Harvard sociologist David Williams offered many ways people can fight back against institutional racism and implicit bias and make a healthier social environment for all people. His suggestions range from little daily acts to big reforms.
- TREAT OTHERS KINDLY: The opposite of what Williams called “the day-to-day little indignities” that African Americans often encounter are daily acts of respect and kindness. “Each of us can be an agent that promotes good health just by the way we relate to others,” he said.
- CREATE STRONG SOCIAL SUPPORT SYSTEMS: Researchers have documented evidence that the discrimination people suffer can be overcome if they are embedded in relationships of social support from family, friends and teachers. Other research shows similar effects for religious engagement and some positive psychological resources.
- SEE PEOPLE AS INDIVIDUALS, NOT AS MEMBERS OF A GROUP: This process is called individuation. Example: We can pledge to ourselves to resist the temptation to put a person into a category when first meeting that person. Instead, we can promise ourselves: “I want to focus on the unique individuality of this person and not assume things about them based on their gender, their race, their age.”
- LEARN BIAS-FIGHTING TECHNIQUES: We can dispatch deeply engrained habits that spring from implicit biases. Prejudice-reducing strategies include stereotype replacement, counter-stereotype imaging, perspective taking and increasing opportunities for interracial contact.
- FIGHT RACISM AT THE TOP: We must confront racism not only at the individual level, but at the level where policies are made and sustained. This means changing rules and regulations and identifying and dismantling the institutional legacies of what Williams calls “The House That Racism Built.” Policy changes need to occur across multiple domains.
- PROVIDE COMPREHENSIVE MEDICAL CARE FOR ALL: Williams pointed to the state of Delaware, where African Americans had a higher incidence of colorectal cancer and deaths from the disease. Over eight years, the incidence rate was equalized and the death rate from colorectal cancer was nearly eliminated. Delaware helped pay for and subsidize detection and treatment.
- ADD LEGAL AND OTHER HELP TO MEDICINE: Disadvantaged people need help in a variety of ways that medical treatment alone can’t address. A Boston program gives doctors the opportunity to refer patients to an array of specialists, including on-site lawyers. This approach addresses matters including unhealthy housing, immigration, income, food, education access, disabilities and family law. Programs such as one in Hennepin County, Minn., reach out to social service agencies to help new Medicaid beneficiaries with such needs as housing, job counseling and treatment for substance abuse.
- START EARLY AND “INVEST” IN CHILDREN: “We know what works, and, (when) invested in our kids, actually leads to improved health,” Williams said. One such success story began in Ypsilanti, Mich., decades ago. Black 3- and 4-year-olds who lived in public housing received in-home tutoring help and advanced preschool education. Forty years later, the people who had received this early intervention were doing much better than the control group in measures such as income, education, savings, home ownership and fewer arrests. “For every one dollar invested in the program, there’s a 17-dollar return to society” in money saved on corrective measures, Williams said.
- THINK PLACE: Place-based solutions can meet a multitude of life’s needs and make for healthy living. Williams offered the nonprofit organization Purpose Built Communities as an inspiring model. The organization’s website says its vision is to “guide neighborhood revitalization by creating pathways out of poverty for the lowest-income residents, and building strong, economically diverse communities.” A map on the website shows 17 programs in 16 cities where the Purpose Built Communities organization is collaborating with local leaders.
—COMMUNITY GRAND ROUNDS TEAM