A Call for the IHP Community to Confront Inequality, Injustice, and Health Disparities

Those reading this column are no doubt as disturbed, dismayed, and disheartened as I am by the seemingly relentless acts of violence in our society, too many of which reflect the persistent racism and injustice that have continued to plague our country – with often devastating impact on people of color – since its founding. It is inconceivable to me that in 2016 we have not yet found ways either locally or globally to achieve a more peaceful, equitable, and just world for all. At the same time, I believe, as President Obama so eloquently noted in his remarks at the memorial for the five Dallas police officers who were gunned down, “we are not as divided as we seem.”

While we cannot solve all the ills of the world, there are things we as members of the IHP community can do to assure a climate of inclusiveness and fairness, one that embraces all who learn and work here and gives each a place and a voice. We, as an institution dedicated to educating health professionals, can equip ourselves and our students with the knowledge and skills to advocate for equality, justice, and inclusion, and to address the inequities in health care that lead to disparities in health among people of color and low income, disparities resulting from long-standing and continuing inequitable access to quality health care.

Our Inclusive Excellence Model encompasses a broad perspective of diversity and inclusion. As an educational community, we espouse a visible and sustained commitment to diversity and inclusiveness; to growing the diversity of our student body and faculty workforce to more closely mirror that of society; to supporting a positive learning and work climate for our students, faculty, and staff; to a welcoming, respectful and equitable campus climate for all; to assuring our graduates are well prepared to provide culturally fluent care to the diverse people for whom they will care throughout their careers as health practitioners; and to equipping our students with the skills to help redress the inequities and unconscious biases in both the education and health care systems. We have made many strides toward realizing these goals, but we also have more to do to ensure our actions more visibly and clearly reflect and reinforce our words.

IHP leaders – beginning with me as president – must be the public voice and be accountable for achieving these professed commitments to inclusive excellence. We must work collectively with our trustees, our faculty and staff, our students, our alumni, and our community and clinical partners to assure that all embrace and act in accord with these commitments. To this end, we must build our internal capacity through education, through dialogue and conversations – even when they are difficult and discomforting – and through our actions and deeds. And we must allocate sufficient resources in support of advancing inclusive excellence to the point where it is embedded as a natural element of all we do. Given today’s climate of fear, distrust, and dismay, this is a tall order, but one I believe we have the capacity and resources to make happen.

Recent conversations with members of our Diversity Council, which I chair, and also with a group of students who courageously came forward recently to express their concerns and offer constructive suggestions, serve as calls to action. The students urged listening especially to those who are marginalized and who have experienced racism and injustice, not only in the wider society but, sadly and regrettably, within the IHP community.

The IHP Diversity Council met last week, and identified several specific actions to create additional opportunities for listening, for respectful dialogue, and for learning – about ourselves and each other – as we seek to foster a more just, equitable, and inclusive climate. These actions will be aimed at strengthening and more clearly formalizing the Institute’s commitments and responses with respect to issues of diversity and inclusion, including responses to incidents of violence and injustice, and will be shared with the IHP community as they are developed. An immediate next step is being led by our Student Services staff – Erin Phair and Kerry Kearns – who will be working with students to form a Student Diversity Council whose purpose will be to represent the student voice and engagement in our efforts to advance inclusive excellence. They also will work with students to identify two or three student representatives to serve on the Institute’s Diversity Council.

The Provost’s Office will offer a September faculty development program titled Embracing Difference in the Classroom to help guide faculty in facilitating classroom conversations on diversity-related issues. And the E. Lorraine Baugh Visiting Lecture program will continue to support a visiting faculty speaker series with an emphasis on diversity and inclusion in the health professions. This fall the program will focus on racial justice, and is open to the entire IHP community.

Our goal in all these efforts is to strengthen our community; take steps to ameliorate racism, injustice, and health disparities; and ensure that our students, faculty, and staff feel welcomed, valued, heard, and supported each and every day – regardless of color, gender identity, sexual orientation, class, country of origin, ethnicity, religion, language, disability, mental health, age, size, or other difference.

