Addressing Institutional Racism & Health Inequality: My Perspective

By Kiki Zeldes —

by Diana Namumbejja Abwoye

Diana Abwoye receiving an award for academic excellence in her Family Nurse Practitioner program.
The author being inducted into the Sigma Theta Tau International Honor Society of Nursing in 2018.

Covid-19 has affected all aspects of our lives. It has exposed how much the United States is an unequal place for people of color. I will speak here from my own experience. It may not be a reflection of all people of color, but I hope it will help us get the conversation going.

I was born in Kampala, Uganda. The difference between me and other people of color born in the U.S. is that I made a choice as a young woman to immigrate from my home. I did so in an effort to support my family, and in a pursuit to find democracy, justice, education, and equity. Those born in the U.S. did not have this choice; their ancestors did not have a choice. I once lived in a country where almost everyone was black and the only thing we sorted by color was laundry, but here in the United States, I am constantly reminded of how much skin color matters.

For the longest time after I arrived, I didn’t pay much attention to racial differences. I held on to my sense of belonging to a culture I left behind. Today, as a mother of two Black girls, I am constantly worried about how I am going to raise them in this new place I call home. A place where I constantly have to worry about them fitting into a neighborhood, a school, a doctor’s office. I worry about raising my girls in a society that will stereotype them, limit their opportunities, challenge their confidence and make them feel like outsiders. I fear for my black husband and worry about his safety very often.

During my Family Nurse Practitioner training, I learned that African Americans have the highest risk for many chronic health conditions, including heart disease and diabetes, and that African American women are more likely to die during childbirth and from breast and ovarian cancers. The  textbooks we used documented this, but they didn’t explain why these people were at greater risk. Once, during a lecture, I asked why African Americans were at risk for a certain condition, but I didn’t get a response. Later, a classmate commended me for my question but also added, “Have you seen the stuff those people eat? It can clog your arteries.”

Following this conversation, I thought about the shallow, white-centered teaching about race and health disparities, and the necessity of educating students about cultures and lifestyles. I thought about why certain ethnicities make the choices they make and about how, far too often, they don’t have access to the resources they need. Many people don’t understand why people eat what they eat, why they can not afford organically grown foods or are sometimes unable to stay home and make a healthy home cooked meal for their family. In order for us to address health equity, we need to focus on solving the underlying social, economic and systemic racial structures that predispose these people to such lifestyle choices.

My work as a Covid-19 case investigator talking to people in the state of Massachusetts has made me think about where the United States is today. It is a reflection of the past, a past that was built with uneven distribution of resources, a past that was set to privilege only a few in the nation. This matters because after so many years we are still facing systemic racism, racial bias, uneven distribution of resources and social injustice. As I spoke to people with Covid-19, I could hear on the other end of the phone their frustration, their fear, and their exhaustion. While I worried about them going out of their homes and spreading the disease, they worried about getting enough food for their families, finding space to isolate, being evicted from their apartments, losing their jobs and/or getting  deported.

Amidst all this, George Floyd’s murder occurred, sparking protests around the world. Black people have called for equality for so long. How many lives should be lost before we put an end to it? My takeaway from all this is that we as a society need to continue having these conversations; it is long overdue for all white people to listen and take part in them. I challenge all of us to do what we can do about racial disparities and inequity. Ask yourself: how have I used my privilege to support those who are less privileged? How can I set the stage for a better world for the next generation?

Those of us who have children need to ask ourselves questions about how we are raising them. We need to set the stage now and raise our children to accept that it is okay for people to be different and it does not matter how they look; all that counts is the fact that they are human and deserve to be treated and regarded as humans.

I challenge white people to not just be our white allies but to be our white accomplices. White people need to use this moment to decide who they are and who they will continue to be in this world we are all sharing. I challenge organizations not to just post equal opportunity statements and protest signs for publicity, but to get these conversations started in their organizations and create suitable environments for a diverse workforce. Diversity does not come from hiring people of color; it comes through diverse mindsets, an inclusive culture and practice. Schools and colleges should focus on an equitable fundamental education that challenges the status quo of institutional racism and creates opportunities for those who are not privileged. Such environments call for continued conversations about whiteness among students and faculty, in addition to a safe space for them to express themselves.

Together we can change history and create a better nation for all our citizens.

Diana Namumbejja Abwoye is a family nurse practitioner and a member of the board of directors of Our Bodies Ourselves. She translated and adapted “Our Bodies, Ourselves” into Luganda. To read comments in response to Diana’s story, see the original post on Our Bodies Our Blog.