a first-come, first-served basis to those that applied through our website, with a maximum of three units per organization.
Over the course of just three weeks, the Pocketalk Relief Program saw widespread interest from all corners of the U.S. and officially donated more than 850 Pocketalks to qualifying applicants in 41 states to aid in the fight. We hope to be able to continue to give back to the medical community, especially during this time of great need.
Explain to our readers what Pocketalk is. How does it work? How many languages can it translate?
Pocketalk is a multi-sensory, two-way translation device. With a large touchscreen, noise-cancelling microphones and a text-to-translate camera, Pocketalk is able to create connections across 74 different languages. It’s equipped with high-quality, noise-cancelling microphones and two powerful speakers so it’s easy to have full conversations, even in noisy environments. The camera instantly recognizes and translates text, the written word, and signs. A large touch screen provides a text translation for additional clarity.
It seems that Pocketalk was initially designed for businesses/companies. Has it been used by health care workers from the start or did that come about because of the COVID-19 outbreak?
While we appeal to a variety of businesses and individuals who travel for both work and leisure, we knew we also have the technologies capable of helping many people in important industries to perform crucial day-to-day tasks. This includes teachers in our education system who work with students and parents who may not speak English as a first language, medical professionals and first responders who need quick, accurate translations on the job, and flight attendants who require translation services when assisting passengers.
Over the last few months as our world has changed, the need to share Pocketalk with health care professionals and first responders, as well as other industries, has grown immensely. Prior to COVID-19, Pocketalk was already in use at hospitals across Japan—including at the National Cancer Research Center and Ehime University General Hospital—to handle the influx of hospital visits by foreigners.
Pocketalk has also been increasingly used in the classroom by teachers and by volunteers in Minneapolis helping on the ground during recent protests and cleanup efforts. As these opportunities became more apparent, we wanted to do our part to give back to those making differences in their communities.
How has Pocketalk been helpful to first responders and medical professionals?
There are many beneficial features and aspects of Pocketalk offering critical value to medical professionals during the coronavirus outbreak. Our handheld translator is designed for accurate two-way communication at the touch of a button, reducing the time needed to communicate with patients. With the ability to translate 74 languages addressing 90% of the world’s population, Pocketalk also ensures that medical professionals can communicate with most, if not all, potential patients that come to their facilities in an emergency. While Pocketalk is able to support translation in emergencies, it can also be used by medical professionals to help with daily tasks, such as talking with family members of patients and communicating with patients who need assistance throughout the day, such as the need for an extra pillow or a meal.
Most importantly, Pocketalk eliminates the need for a human translator, reducing any human translators’ risk of exposure to COVID-19 and other contagious diseases. By dedicating ourselves to developing a product that is accurate, quick, and efficient in high-risk situations like those in the medical industry, we are trying to do our part to keep people safe and well-equipped to handle any translation challenges.
Do you have any anecdotes you can share about how they’ve made a difference?
After conducting our relief program, we did hear back from a number of members in the medical community about how Pocketalk has made a difference on the job after only a few weeks.
One respondent, an advanced emergency medical technician, told us that he was able to use Pocketalk to attend to and triage three different patients—who were native Vietnamese speakers and the other a native Spanish speaker. “What typically took 30 minutes, only took five minutes,” said the respondent.
An emergency medical specialist has spoken about Pocketalk’s immediate impact in the ER, noting how much easier it is now to talk with patients for quick reassessments and during critical moments without having to call a human translator. They said, “It’s in my whitecoat pocket on every shift.”
Is there anything else about Pocketalk or your relief program that you think is important for our readers to know?
As our world continues to tackle COVID-19, we are identifying other ways in which we can help other communities in other industries. Translation services are in higher demand right now not just within the medical community, but within other industries. Translators without Borders recently gave community organizations open access to their services, after receiving multiple requests from local organizations and nonprofits that need to translate information for their non-English speaking community members.
In addition to medical professionals, Pocketalk relief units were also given to members within other industries to help with translation needs. While most units were given to doctors and nurses in hospitals, a number of units were also given to workers in fire departments, law enforcement and pharmacies.
This is a time for us to come together as one voice made of many languages to help each other through the power of connection.
Starting now, medical professionals and first responders can purchase a Pocketalk Classic for $129 ($70 discount) using the special code MinorityNurse70 at discount–while supplies last.
The UConn School of Nursing is pleased to announce it has received a nationally competitive grant award from the U.S. Health Resources and Services Administration for a groundbreaking program. The innovative “PATH to PCNP” Clinical-Academic Partnership aims to increase diversity among primary care providers in medically underserved communities in Connecticut.