As a collective community, we must acknowledge injustice and its devastating impact; confront unconscious bias, in ourselves and in others; speak up when and where we witness evidence of insensitive, unequal, and hurtful treatment; support a climate where all feel safe, respected, and cared for; and move ahead with specific actions to address immediate needs as well as assure that we sustain – and daily live – our professed commitment to diversity and inclusion.

Just this past weekend, the Boston Globe reported that a group of young black men who were “mouthing off” were asked by the MBTA police to disembark. Another young black man who was not with the group was also asked to get off the train, even though he had no association with the group and told the police so. Nevertheless, they repeated that he needed to disembark, and he did so – quietly and obediently. When a white woman in the same car told the police the young man was not part of the disruptive group, it was then – and only then – the police told the young man he could get back on the train. The white woman’s word was good enough, the young black man’s was not. Her Facebook post transcribed her subsequent conversation with him:

“That was because I am black. Wasn’t it?”

I nod. He looks down sheepishly at his shirt and says quietly, “I’m just happy they didn’t hurt me. That would kill my mom. And she is not someone you want to mess with.”

I say the only thing I can think, “I’m so sorry.”

He says, “With all that’s going on in the world I am so scared all the time.”

I cannot imagine what it must be to live in fear that just going about your business puts you at risk of harm solely because of your skin color, especially when it occurs at the hands of those sworn to protect. When these incidents of bias and overt discrimination occur with what seems increasing frequency, or at least increasing visibility, they understandably perpetuate fear, anger, and backlash. At the same time, we cannot broad brush law enforcement and the dedicated men and women who put themselves at risk every day to keep us and our communities safe. We must overcome our natural tendency to cast blame, to lash out, and instead seek to understand the underlying systemic causes of inequality, racism and marginalization for being different, and do what is in our individual and collective power to ameliorate them.

Recently, Dena Simmons, a Yale educator, wrote: “Th[e] work for racial justice should not rest solely on my shoulders or the shoulders of other people of color. This work is all of our work; it is a collective struggle for our shared humanity. Racial equity is a national imperative that requires purging our embodied hate towards blackness [and brownness] and revising the way our country functions. There is no silver bullet response, but that’s no excuse for inaction or silence.”

Action and voice can begin with each of us, here and now – today, tonight, tomorrow – in the ways we show respect for each other, engage in small acts of care and kindness, reach out in friendship and respect for one another, and stand up as the courageous young woman on the MBTA did last weekend when we see acts of injustice and discrimination play out in our daily lives. We must summon the courage and the will, individually and collectively, to do so.

 

Janis P. Bellack

President of the MGH Institute of Health Professions and John Hilton Knowles Professor, and editor-in-chief of the Journal of Nursing Education. She currently serves on the governing boards of Partners HealthCare International and the Center for Medical Simulation (Boston). Jan served as consultant and core faculty member for the Robert Wood Johnson Foundation’s Executive Nurse Fellows leadership development program from 1998-2010, based at the University of California, San Francisco (UCSF) Center for the Health Professions, where she also held a role as a senior fellow from 1996-2012. She is a Fellow of the American Academy of Nursing and the National League for Nursing’s Academy of Nursing Education, and an elected member of Sigma Theta Tau International nursing honor society and the Raven Society, the oldest honorary society at the University of Virginia. She was honored as the 1998 Outstanding Alumnus of the University of Florida College of Nursing, inducted into the Alumni Hall of Fame at the University of Kentucky in 2002, and named the 2007 Distinguished Alumna of the Year by the University of Virginia School of Nursing.

Posted in President's Perspective
One comment on “A Call for the IHP Community to Confront Inequality, Injustice, and Health Disparities
  1. Peter Cahn Peter Cahn says:

    The example of the woman on the train powerfully illustrates how everyday acts of courage can promote racial justice. I also think about the structural conditions that lead to adverse health outcomes for people of color: residential segregation, inadequate schooling, mass incarceration. It’s inspiring to see in the same issue of the Yardarm how IHP students are advocating for systemic changes at the State House.

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