Structural and interpersonal racism is blocking aspiring midwives of color from joining the workforce at a critical time for the health of pregnant and birthing people.
The U.S. has alarming disparities in maternal health that will likely intensify following the erosion of reproductive health access in states across the country. Midwifery care and care from providers who share a racial and cultural identity with their patients are proven to improve outcomes for parents and babies. Yet an overwhelming majority of midwives in the U.S. identify as white.
People also frequently cited the lack of midwives of color to teach and mentor them. Barriers to becoming a midwife were greater among people with lower levels of income or education.
This survey of aspiring midwives of color across the U.S. is the first study exploring a wide range of barriers to entering midwifery education.
“Aspiring midwives of color are motivated to provide care in their communities to counteract the effects of racism on maternal and infant health,” says Renee Mehra, Ph.D., ACTIONS postdoctoral fellow and first author on the paper. “We need them in the workforce, yet the cost of midwifery education and the lack of racial and ethnic diversity in the profession are standing in their way.”
“We must act now to train, diversify and deploy a midwifery workforce that can tackle the persistent maternal morbidity and mortality that disproportionately plagues Black and marginalized people in the USA today,” says midwife Jennie Joseph, Founder and President of Commmonsense Childbirth.
The structural and interpersonal racism that impacts people’s ability to become midwives also motivated them to want to provide this care. The strongest motivating factors in the study were providing racially concordant care in their communities, reducing racial health disparities, and their own prior experiences of discrimination in healthcare settings.
To help aspiring midwives of color meet their goals, the researchers suggest solutions including providing funding for students of color for tuition and other living costs, creating a pipeline for midwives of color by enrolling more students of color, and supporting and hiring more teachers of color, and opening more midwifery schools, especially in Historically Black Colleges and Universities.
At its core, nursing is an inherently humanitarian career path: The job can’t be done without compassion and a willingness to advocate for patients, by any means necessary. As a nursing professional, you’re also likely to be unwittingly thrust into the political arena, treating both injured protesters and law enforcement officials following a violent clash.
Nursing Professionals on the Front Lines of Social Justice
As such, for modern nursing professionals, the lines between individual health care and politics often collide. Along with treating injured protestors at medical facilities and hospitals, many nursing professionals are volunteering their time on the front lines. In many cases, nurses at protests simply show their support to the cause.
But, if a nonviolent protest escalates into a dangerous situation, having a nursing professional on the scene is vital. You may be able to provide emergency care, of course, but even more importantly, nurses on the front lines of protests have a unique insight into police brutality. This sort of information is an invaluable tool for fueling the conversation about systemic racism in the health care industry as well as everyday life.
So, once you’re aware of the current landscape of protests and the tactics used by police, however, what will your next steps be? There are various ways that you can get involved and take a stand against police violence, on both a professional and social level. Here’s what you need to know about the consequences of police violence and how you can help protesters, no matter if you’re on the front lines or working in the ER.
Racism, Police Brutality, and Public Health
The COVID-19 pandemic had already altered daily life around the world long before May 25, 2020. That night, George Floyd lost his life in the hands of law enforcement officials, and U.S. citizens flooded city streets in response. These widespread protests didn’t dissipate overnight — in fact, they only grew larger, and the violence that escalated in several cities left health care workers in a dire situation.
Already under the threat of the pandemic, nurses from all walks of life suddenly found themselves working to balance public health considerations with the reality of police violence. As a patient advocate in these politically charged times, you should thus be aware of the unique needs of your patients. Victims of police violence and brutality, for example, may fear for their safety.
Discretion is a key factor in situations involving institutional racism and police brutality. Further, the provider-patient confidentiality agreement is especially vital if a protestor in your care wishes to pursue legal action against a law enforcement official or organization.
Patient Privacy in the Modern Health Care Landscape
Privacy is an important consideration in 2021, as so much of our everyday lives can be easily found on the internet. Protesters further put themselves on display, and the plethora of camera phones, as well as professional cameras wielded by the media, make anonymity nearly impossible. If you participate in a protest, whether as a curious observer, an active participant, or in a care-related capacity, it should be expected that your image will be captured on camera.