The nearly $3 million grant will provide scholarship support to 24 undergraduate students with disadvantaged backgrounds each year for five years. Six students from each academic year – freshman, sophomore, junior, and senior – will receive scholarships starting in the 2020-21 academic year.
“The mission of the School of Nursing is to educate nursing scholars, clinicians, and leaders, with the goal of advancing the health of individuals, communities, and systems,” says School of Nursing Dean Deborah Chyun. “The funding provided through this innovative program for underrepresented students will enhance their ability to focus on their education and graduate with minimal debt, in the hopes that they will go on to serve the areas of our state that are most in need.”
The group of faculty members leading this initiative at the School of Nursing includes: Ivy Alexander, Ph.D., APRN, ANP-BC, FAANP, FAAN; Natalie Shook, Ph.D.; Marianne Snyder, Ph.D., MSN, RN; and Thomas Van Hoof, MD, EdD, FACP.
Despite efforts to recruit registered nurses with disadvantaged backgrounds to the School of Nursing’s primary care nurse practitioner (PCNP) master’s program, numbers of such students remain low, according to Alexander. In order to increase diversity among PCNPs, the School must first increase successful completion of the bachelor’s program among disadvantaged students, and without overwhelming debt.
The objective of “PATH to PCNP” (Provide Academic Transformational Help for disadvantaged nursing students to become Primary Care Nurse Practitioners) is to help such students graduate on time through a “fast track” undergraduate program. The partnership will: increase educational support for students with disadvantaged backgrounds; foster a sense of belonging and ability for positive self-care to reduce stress, anxiety and depression; and infuse primary care curriculum and experiences in medically underserved communities.
“Students participating in the ‘PATH to PCNP’ Program will have primary care experiences during their undergraduate nursing education and graduate ready to begin graduate school to become primary care nurse practitioners,” the faculty team says.
“PATH to PCNP” is a partnership between the UConn School of Nursing and Community Health Center Inc. Senior-level students in the program will complete a capstone clinical rotation at CHCI, gaining experience providing primary nursing care to patients with complex health issues in medically underserved communities. CHCI’s Chief Nursing Officer Mary Blankson, DNP, APRN, FNP-C, will lead the initiative at CHCI, which is one of the largest federally qualified health centers in the country.
The first quarter of 2020 has revealed, to many, the depth of the racial problem in American society. First, COVID-19, which has disproportionately impacted communities of color, revealed the inequities in the American health care and economic system. Then, the killings of three African Americans, Ahmaud Arbery, Breonna Taylor, and George Floyd, by white men, including police officers in two of the cases, restarted a conversation on racial violence and police brutality in America. All of this has led to a national discussion on the health of the American republic.
To provide some illumination on this important topic, we interviewed Dr. Stacie Craft DeFreitas, who has a PhD in Clinical Psychology from Duke University. Her interest in race, ethnicity, and academic achievement was sparked in high school when she participated in Kaleidoscope, a math and science enrichment program for African American students housed on the campus of Wake Forest University. Her work, African American Psychology, is a highly relevant work that covers many of the issues raised by the recent events in America. She is currently an Associate Professor of Psychology and the Assistant Chair of the Social Sciences department at the University of Houston-Downtown.
DeFreitas, what is your reading of the origins and purpose of the current Black Lives Matter movement and how do you place it in the historical context of black civic action in the United States?
The current Black Lives Matter movement stems from the murder of Trayvon Martin in 2012 when women of color began using the hashtag to bring awareness to such acts against people of color. Nearly 10 years later, the movement is still striving to protect black and brown people from such state sanctioned murder. Black Lives Matter is one of the larger current movements pushing the United States towards the ideals that are penned in the Declaration of Independence and Constitution. BLM is forging a place in history as an agent for change.
What motivated you to write the book African American Psychology and how is it relevant for understanding race in America today?
It seemed to me that there were not enough messages about the strengths of African Americans out there in the world. There was so much negative media and I wanted to realistically counter that. I wanted to tell more of the story of the African American community by focusing on the historical elements that have led to the current psychological state of African Americans as well as look at how the strengths can be used to help the community prosper. There are so many people that really need to read this book so that they can begin to get a better understanding of African Americans in this country. Many people assume that they know about Black people because of the media that they ingest, TV, movies, news, and music. Many people do not know that they often get a stereotypical view of African Americans and only see the lives of a small subset. African Americans are heterogeneous. There is so much diversity within this group that is often ignored. This book also helps to bring some of that out. It will help readers to understand that African Americans are strong and resilient people who have survived so much and often come out of the other side better off. But it will also help readers to understand that they are battling so much and that we should marvel in all of the progress that has been made despite the plethora of barriers. Perhaps readers will love and admire the African American community as I do once they have a better understanding of their lives, or at the very least reevaluate their own biases and stereotypes.
