Why #BlackLivesMatter: Public Health, Police, and Us

By Kelsey Donnellan September 14, 2016

Over a year ago, I stood toe-to-toe with the National Guard in Baltimore. I watched the protests move from peaceful to contentious, and I will never forget the image of the National Guard walking towards groups of families in full riot gear, bullet-proof shields separating us from them. How did we get here? 

I would like to start by first acknowledging my privileges and biases. I am a White, cis-gender, straight woman. I am the first in my family to graduate from college, and am continuing my education through a Master’s of Public Health in Washington, DC. During my undergraduate career I worked for an after school cooking program in a neighborhood adjacent to the one Freddie Gray called home. The night protests began in Baltimore, I was taken by car to my bus stop, because the afternoon before a murder took place in front of our center. I rode in a car out of the neighborhood while the students I worked with walked home on the same streets. I was protected based on the color of my skin, the level of education I obtained, and the neighborhood I called home. 

As I was writing this blog post, the Department of Justice released a 163-page report on the actions of the Baltimore Police Department, which highlights the series of civil rights violations against citizens of Baltimore, particularly Black citizens. Similar reports were completed in Chicago and Ferguson, but have yet to make change in the policing of those communities. How did we get here? 

The truth is we have been there for a long time, the protests and distrust between institutions and Black communities are rooted in systemic oppression and discrimination. These same systems influenced the foundations of public health, which date back to the late 1700’s when the first boards of health were established. The first boards of health focused on quarantine regulations and sanitary practices. Almshouses and Pest Houses were established by the medical community, public health officials, and monitored by police departments. While almshouses provided some medical care, Pest Houses were designed to keep the community safe by isolating the sick. The sick in this case were enslaved African people in Charleston and other ports serviced in the slave trade. People were infected with various diseases on the slave ships due to the horrid conditions and overcrowding. Later in Chicago, during the 1860’s, there were reports of poor oversight by the city physician leading to the escape of people infected with small pox. To prevent people with small pox from escaping, the city responded by stationing police at the Pest House instead of increasing medical care. 

While we no longer operate Pest Houses nor ask police to hold our clients captive, we do participate in systems rooted in discrimination. We, as public health leaders, represent a field that forced segregation of the sick and the healthy, mandated vaccines without health education, and built a response to AIDS for primarily White gay men. We, as governmental program staff, represent a system that legally upheld slavery, segregation, discriminatory voting laws, and policing systems that allows the death of Black people but the disarming of White people. We, as scientists, represent a system of abuse against Black bodies from Henrietta Lacks to the men in the Tuskegee Syphilis Study for the gain of the medical community. 

I represent these systems among other complex identities that have led to violence against Black people, and I need to consider how I uphold these systems of inequality. We need to consider how we uphold these systems of inequality. We need to pivot away from the status-quo by being critical of our own actions and behavior. 

When we talk about communities disproportionately impacted by HIV, do we say blacks or Black people? By saying, “blacks” we are stripping people of their humanity and condensing their identity to their race. When we say Black people, we are validating the person as a person and not a race. I call for us to be critical of our language and how it can empower or perpetuate hate. 

When we interact with clients who identify as Black, do we treat them with the same level of empathy and sensitivity as clients who identify as White? Do we make assumptions about the client based on their appearance? When we interact with clients, we are the representative of systems that have historically hurt Black people. We need validate the medical mistrust among the Black community and work with clients to make them comfortable on their own terms. I call for us to be mindful of our body language, tone, and attitudes when interacting with clients. 

Do we assign value equally or equitably to our clients? When we assign value equally, we continue to ignore the disparities among White clients and Black clients. When we assign value equitably, we acknowledge the disparities and actively work towards reducing the disproportionate service delivery between White clients and Black clients. I call for us to move towards equitable services that meet the needs of all clients and especially those most at need for change. 

To move towards equitable services, I suggest the following: 

  1. Engage with leaders within communities of color. 
  2. Recognize the valid mistrust of governmental public health. 
  3. Identify actionable steps that can be taken immediately, in the short term, and in the long term. 
  4. Practice cultural humility and responsiveness, and seek help from experts on how to develop these skills. 
  5. Learn more about systemic oppression and the impact it has on the health of communities. NASTAD will be sharing articles, books, videos, and podcasts that are social justice focused and provide context to much of our work.