For example, even masks and costumes couldn’t hide the identities of countless right-wing protestors who stormed the U.S. Capitol on January 6. Thanks to the internet and social media, identifying the Capitol rioters was a simple endeavor. While this sort of facial recognition may represent a slippery slope scenario, at least where personal privacy is concerned, the tech proved crucial to holding the rioters responsible.
In the age of telehealth, patients should be afforded more privacy considerations than the protesters, yet various challenges exist when it comes to protecting patient information. To ensure that you’re properly adhering to patient privacy laws, as well as protecting vulnerable patients such as victims of police violence, you must take every possible precaution when collecting, accessing, and storing patient data. You may also want to stay up-to-date on relevant laws and HIPAA regulations, which can change without warning.
There’s No Place for Violence in a Caring Society
As long as police violence remains prevalent, the minority nurses of the future are likely to face unprecedented challenges while on the job. Whether you find yourself in a position of mentor or you’re working directly with patients injured during a protest, your voice is powerful. In the wake of a global pandemic and continued racial disparity, nurses may be inspired to stand up for their patients and actively address police violence, for the sake of both public health and social justice.
Unfortunately, racism and gender inequality still exist not only in our country at large, but also in the nursing field. Because she saw this in anesthesia, Wallena Gould, EdD, CRNA, FAAN, founded and is the CEO of Diversity in Nurse Anesthesia Mentorship Program.
Gould took time to answer our questions. What follows is our interview, edited for clarity and length.
Fred Reed, DNP, CRNA, who has mentored many nurses of color interested in Nurse Anesthesia.
The homepage of the Diversity in Nurse Anesthesia Mentorship Program (DNAMP) states that only 11% of nurse anesthetists are people of color. Why is that? Why hasn’t there been more diversity in these positions?
Honestly, it stems back from decades of graduate nurse anesthesia programs accepting all white cohorts with only one or two nurses of color in each cohort. Also, contributing to the lack of diversity in the nurse anesthesia profession is the historical treatment of Black nurses at the turn of the century. In the early 1900s, until late 1940s, professional nursing associations did not include members of color just based on race. The American Association of Nurse Anesthetists (AANA), founded in 1931, included Black CRNAs into the membership in 1944.
In addition, nursing schools including nurse anesthesia programs were segregated until the late 1940s. One of the historical nurse anesthesia programs that consistently accepted diverse cohorts with faculty that mirrored the community since the Jim Crow Era was the Harlem School of Anesthesia founded by Goldie Brangman, CRNA, MEd, MBA. Founded in New York City in 1951, it lasted for 36 years. Brangman would later become the first and only Black Nurse Anesthetists who was elected as President of the AANA in 1973.
The emergence of diverse nurse anesthesia faculty started in the 1990s and has increased in small increments in the 124 graduate programs. In addition, contributing to the 11% of Nurse Anesthetists of color, is the lack of exposure or encouragement for nursing students of color to pursue Nurse Anesthesia at Historical Black Colleges & Universities, Hispanic Serving Institutions, and Tribunal American Indian Nursing Schools.
There is also gender inequality in nurse anesthetists. Does this mean that more nurse anesthetists are male than female? If so, why does this disparity exist? What has caused it?
According to the American Association of Nurse Anesthetists 2018 Profile Survey of Nurse Anesthetists, there were 52,000 CRNAs in the country with 59% of female and 41% male providers. Male nurse anesthetists were accepted into the membership in the 1950s, into what was a predominantly female profession. There was a stigma of male nurses in the profession from 1950s—2000s.
Today, more men are entering the profession, but still have a majority of female nursing school cohorts. Also, men are pursuing more specialized careers such as nurse anesthesia with the addition of military male nurses entering the profession.
Why did you establish DNAMP? What did you want to accomplish?
As a nurse anesthesia student enrolled in La Salle University in Philadelphia, I had an individual class assignment in the form of a poster project. My focus was to find out the racial and ethnic composition of the nurse anesthesia profession. In addition, I noticed that the six nurse anesthesia programs in the Philadelphia area did not have one full-time faculty teaching in the programs and only a few students of color in each program.
I was able to retrieve demographic statistics from the AANA and polled the Philadelphia nurse anesthesia students from each program. The data from the national statistics mirrored the Philadelphia programs, which demonstrated a severe lack of diversity in nurse anesthesia.