What was the most surprising thing you learned, as an African American woman and psychologist, about the psychology of African Americans during your research for the book?
This may not be surprising to others, but I learned more about all of the ways that the United States has worked to keep African Americans from prospering. I knew about some of it, but got a much better understanding of the events in Rosewood, lynchings, the Tulsa bombings, redlining, and other ways that citizens and businesses worked to keep African Americans from prospering. There was so much, I chose not to include much of it in the text as I assumed someone would say that I was being anti-American and would therefore discount the book. It amazes me that we sweep these things under the rug and imagine that since slavery, or at least since the Civil Rights Movement, the U.S. has only tried to support African Americans. That is clearly not true and continues to be untrue today. Doing nothing is often the same as doing harm.
Can you discuss the nature of structural racism in the U.S. and some of the ways it impacts the mental and physical health of African Americans?
Structural racism is weaved into the fabric of the United States. It is inherent in its capitalist ideologies, laws, history, and culture. Racism impacts the mental and physical health of African Americans in so many ways. One very important way is through racism’s impact on where and how people live. African Americans are much more likely to live in impoverished neighborhoods as a result of the history of racism in this country and the current laws that do not protect or support them fully. Unfortunately, I cannot go into all of the racist practices that work to push Black people into segregated and often lower income neighborhoods, but there are many, and they continue to be practiced today. One example is crime free housing ordinances which allow landlords to evict or deny housing for any person who is suspected of a crime which effectively works to deny housing to people of color as a result of heightened, unjustified police surveillance among people of color, especially Black men. The neighborhood that one lives in impacts the schools that they attend, the quality of the restaurants that they are near, whether they live in a food desert, the recreational space available to them, and other factors that all impact mental and physical health.
Further, racism has created a system of mistrust between Black patients and their often non-Black health care providers. Black patients often do not trust these health care providers to really have their best interest at heart as result of a history of mistreatment. Because of this mistrust, they often avoid going to the doctor for as long as they can and they are less comfortable sharing all of their symptoms when they finally do go to the doctor. Doctors in turn do not trust their Black patients to carry out their prescribed orders and they often discount their experiences. This cycle leads to lower quality care for Black patients.
You talk about the need to embrace a more holistic view of mental health in the Black community that goes beyond the presence or absence of mental disorders. Can you discuss this point further?
It is really important that all people start considering a more holistic view of health in general. We create these false divisions between different aspects of health, but what makes us think that we need to separate our mind from our body? We have so much evidence that they are very connected and that what happens in our minds impacts our bodies and what happens in our bodies impacts our minds. For that reason, all people, Black people especially because of the number of stressors that they face, should really focus on taking care of the whole self, mentally, physically, and spiritually. Ideally, we would have more health care centers that take this integrated approach. One piece of evidence for this interconnection is the fact that Black people have relatively good mental health overall when we consider their typical life stressors, but often have poorer physical health. It could be that in an effort to preserve their mental health, Black people are harming their bodies. This goes beyond things like a tendency towards eating unhealthy comfort foods when a person is stressed. It appears that for many Black people, negative factors such as stress may not result in mental health problems like depression, but instead would result in physical manifestations such as high blood pressure. With a more holistic view of health, doctors could examine whether there are mental health factors (such as stress from experiences of discrimination) that are leading to physical problems (poor cardiovascular health). That type of treatment approach could help us to reduce health disparities. Further, I am a huge proponent of mental health treatment. I believe that people should get yearly mental health check-ups just like they get physical exams, but the African American community has a lot of stigma surrounding mental health. An integrated approach would help remove this stigma if your mental health check-up is just a part of your regular health care practice.
What are some things about the African American community that members of the health care profession should be aware of in order to provide the best mental and physical health service to members of the community?
The most important thing for health care providers to do is to check their own biases and assumptions. Health care providers must do some soul searching. What do you really think about people of color? Do you expect that they will not follow the doctor’s orders, so why give them anyway? Do you make assumptions about how they live and what they understand without proper assessment? Do you truly listen to their concerns? Do you make an effort to build rapport with all patients equally so that they feel safe and cared for? Further, medical facilities need to start really looking at their practices and making sure that treatment of all patients is equitable. For example, hospitals should keep track of things such as how often patients are given pain medication based on ethnicity. There is an assumption that African Americans can handle more pain and therefore they are denied this medicine. Also, African Americans experiences can often be discounted by medical professions. One example of this is the high rate of deaths by African American women during childbirth. These deaths are often preventable and occur because health care providers may discount the complaints and concerns of African American women. I experienced this first hand and it resulted in the one of the scariest moments of my life. If the only time that health care providers interact with people of color is at work, this is a recipe for poor rapport and low quality care.
