React and Respond

Letters: Spring 2021

Racism and Public Health, Covid-19, and More

The two biggest public health crises of our time—racism and COVID-19—dominated our Fall 2020 issue. Led by guest editor Keshia M. Pollack Porter, the racism and health section used data-driven stories to share the health impacts of structural racism on Black women, men, and communities. Our faculty offered their perspectives on the problems and solutions. And we offered new takes on COVID-19’s evolving science and its effects on everyone from a long-hauler to Navajo Nation residents.

 

Thanks, [guest editor] Dr. Porter. I’m exhausted, too. I’m a man of color (from Black American and Filipino American parents): I’ve had to work twice has hard as my white, male counterparts all of my life to get the same level of respect and the opportunities for advancement. And the thing is: My skin color is what God gave me. I’m insulted by those who allow racism to exist. I’m exhausted. And I’m hopeful with you. —Gregory Fant

I received your magazine this afternoon. I read it cover to cover this evening and simply could not put it down. I thank you for the candid, honest, statistic-driven reports. —Denise Thienes

The term “structural racism” implies an intentional disregard for a particular race. This may have been racism 50 years ago but not in today’s world. If there is systemic racism, it is maintained by politicians, not the general population. —John Caprice

Keshia M. Pollack Porter, PhD ’06, MPH, vice dean for Faculty, a professor in Health Policy and Management, and guest editor of the Fall 2020 issue’s section on racism and health, responds: The systemic oppression of Black people and people of color due to racism is real and very present today. The recent murder of Daunte Wright in Minnesota is another egregious example how racism kills. Structural racism is not maintained by “only politicians.” Racism is perpetuated by the general population, and stems from policies and systems that have systemically oppressed Black people and people of color. More than 400 years ago, nonwhite people were placed into an artificial hierarchy because of the color of their skin, which according to Isabel Wilkerson in her book Caste, “helps determine standing and respect, assumptions of beauty and competence, and even who gets benefit of the doubt and access to resources.” These inequities are real and oppressive. Everyone reading this letter can support structural racism (without air quotes) by actively promoting or doing nothing, or you can choose to be anti-racist and dismantle it.

Thank you for the article [“Hope in a Racialized Society”]—although the fact that we continue to require such articles is egregious. I am so sorry. My favorite current political comment is printed in large letters on a building in Toronto: White silence is violence. —Heather Sampson

Is all of this society’s fault or do the families and individuals responsible for those families have to take a large measure of the responsibility? My wife and I had two kids because we knew what we could afford and that it was our job to give them guidance. The same cannot be said of those in your study. Tell it like it is. —Ross Morrison

Sarah LaFave, MPH ’18, PhD candidate, Johns Hopkins School of Nursing, responds: We’re not all running the same race if some of us face systematic, compounding barriers on the way to “good decisions” and some of us don’t. Racist policies have resulted in Black neighborhoods lacking access to transportation, grocery stores, jobs, and fair lending. It’s widely reported that Black Americans have high rates of outcomes that are linked to unhealthy behaviors, like uncontrolled hypertension, diabetes, smoking, and obesity. However, the Bloomberg School’s Roland Thorpe, PhD, MS, and colleagues have found that when we compare people of different races living in the same neighborhoods, the racial disparity in these outcomes evaporates—highlighting the role circumstances play in decisions and behaviors. Anti-racism doesn’t work toward a future in which each person’s outcomes are the same regardless of their decisions and behaviors; it works toward a future in which each person has equal opportunity to make decisions that lead to better health.

While I agree that there is rampant racism in the country, Black people are not the only ones affected here. The other races should be included every time there is talk on racism. Because I belong to one of the other races, I also feel the inequality every time and everywhere. Sometimes I need to dress up to get out in order to show that I am a decent person and not a burden to the government and the society as a whole. I am a professional who came into this country and who pays my own expenses, pays for my children’s education from my own sweat and tears. We are a hardworking race, and we do not depend on the government for our existence. —M. Cortes

You seem to be in a bubble thinking that only people who are African American have health disparities. I am surprised at the narrowness of your point of view. How about getting outside of Baltimore and traveling around the U.S. and see what is going on, everywhere? 

I have a friend who immigrated here legally and is from Poland, and is not able to afford the very expensive Obamacare. This is also something (the expense of Obamacare) that I do not see reflected in this magazine. Obamacare meant having no more than access to Medicaid in many cases. You have not reflected that in any material I have seen. —Susan Lepre, PhD

It’s wonderful that water is finally available [on Navajo Nation] ... but sad that it took such a catastrophic pandemic to do something that should have been done long ago. —Gina Toth-Becker

I have a difficult time figuring out how our health care system prioritizes life, period. The Black, brown, and impoverished community is no longer depending on the social services, local church, and schools in the community. That system has failed them over and over again. If you want to reach the poverty level persons go to a shelter, food bank, or thrift store. This is the new downtown in America. —Stephanie Brown-Montford

Thank you for the comprehensive detailing of how [the understanding of] COVID-19 has evolved. I continue to be perplexed by the resistance to mask wearing, social distancing, and even hand washing. I have concluded that because we do not see people falling down dead in the streets with foaming mouths and blood running out of their eyes and ears, the impact of an unseen virus is not real to them. —Shirley Bryant

Thanks for putting [“The Long Haul”] out there! More of these stories need reporting to put an actual face on this terrible disease. Way too many folks do not think COVID-19 is real, or that if they get it, it will be no big deal. If you survive, you may be haunted by its vestiges for a long time, if not forever!  —Gregory Norkis

Thank you for your research and attention to this pandemic, even before it existed! Two worries: One, why is society bent on giving vaccines to those 65+ when in fact those over 60 must recognize their mortality and society should prepare them and itself for their/our deaths? 

Second: This contact tracing idea is first of all impossible due to technological factors and the amount of time that elapses, and also people like me who vigorously opt out of it. We have to be vigilant about our civil and human rights, and the right to gather with others unmonitored by the government is one of those basic rights we have in this country. If we go back to surveillance and tracking peoples' contacts we will be back in the McCarthy era toward which we are already heading. —Yvonne Farrell

I’m a rare U.S. adult with a serious birth defect from my mom taking thalidomide when she was a missionary in Rhodesia. I think tests on pregnant woman need to wait until it can be proven— over time—that the vaccine won’t hurt a developing baby. —Lois Corrigan

I spent 30 plus years working at a county health department as a public health nurse. I loved working on programs funded by the CDC like the tobacco control program. Working on the clean indoor air law was so exciting. We got it passed and what a difference it has made! Now I teach a community health nursing clinical at a local college.

Unfortunately people do not understand what public health is or its value. it is proactive rather than reactive. It saves money. Education on what it is and what it does is so important. Everyone needs to do their part. —Victoria Lucarini