Learning critical Black history can change white perspectives on racism in health care

Key takeaways

  • Two-thirds of white Americans believe that Black Americans do not experience racism or racial inequities in health care.
  • UCLA psychologists exposed white study participants to the well-documented history of medical-related mistreatment of Black Americans.
  • Subsequently, white participants were more likely to adopt a new perspective and support policies aimed at reducing racial disparities in health care.

Being exposed to some of the many historical incidences of anti-Black racism in American health care can contribute to white peoples’ recognition of health disparities currently faced by Black Americans and lead to their support for policies that aim to create more equitable health outcomes, according to UCLA psychologists.

Their findings are published today in the peer-reviewed Journal of Experimental Psychology: General.

Poorer health outcomes for Black Americans, compared with white Americans, are well-documented in many areas, including infant mortality, life expectancy, hypertension, heart disease and breast cancer mortality. However, 67% of white Americans say they do not believe that racism exists for Black Americans in the health care system.

The researchers sought to determine whether white Americans would attempt to understand racial inequities from the perspective of Black Americans after being exposed to history lessons about Black experiences in health care and whether such “perspective-taking” would lead to greater recognition of racism in health care­.

Kimberly Martin, who conducted the research as a UCLA doctoral student in social and health psychology, and Kerri Johnson, a UCLA professor of social psychology and communication, recruited 1,853 white participants online for two studies.

In the first, the researchers exposed roughly 400 participants to a “critical Black history” lesson that consisted of photographs and captions illustrating health care injustices experienced by Black Americans from the 1800s to the present. The researchers instructed half of them to try to imagine the “feelings, thoughts and experiences” of the Black person who had been mistreated in history, while the other half were simply told to read the information. Afterward, participants were asked questions about how much they tried to “perspective-take” with Black people and about their thoughts and acknowledgements of the existence of racism in American society.

The researchers found that people who reported higher perspective-taking were also more likely to recognize racism in the present day. The finding was similar whether the participant was instructed to try to take on the perspective of the Black person who had been mistreated in history, or whether they did so spontaneously, without being instructed to do so.

For the second study, about 1,400 participants were divided into three groups, with each group exposed to one of three Black history lessons. Participants in the “critical Black history” group were shown photographs and captions, as in the first study. One example told the story of civil rights activist Fannie Lou Hamer, who in 1961 underwent what was to be a routine tumor-removal procedure during which her uterus was taken out by a white doctor without her consent. The caption also included the broader, systemic context of Hamer’s story, as doctors at that time were disproportionately performing hysterectomies on Black women without consent.

Other photographs in this lesson documented stories of harmful, unconsented-to and even fatal medical experimentation on Black people aimed at advancing medical research — experimentation that was supported by medical and broader national and government agencies.

A second group was exposed to a “celebratory Black history” lesson in which photographs and captions focused on the accomplishments of Black Americans in health care rather than episodes of systemic or individual racism and mistreatment. One photograph, for example, depicted Dr. Patricia Bath, the ophthalmologist who invented laser cataract surgery.

The third group — a control group — saw photographs of Black Americans from the 1800s to the present that included no critical or celebratory information.

After being exposed to the history lesson, participants were asked a series of questions about their level of perspective-taking, their recognition of racism and discrimination, and their support for policies that would reduce racism and health disparities in the U.S. health care system.

The researchers found that the spontaneous perspective-taking that occurred in the first study occurred in the second study after participants were exposed to the critical Black history lesson and was much more prevalent than when exposed to the celebratory Black history or the control lesson.

They also discovered that this led to a recognition among participants that there is individual and systemic racism in the present U.S. health care system, as well as to support for policies that promote equal access to health care for Black Americans and educate the public about the public health impacts of racism.

“The findings have far-reaching impacts toward creating an anti-racist society and a health care system that treats patients more equitably,” said Johnson, the study’s senior author.

Surprisingly, their research also showed that certain false biological stereotypes — such as the belief that Black people are more resistant to pain — persisted, regardless of which lesson participants were exposed to.

“There is overwhelming evidence of the existence of racism in health care and the persistence of stereotypes, but with our work, we aim to demonstrate that there could be ways to intervene, reduce discrimination and create more equitable health care outcomes,” said Martin, who is now a postdoctoral scholar at Yale University.

Martin’s research focuses on developing culturally relevant methods and interventions to reduce discrimination and to increase acknowledgment of and support for addressing racial inequities. One of the next steps in her work is to explore how to change the medical school curriculum and requirements for doctors in ways that will lead to better patient interactions, more referrals for needed screenings and treatments, better trustworthiness and, ultimately, a healthier, more equitable society.

Another key takeaway from the research for the field of social psychology and even more broadly is the value of teaching and learning of history, said Johnson, who noted that learning history promotes perspective-taking that is beneficial to society.

“Efforts to silence stories of oppression,” Martin said, “rob people of the opportunity to gain insights and perspective, particularly about oppressed people. Our evidence suggests that with the study of an accurate history of injustice comes increased perspective-taking and broader support for a more equitable, just society.”

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