I approached one of our faculty members who taught regional anesthesia, the late Dr. Arthur Zwerling, DNP, CRNA, DAAPM, about my poster and my urge to do something about it. Dr. Zwerling encouraged me to attend the American Association of Nurse Anesthetists Annual Conference in Boston. As a senior nurse anesthesia student, I attended the conference as suggested.
On the first day of the conference, I met Goldie Brangman, CRNA, MEd, MBA (retired), spoke with her for a moment, and knew my purpose was going to make attempts to achieve diversity and equity in the profession.
Today, the non-profit organization, Diversity in Nurse Anesthesia Mentorship Program has mentored more than 510 nurses of color to successfully matriculate into 74 graduate nurse anesthesia programs. We are able to extend the pipeline to diversify the nurse anesthesia profession with a second initiative of a Diversity CRNA HBCU and Hispanic Serving Institution School of Nursing Tour. Lastly, we started our newest initiative with a Diversity Advanced Practice Doctorate Symposium with a collaborative effort of doctorate prepared CRNAs, Nurse Practitioners, Nurse Researchers, and Nurse Midwives to encourage nurses of color to pursue a doctorate and build a body of work.
How can the nursing community at large be an ally or offer support to BIPOC nurses who want to get into anesthesia?
Deans of Nursing serving at predominantly white institutions, HBCUs, Hispanic Serving Institutions, and Tribunal American Indian Nursing Schools can intentionally hire CRNAs of color as full-time, part-time or adjunct faculty. They can also invite CRNAs of color to classrooms to speak to nursing students about nurse anesthesia or teach didactic courses. This includes hiring CRNAs in doctorate-prepared nurse anesthesia programs and affording opportunity to be promoted in rank and publish in nursing peer-review journals. This need to be a national effort to make a profound impact in the trajectory of a diverse profession with accountability.
How does mentoring help assist and encourage more BIPOC to get into this facet of nursing?
For many nurses of color, myself included as a first-generation college graduate, we have been motivated, but just need proper direction in career trajectory. I was a registered nurse for eight years before enrolling in a graduate nurse anesthesia program. So, if CRNAs of color can mentor diverse nurses and nursing students prior to their enrollment into a graduate nurse anesthesia program, students will have the support needed to complete the graduate program successfully.
Is there anything else that nurses need to know regarding racism and gender inequality in anesthesia?
In many nurse anesthesia programs, nurse anesthesia students of color experience social isolation, microaggressions, and in some cases, racism as one of the few in their own program in clinical and or in the classrooms. Nurse Anesthesia students need to be very familiar with student policies and in certain cases, should direct any inequities to the Director of Diversity and Equity Officer for any concerns.
Bankert, M. (1989). Watchful care: A history of America’s nurse anesthetists. New York
Carnegie, M. E. (2000). The path we tread: Blacks in nursing worldwide, 1854-1994. 3rd (eds.). Sudbury, MA: Jones and Bartlett Publishers, and National League for Nursing.
American Association of Nurse Anesthetists (2018). AANA 2018 Member Profile Survey. Park Ridge: IL.
Black Lives Matter. These three words have been used countless times in protests and in the media. As a result of the protests, more people are talking about racism and how it affects people who are BIPOC (Black, Indigenous, and People of Color).
Many nurses have experienced it. We interviewed three Black nurses to listen to their experiences with racism, learn how to begin conversations about it, and how allies can help.
Shantay Carter, BSN, RN, founder of Women of Integrity and best-selling author of Destined for Greatness, and nurse of more than 20 years, encountered racism back in nursing school. She recalls that some instructors would “try to wean students of color out of the program.” “I had instructors accuse me of cheating on tests or tell me that I would never become a nurse,” says Carter. Early in her career, she says, “I had patients say that they didn’t want a colored nurse taking care of them…I have had patients call me the N-word or threaten to hit me….I also experienced medical providers speaking down to me because they assumed that I am dumb.” Carter also got asked, “Are you the nurse?”