Can you discuss the nature of symbolic racism and the role it plays in the current racial dynamic in the U.S.?
Symbolic racism is a subtle form of racism in which people believe that racism is not real and that people of color have not progressed more in life due to their own deficiencies. This is one of the most damaging forms of racism because it is widespread and people can feel good about themselves for having an “American work ethic,” believing they have achieved their goals completely due to their own hard work. What they do not consider is the fact that often, they have had many people and situations help them along the way that people of color have not had. European Americans are more likely than African Americans to have parents that went to college, have parents that own a home and can pass that home down to them, get inheritances from other family members, have teachers that look like them and have similar cultural values, live in a neighborhood that is middle class with access to healthy food and medical care, and see positive images of people who they can identify with in the media. All of these factors are aspects of structural racism and impact health, financial, and educational outcomes. So those who harbor symbolic racism beliefs discount all these factors and the many more that impact the lives of African Americans. These are the same people who ask “well what did he do” when an unarmed Black man is shot by the police because they cannot fathom that the murder could be a result of a system of racism and no fault of the murdered Black man. Such ideas are inherent in those who assume that the Black Lives Matter movement suggests that other people don’t matter. Unfortunately, we have to state that Black lives matter even when WE know that all lives matter; it is just that the United States does not seem to know. For that reason, they need to be reminded, Black lives matter.
Can you discuss color-blind racism and how it impacts the psychology of African Americans?
Color-blind racism is when a person says that they don’t see color so they cannot possibly be racist. This is problematic first of all because it is not true. Perhaps a person may not have biases against other people due to their race or ethnicity, but unless you have some type of disability, you will determine (or attempt to determine) an individual’s race or ethnicity when interacting with them. This is part of being human. We categorize people into ethnicity, gender, age, etc. when we first see them. It is a quick way to get information about who a person is and how you should interact with them. What we must pay attention to is the fact that we often do treat people of different ethnic groups differently, even when we think that we do not. This is the major problem. One important way that color blind racism may sneak into the world of health care providers is through mentorship. When you think of who you have mentored or been mentored by, how often has a good mentoring relationship been with someone of a different ethnic background? Usually it is not. This is because we assume that we are color blind, but biases and expectations often cause us to connect with those who we believe are like us. People may reach out to support others who they can identify with, but if one is being color blind, they can pretend that ethnicity has nothing to do with it, when often, it does. They can say, “well she reminds me so much of myself when I started” and deny the fact that they had biases about the Black nurse and therefore did not reach out to support her. Color-blind racism is also problematic because by trying to discount ethnicity, people are ignoring important aspects of who a person is and often this will result in a poor interaction. This can be particularly problematic for a health care worker who is unwilling to ask the questions that they need to in order to better understand a coworker or patient and is instead just acting on their assumptions.
In your book, you discuss some of the gender based ways that Black men and women react to the experience of racism in the U.S. Can you describe some of these responses?
My text discusses John Henryism—when referring to Black males—and Sojourner Syndrome—for African American women—as coping mechanisms for overcoming the barriers that racism creates to their success. Both ideologies suggest that Black people must work harder to achieve what European Americans are able to achieve in this country as a result of racism. Though these coping mechanisms may result in financial, career, or educational success, they often take a toll on the individual’s physical health through negative impacts on the cardiovascular system. The individual is often under constant stress as they try to overcompensate for the racial barriers that are placed in their way. Another interesting idea that has been put forth about Black women is the Strong Black Woman ideology which suggests that Black women often feel that they must be independent, resilient, and self-sufficient to the point that they often do not ask for help when needed and are ashamed to demonstrate weakness. They have often taken on the more of the burden of supporting their families than Black men because Black men face so many more racial barriers than they do. The Strong Black Woman ideology often is linked with poorer mental health as these women do not seek out support when they are struggling.
What is one area of ongoing research into the psychology of African Americans that you feel excited about and why?
I am excited about any research that works towards improving the outcomes of African Americans across the board. Right now, I am doing work examining mental health stigma, which is negative beliefs about individuals who have a mental health disorder or about treatment of mental health disorders. Mental health stigma is relatively high in the African American community. I am very interested in research that focuses on the best ways to reduce this stigma because it has such a profound impact on treatment. If there is less stigma, more African Americans would be willing to seek mental health treatment. Then the next step for research would be making sure that there is effective and available treatment.