Linnea is a psychiatric nurse for Lakeland Health system. What Harvard sociologist David Williams said in his July 10 morning presentation in St. Joseph, Mich., shook her up and opened her eyes to her own racial prejudices.

Sherine R. Brown-Fraser is chair of the Department of Public Health, Nutrition & Wellness and an associate professor at Andrews University in Berrien Springs, where, among his several degrees from four universities, Williams earned a master of divinity degree in 1979 and where he spoke for his evening presentation. What Williams said underscored for Brown-Fraser the need to look at institutional racism and not just rely on diversity training.

‘Shook Me Up’

Linnea (last names of staff members are not identified in the psychiatric unit) is white, and Brown-Fraser is African American.

“I was struck by just some of the cases he presented – the evidence of this innate prejudice that exists in our society. That just shook me up,” Linnea said. She mentioned specifically the Portland, Oregon, street crossing-street experiment and the average difference of time black and white people had to wait to vote in the 2012 presidential election.

“The fact is, here I am, a comfortable white person going through my life,” thinking about such things as equal opportunity through college scholarships. But she said Williams got her to wonder about “where does this (racial discrimination) come from?

“I used to believe I didn’t have prejudices,” Linnea said. But “there are ingrained prejudices I’m not even aware of in myself. That was a shock and even helpful” as a lesson from Williams’ presentation. It was also helpful to learn “how those little things affect the African American community,” said Linnea, who is now “trying to see the world more from their eyes and their experience.”

She noted the high levels of hypertension and diabetes among the psychiatric unit’s black patients and among black people in the local community at large. She had thought this was “a genetic thing.” Now she is wondering how much could be due to everyday discrimination. (Williams dispatched the idea of health outcomes caused by racial genetic differences. “The dominant explanation for most of the 20th century of racial differences in health was that it was due to genetic differences between the races. The problem is we have come up with precious little evidence consistent” with this view, he said.)

Williams’ emphasis on strengthening the overall community environment through such means as doctor-lawyer collaboration for patients resonated with Linnea. “I’d rather push changes in our community, services and things, rather than a new magic drug that you can take,” she said.

Diversity by Design

Brown-Fraser has a doctoral degree in biological sciences in public health/nutritional biochemistry and teaches courses about plant-based vegetarian nutrition at Andrews University. She once worked as a scientist for the U.S. Food and Drug Administration’s Center for Food Safety and Applied Nutrition. She is a registered dietitian and a certified personal trainer, and her university biography says she is dedicated to eliminating health disparities.

She became department chair in 2014. She set about through hiring to create a diverse department, not just racially, but also in terms of age, gender and other characteristics. This diversity has “a trickle-down effect,” she said.

Hiring the right people can have a great impact on the direction of an organization, Brown-Fraser said.

“If you always have one group of individuals, and you’re intentionally not wanting to hire another group because you don’t think they’re smart enough (or for some other reason), you’re missing opportunities for innovation,” which she said can lead to group think. “If you don’t invite different kinds of people, you’re really not going to harness a great think tank.”

Brown-Fraser said Williams’ presentation reinforced for her the need to look at the institutional form of racism. “We often focus on the individual and not the edifice.”

While she acknowledges that “the individual approach is very, very important,” including diversity training, “I believe addressing the institutional discrimination of racism at an organizational level … is often omitted.” That means setting out “to assess the edifice of our organization,” encouraging “new thinking” and offering training to address the organization’s policies.

Brown-Fraser mentioned Williams’ description of how white physicians can, in less than the blink of an eye, make a treatment decision about a black patient because of embedded, unconscious bias taught by the society at large.

“If physicians were more aware of these biases that happen, it could potentially be of great value,” she said. “Just having the awareness that it exists” is valuable.

She called herself a great believer “in having the dialogue. It may sound simple, but just having the dialogue” is important. “Let’s at least talk about race.”