At the 2019 Virginia Oral Health Summit author Tamara Lucas Copeland spoke with Dr. Vanessa Walker Harris, who now serves as a Virginia Deputy Secretary of Health about the intersection of race and health. I encourage you to relisten to their conversation now through the lens of the COVID-19 crisis and the inequities it has magnified. Disparities in health outcomes are not new, but the media coverage given to the stark differences in rates of infection, hospitalizations, and death for people of color as compared to their white neighbors provides an opportunity to engage more people in change efforts. During their forthright dialogue, Tamara stresses that to address racism we must first recognize and name it and she offers steps we can all take to dismantle the systems that perpetuate it.
In addition to the podcast of their conversation, Tamara’s blog below, adapted and originally published on her website Daughters of the Dream, further addresses how decades of systemic racism have led to the significant racial disparities in COVID-19 cases. As we enter our new normal, with dental clinics opening and care delivery models re-defined, Tamara’s blog below reinforces for me the opportunity that is in front of us. We have the chance now to not just recognize and name the racism that exists in our health care system, but address it and together create a system that works for all people.
Equity—Not Equality—In a Post-Coronavirus America
“It’s just not fair.”
You don’t hear that only from your kids. It comes from adult friends and family, too. We all seem committed to a level of fairness that, well, just isn’t fair… not really.
I write this Daughters of the Dream blog as my way of revealing racial truths, at least racial realities, as I see them. These “truths,” like the myth of fairness, might be overlooked if not pointed out.
Many have said that COVID-19 shows no preference for race, gender, or income status. All—any of us—can get it. Well, that’s true, and by that measure, it is fair. However, we now see that susceptibility to the disease and treatment for the disease really is not.
Headlines reveal that race-specific data isn’t always collected. But when it is, it shows more African Americans are dying from the disease. Race-based treatment of African-Americans in the health care system and more deadly outcomes isn’t new. Stories from slavery reveal experimentation on humans that rivals Josef Mengele in Nazi prison camps. In the 1930s, African-American men in Alabama thought they were part of a research project to determine the impact of different treatments for syphilis. But their disease went untreated, and the test continued for decades. Most will know the name of Henrietta Lacks, whose cells, taken without her permission in the 1950s, form the basis of many medical breakthroughs and treatments today. But few will know the name of Sterling Matthews. He was a 60-year-old diabetic, cancer survivor, told in late March 2020 he had pneumonia and sent home by a suburban hospital in my hometown, Richmond, VA. He died a few days later after finally being diagnosed with coronavirus.
Our pain thresholds are perceived as higher, and the value of our lives seems to be lower. This isn’t just historical. It’s not in the past, it’s ongoing. This is now. Is it fair? No.
The perception is the disease affects all equally, but that isn’t true. African-Americans are more susceptible because of a higher incidence than their white counterparts of asthma, hypertension/heart disease, and diabetes, the main conditions that the World Health Organization state place a person at highest risk for coronavirus.
It’s. Just. Not. Fair.
According to many surveys of American values, equality is second only to individualism as what defines us as Americans. That needs to change. Equity, not equality, must become the new watchword for America. We must realize that we aren’t all starting in the same place. One size does not—and never has—fit all.
We now have the opportunity to reshape our country in so many ways. Coronavirus has placed us on pause. What can we do in the post-COVID-19 America that will help to address some of the inequities that exist?
I wish I had answers and not just some insights and a few questions. I know the individualism that America celebrates, that pull yourself up by your bootstraps mentality, isn’t true. Everyone who has achieved a level of success has had help. Sometimes for a single generation, but it is often multi-generational support that has bolstered a family. America must become more focused on helping those who haven’t had the opportunities or who haven’t been able to avail themselves of those opportunities. The solutions are out there. Probably—hopefully—developing in the minds of those with a much higher pay grade than mine. It will take the collective thinking of economists, educators, social scientists, community organizers, and working folks to define the problems and the barriers fully and then craft a new America. It can be done.
The. Time. Is. Now.