Bianca Austin, RN, BSN, CCRN, has been a nurse for 19 years. She works at an inner-city Level I Trauma Center as an intensive care nurse and is also a Major in the Army Nurse Corps, U.S. Army Reserves. Austin recalls an instance in which she and three other nurses, all dressed alike in navy scrubs, were waiting for their assigned rooms. The pod leader made the assignments based on having three nurses on duty. She had to be told that Austin was a nurse, even though she was dressed like the other nurses and wore a badge with her credentials.
Glenda Hargrove, BSN, RN, owner of Pill Apparel, has been a nurse for 11 years. She says that once a patient didn’t want her as their nurse because she is Black. Another instance occurred when she was the only Black nurse working on a unit and also the only nurse who was never invited to after-work staff outings. “At first, I tried to brush it off—until even the new nurses were invited, and I was not,” she says.
We asked all three nurses to weigh in on their experiences with racism and how to start the conversation.
If nurses experience racism, what would you suggest they do? How should they react?
Carter: “In situations where the patient is being really disrespectful, I have asked another nurse to care for that patient. As a nurse, I don’t have to be subjected to or tolerate someone’s ignorance. I also make sure to know the policy when it comes to escalating a situation to management. Knowing my rights as a nurse and employee of the institution that I work in is very important. If you encounter racism, I strongly recommend that you make your manager aware and HR if necessary. Racism and any other forms of discrimination should not be tolerated at any institution.”
Austin: “Use it as a teaching moment. Always be gracious.”
Hargrove: “There is really no easy way to answer this question. Racism has different types—it can be overt or covert. As the nurse, we have to always remain professional because like Michelle Obama said, ‘When they go low, we go higher.’ In some medical spaces, there is no one else who looks like you or even believes racism is occurring. As nurses, we are taught to advocate for our patients, but when experiencing racism, you have to essentially advocate for yourself and your right to practice in a racist-free clinical setting.”
How can nurses start the conversation about racism—and this may be different with patients, coworkers, and facility management? What steps should they take to make sure that if racism occurs, it doesn’t continue.
Carter: “As nurses, we have the power to create change. In order to have a discussion about racism, the hospital, community, and country has to be willing to talk about implicit bias, and system oppression. Joining an employee resource group or (BERG) is a great way, to encourage employees and leadership to come together to address the issues that are affecting their employees and finding solutions to make the workplace a better, more diverse, and safer environment for all. There also have to be policies in place to address those issues and have training on Diversity & Inclusion as well as on Implicit Bias. The culture and tone have to be set by the hospital leadership. Racism is something that can’t be tolerated or accepted.”
Austin: “The steps to take to make sure that racism is stopped is to not let an opportunity pass by to educate someone. Kindly let the person know the offense and explain why you were offended. They would tell us if we said something to offend them.”
Hargrove: “Nurses must start the conversation about racism by acknowledging the African-American nursing pioneers. Every nursing student learns about Florence Nightingale, but the majority have no idea who Mary Mahoney is. She was the first African-American Nurse to work professionally in the United States in 1879. When I started the brand, Pill Apparel, the mission has been to educate and acknowledge Mary Mahoney and her historic contribution to our profession.
“If racism occurs the only way to make sure it doesn’t continue is to NOT ignore it. Don’t let racism be the ‘elephant in the room’ but acknowledge it in order to learn from it and prevent it in the future.”
How can the community at large be an ally or offer support to BIPOC nurses in these situations?
Carter: “The community at large can be our allies by calling people out on their racist behavior towards others and standing with them in solidarity. BIPOC nurses would appreciate their friends and colleagues to stand up for them. We have to come together as one in the face of adversity. Just because you are not a BIPOC nurse, doesn’t mean you can’t fight against what’s morally and ethically wrong.”
Austin: “The facility I work for makes annual statements that they encourage diversity. It is a major player in the community with many business alliances. I would like to see more recruitment of BIPOC nurses, starting in high school. I believe the University and the hospital could improve enrollment and employment of BIPOC nurses if they start at that level, and the community could offer resources such as money, opportunities for shadowing, and help with preparation for nursing school.”
Hargrove: “We all know the difference between right and wrong. Martin Luther King Jr. said it best, ‘The ultimate measure of a man is not where he stands in moments of comfort and convenience, but where he stands at times of challenge and controversy.’”
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.