Liberation v Antiracism and Public Health
When George Floyd uttered “I can’t breathe” more than 20 times moments before his murder, that was an expression of Black liberation. It was an attempt to speak to his experience and pain as a Black man under the literal and figurative weight of a system that devalued who he was and what he represented. Derek Chauvin barked back orders to “stop talking, stop yelling, it takes a heck of a lot of oxygen to talk.” Mr. Floyd’s exercise in liberation that day on May 25, 2020 showed us the most abhorrent and vile consequences when a single Black man encounters a single white officer. In the years following his murder, Mr. Floyd has become a venerated figure in the antiracism movement. Yet, we are challenged to find space in this discourse to situate Black liberation.
Millions of Black Americans experience health burdens arising from constraints on their liberation expression that broadly take two forms. First, they may be too overcome with fear to ever speak out against personal encounters with racism or racist practices within their organizations. In some cases, Black Americans may find it easier to implement policies that they find racially unjust to advance their economic interests and safeguard family wealth. The vast racial wealth gap also means that fewer Black Americans have a financial safety net and are less able to resign from a position without financial ruin. Fear can be all-consuming: fear of non-promotion, fear of retaliation, fear of being subjected to a “whisper campaign,” fear of being socially ostracized, or fear of losing employment. Although retaliation for complaining about racial misconduct is illegal, the effort involved in proving retaliation can easily exhaust legal and emotional resources. The effect of suppressing one’s desire for liberation expression can take a mental and physical toil over time, which can be considered part of “allostatic load”. It can adversely impact physical and mental health and result in low self-esteem, depression, internalized racism, or lack of physical care. Although hard statistics on this phenomenon are difficult to find, there are many promising innovations. For example, there exists an allostatic load measure based on specific biomarkers. Research is desperately needed to advance this field.
Others may engage in “covering” behavior in which they present one way at work and another at home. This social practice is not uncommon for marginalized groups. “To cover is to tone down a disfavored identity to fit into mainstream,” Kenji Yoshino begins in his highly acclaimed book, Covering: The Hidden Assault on Our Civil Rights. Covering separates the individual from within. This duality can spill into home life and diminish individuals’ capacity to be fully involved in family and social life or to fixate on employment conditions given the energy to maintain two identities.
The second form concerns the consequences arising from expressing liberation. If you were to ask the Human Resources manager about your organization’s typical response to allegations of racial employment discrimination, they are likely not to tell you. If they did honestly, then you would probably be surprised how organizations – regardless of having a liberal or conservative agenda – will almost certainly mount a vigorous fight against allegations whether with in-house or legal proceedings. Challenging an individual in a position of power, much less an organization supporting that individual’s misconduct, can carry lifelong emotional injury. It is not just in employment situations that should concern public health either.
Communities that express desires for better conditions and resources to meet their needs are often compelled to sustain engagement with policy makers and regulators. These efforts can concern just a single policy issue such as redevelopment plans that cover ten years or more and increase stress and maladaptive behaviors such as smoking. In my community work with public housing communities in Washington, DC, I have seen firsthand the mental health stress that comes with speaking against poor living conditions, displacement, and errant practices. Fear of retaliation keeps many from ever speaking up in the first place. Those who do speak up are often emotionally distraught and upset during public hearings and in private. Many have to disclose personal health information in public Board meetings over several months for issues to be resolved. It seems to me that the more socially and economically vulnerable a population is, the more resources and time it takes for public officials to listen and respond. The public lacks insight into the daily challenges of public housing residents to attenuate the health burden of liberation. Public health should be concerned about this issue and dedicated to offset physiological harm.
Black Liberation v Antiracism
Black liberation and antiracism are synergistic and interdependent - different sides of the same coin. Both must be addressed in tandem if meaningful gains in social reform, including in public health, are to be achieved. Generally, when we speak of antiracism, we call attention to perpetrators of heightened racial violence. This violence can manifest in various forms from bodily harm to structural violence involving social forces that harm certain groups. A framework of antiracism divorced from liberation relies on a set of faulty assumptions. First, antiracism seeks accountability in policy or judicial proceedings and is usually context-dependent, but hardly addresses what happens when interests in and resources for reform wane. The attention in antiracism will inevitably diminish, as social movements do. A major piece of legislation, a guilty verdict, dysfunction or implosion of a major organization, or withdrawal of key figures can signal to the public that justice has been rightsized. Because there is fertile ground for racial violence in the United States, we cannot reasonably expect an end to violence and should seek alternatives for continued improvement.
A second assumption of antiracism is that we should focus our singular attention on the social representation that is embodied in the individual(s) who inflicts violence rather than dual approaches that encompass the victim. Police reform, even defunding the police, and community investment have been the main talking points for antiracism in the aftermath of major officer-involved shootings. No doubt, those are important discussions to have and, in some instances, have resulted in major structural changes. Much of this discourse have failed to account for the social representation within a liberation framework, which seeks to achieve equity through power-, resource-, and information-sharing. In a phrase, it is about telling communities how to get what they want and deserve through all available means.
I recently published an article discussing a counterfactual for the Flint lead crisis. To my understanding, an injunction to prevent a switch to the Flint River was not requested. If granted, a request to enjoin the switch could have prevented the public health crisis while demanding that the Flint government and State of Michigan disclose more information, including its plan to not adequately treat water from the Flint River, through a process of discovery. It would have involved Flint paying to extend its contract with another water authority until at such time that an adequate plan could be put into place. Because antiracism directs our attention to the social representation of the “other,” we miss the victims’ social representation. Liberation seeks to empower and strengthen.
Third, although not the fault of antiracism philosophy per se, antiracism training has become problematic and anti-liberation. Admittedly, I attended only one antiracism training, but I was taken aback by the lack of liberation teaching. Here is what I wrote to the organizer following the training, “Thank you for hosting a session on anti-racism…the framing of anti-racism largely caters to individuals in positions of power outside communities of color. This forms a pattern and practice wherein the power structure is reinforced - that workshop became about their needs, their learning, their being at the center of attention and resources. An African American faculty member in the workshop privately messaged me in support. In response to my remarks, they said, "It needed to be said." The organizer (an African American woman) for the webinar asked me what her office can do to support Black students and faculty following the meeting and requested a meeting…This should illustrate the extent of the problem.”
Many of the arguments in this article are underexplored in the academic literature. Public health must evolve to address several needs – 1) more funding to study how racism affects health through suspended and expressed liberation, 2) mechanisms to support communities engaged in liberation work to prevent the worsening of the health burden, 3) advocacy for greater legal protections for Black liberation expression, 4) integration of liberation throughout funding, accreditation, training models, and clinical practice, and 5) engage Black scholars who are free to express concerns about weakness and opportunities in current approaches.
