Dismantling Structural Racism—Our Role

Wednesday, December 6, 2017

by Rachel R. Hardeman, PhD, MPH, Assistant Professor, University of MN School of Public Health

Keynote Address, Presented to the University of Minnesota 10th Annual Equity and Diversity Breakfast, November 16, 2017

Good morning, everyone.

I am extremely happy and incredibly proud to stand before you this morning. It was six years ago that I first attended the annual Equity and Diversity Breakfast and received the Scholarly Excellence in Equity and Diversity (SEED) Award for my doctoral dissertation work. It is an honor to be back representing the University of Minnesota faculty.

I grew up in this community. In Minneapolis, where black and American Indian babies are twice as likely to die in their first year of life. A community where it was very clear that not everyone had the same opportunities to be healthy. Where by the age of 16, I had spent countless evenings and weekends in the hospital with my Grandmother while she received hemodialysis. I eventually watched her succumb to kidney failure simply because she was tired of dealing with a health care system that didn’t seem to care about her.

I am not here by accident. I am here because of my Grandmother and because of the ancestors whose shoulders upon which I stand. I am here because of my family, whose support and unwavering belief in me has fed my soul and my desire to keep affecting change. I am also here because of the support of mentors who believed in my vision, who created a safe space for me to express my thoughts and ideas and to grow intellectually, and who continue to help me to achieve my goals.

While the mentorship and support that I’ve received along the way has been invaluable, as I reflect on it, I recall that I never had a mentor or professor during my graduate work who looked like me. There was no one to help me to navigate the ins and outs of academia who also shared my lived experience. So, as I considered my career path as an academic, a professor, and a researcher, I could easily have chosen a different pathway, one that may have felt more comfortable and accepting of who I am and what I stand for. But I kept hearing the words of my Grandmother and so many others that paved the way before me… “If not you, then who?” I knew that part of my path must be to change the face of academia. In accepting my position on the faculty in the School of Public Health’s,Division of Health Policy and Management, I became the first African American tenure track faculty member in my department. I don’t, however, wear this status as a symbol of pride. Rather, I wear it as a reminder of how much work we still have left to do.

In my research, I study the impact of structural racism on birth outcomes. Structural racism is the totality of ways in which societies foster racial discrimination, via mutually reinforcing and inequitable systems…that in turn reinforce discriminatory beliefs, values, and distribution of resources. Structural racism is reflected in our history and in our culture. And it is making us sick.

“We’re Sick of Racism, Literally” is the title of an Op Ed recently published in the New York Times. The author describes, among many things, the stress response: “while blood pressure normally dips at night, those who said they’d experienced racism were more likely to have blood pressure that did not — and this has been strongly linked to increased mortality.”

My current research supports this notion. I recently discovered that structural racism is associated with preterm birth (babies born before 37 weeks gestation) here in the Twin Cities. We also must recognize that racism doesn’t have to be experienced in person to impact health — recent studies suggest that the current political climate may play an important role in the health and well-being of many in our communities. My forthcoming work examines if living in a community where there has been a high-profile incidence of police brutality impacts birth outcomes. Sadly, there are incidences in the Twin Cities that offer perfect conditions to study this research question — Jamar Clark and Philando Castile.

My goal as a researcher and professor is not just to document these inequities and injustices, but also to explore and test interventions that solve them. Interventions in my case that dismantle structural racism. Yes, I’ve always been ambitious!

In July 2016, just after Philando Castile was killed by a police officer in Falcon Heights, I was left feeling hopeless. I very quickly realized that, I wasn’t alone in that feeling and as a result, I, along with two colleagues, wrote a call to action to our colleagues entitled “Structural Racism and Supporting Black Lives — The Role of Health Professionals” which was published in the New England Journal of Medicine.

Before I close, I would like to share with you some of this call to action in which we offer four steps that our colleagues (researchers and clinicians) can take to support black lives. I would offer that this call to action extends beyond the health care field and is certainly relevant for all of us in this room today:

  • First, learn about, understand, and accept the United States’ racist roots. Structural racism is born of a doctrine of white supremacy that was developed to justify mass oppression involving economic and political exploitation. In the United States, such oppression was carried out through centuries of slavery premised on the social construct of race.
  • Second, understand how racism has shaped our narrative about disparities. For far too long we have used rhetoric implying that differences between races are intrinsic, inherited, or biologic. These beliefs persist today and it’s incumbent on us to challenge them, especially when we see them contributing to health inequities.
  • Third, define and name racism. We need consistent definitions and accurate vocabulary in order to discuss racism. Armed with historical knowledge, we can recognize that race is the “social classification of people based on phenotype” and that racism “is a system of structuring opportunity and assigning value based on phenotype (race) that: unfairly disadvantages some individuals and communities; unfairly advantages other individuals and communities; and undermines realization of the full potential of the whole society through the waste of human resources.” If we acknowledge and name racism in our work, writing, research, and interactions, we can advance understanding of the distinction between racial categorization and racism and clear the way for efforts to combat the latter.
  • Finally, we must “center at the margins” — that is, we must shift our viewpoint from a majority group’s perspective to that of the marginalized group or groups. Historical and contemporary views of economics, politics, and culture, informed by centuries of explicit and implicit racial bias, normalize the white experience. For example, in describing Philando Castile’s death, Governor Dayton noted that the tragedy was “not the norm” in our state — For me, this reveals a deep gap between his perception of “normal” and the experiences of black Minnesotans.

Centering at the margins also requires re-anchoring our social institutions — including our academic systems — specifically, diversifying the workforce (so I am not the first and only black faculty in my department), developing community-driven programs and research, and helping to ensure that oppressed and under resourced people and communities gain positions of power.

In closing…

Many of you in this room wield an incredible amount of power, privilege, and responsibility and I encourage you to use it. Use it to have a difficult conversation with a neighbor. Use it to ask a challenging question about bias in your work place. Use it to hold your political representatives accountable. We all have an obligation and opportunity to contribute to dismantling structural racism and I encourage you to find the courage and conviction to do so.

Thank You.






"Perspectives" stories are the views and opinions of their authors and do not necessarily reflect any official position of the University of Minnesota.