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Racism, structural Racism and a wonderful speaker, Dr. Kimberly Manning


I just heard a talk by Kimberly Manning MD, Associate Professor of Medicine as well as the Associate Vice Chair of Diversity, Equity, and Inclusion at Emory University School of Medicine, department of Medicine at the American College of Physician's virtual yearly meeting. She gave one of the plenary addresses and hers was called "Broadening your life lens, the case for diversity." I almost didn't watch it because I attend this meeting for the concentrated information on how to take care of patients with certain conditions that I get from talks with names like "Pearls for the management of insomnia not to miss." I thought that this was a talk for other people, and since I had studied this subject, maybe not for me. But I watched it anyway. It was great. 

Dr. Manning is a full professor at her institution, which makes her very special. She told us that 0.7% full professors of medicine are black women. 25% of full professors are women and Black women make up about 8% of our population. There is just no statistical justification that I can see for this dismal representation. When I was in training, over 30 years ago, at Johns Hopkins University School of Medicine, centered in Baltimore in a part of town which was overwhelmingly Black, I had no physician teachers who were Black and I can only remember 2 who were women. That seemed normal at the time.

"Every system is perfectly designed to get the results it gets." she quoted (the internet attributes this to W. Edwards Deming, a statistician and engineer who wrote about changing systems and famously about the lenses we should use to see the world in order to improve results. He was an important part of the revolution in manufacturing in Japan that lead to them becoming famous for innovation and high quality, but I digress.)

Our system is racist. Systemic racism means the system is racist, which it is, looking at outcomes. The average black family has $8600 in savings, the average white family has $51,400 per Business Insider. Black unemployment during Covid is 5.4% higher than white unemployment. 40% of prison inmates are Black though only a bit less than 14% of the US population is Black. 

Everyone who is part of the system who isn't actively working to change it is racist, not meaning that they have any particular beliefs but that their involvement in the system that is racist is complicit (Dr. Manning didn't say this, perhaps she was being gentle, perhaps she has a better way of approaching this issue. That's just how I parse it.) 

Some people who are white feel really uncomfortable with the term and would like to drop it, or explain that they are not racist. That's not useful. White people have generally benefitted in terms of economic and social advantages and it is useful to take responsibility for that and work to change things. It is not necessary to point out that it was our dead relatives that directly participated in slavery or enforced Jim Crow laws, or even that they were among the white people who thought that slavery was bad. At this point, if you are white, you reap benefits not available to people of color. If you are my age, you may think about how we felt about white people participating in the apartheid system in S. Africa. As I recall we did not cut white South Africans a break. Also the American south. I recall not having much sympathy for white southerners living in a system that had race separating policies if they weren't actively working to change those. History will probably judge white people like me badly.

People may say that we did fix that, we changed policies after the civil war and now laws don't uphold overt preference for white people. Those laws relating to race were a start and outcomes that are unequal require that we keep working. There is a lot of history, going back to the transatlantic slave trade, and it's going to take ongoing work to move away from racism. Racism is tied up with many other social and economic inequalities, very tricky and very embedded in our day to day reality.

We are in an ongoing situation of wealth disparity, climate catastrophe, lack of opportunity for women. Add your own. Picture yourself in the future, reading a history of our present. Was there something you could have done that you would wish you had done?

I realize that in writing about this subject, I am presuming that I know more than other people and deserve to be heard. Traditionally that has been the privilege of being white in America. It is an important practice for me to work on, to hush and let others talk. In the spirit of that, here is Dr. Kimberly Manning speaking about diversity and inclusion in her experience in Medicine: https://www.youtube.com/watch?v=YsfvDAeMqdI

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