Racism's Threat to Public Health - a Message from the Dean

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On April 6, 2020, my message to SIU Medicine employees focused on racial inequities in the delivery of health care, racial disparities in health care outcomes, and the overt and implicit systemic racism that lies at the root of these inequities and disparities for African Americans. On that day, using concepts articulated by Anthony Fauci, I wrote: 

“[The COVID-19 pandemic] has shined a light brightly and directly on America’s greatest shame – the inequities that African Americans have suffered and endured for centuries...  Inequities have always existed for African Americans. Over four centuries, inequities perpetrated by systemic and institutional racism have held African Americans at a collective disadvantage, with less chance for a good education, less chance for financial success, less chance for health and wellness, and a greater chance for maltreatment and mass incarceration… This toxic mixture of adverse social determinants of health and inequitable health care is manifested in the COVID-19 pandemic.” 

I pointed out that African Americans suffer COVID-19 infections and die from it at a rate more than twice than the white population. Unfortunately, that dismal statistic continues.

“Stunning. Shameful. Unacceptable.” I wrote, and seven weeks later things have not improved.

Not improved? Things have gotten dramatically worse. Now, more than 100,000 Americans have died of COVID-19 infections. More than 23,000 of the dead are African Americans, an excess of 11,000 over that predicted by epidemiologic calculations. These stats are reported, but we collectively do not seem to care. We can’t see that anything is being done.

And now, a series of events has shined that light even more intensely on violent racism in America. Breonna Taylor, killed when her home was stormed by police hunting for suspects already in custody. Ahmaud Arbery, pursued and murdered by vigilantes. Christian Cooper, threatened by a woman emboldened only because she knew her race would trump his race and the facts. And the most horrid of all the recent events that expose our nation’s deepening racism - the brutal, slow torture and murder of George Floyd that occurred before the eyes of bewildered bystanders. 

One of our colleagues put it this way: “This has become far too ‘normal.’” Yes, these repeated violent atrocities have numbed us, just as we have become more and more numbed by all manner of bigotry, insensitivity, belittling, cold-heartedness and callous, demeaning behavior. We feel anger, but we cannot imagine the pain and suffering that this has caused for millions of people.

We can no longer stand by and idly give meager excuses that tiptoe around the core issues. Health and human life are in our hands. We, at SIU Medicine, institutionally and individually, reject violence and hatred. We reject racism in all its forms, overt and insidious, systemic and implicit, national and local. 

Racism is a threat to individuals, and it is a threat to the health of the public. And, it is a threat to the heart and soul of our nation. We will actively fight all of its ugly manifestations. As healers, we must. And we must teach all of our learners that health care and medicine are much more than that which occurs within the walls of our hospitals, and clinics, and classrooms. We must be in the community, proximate to the people, proximate to the racism, learning and understanding, helping to influence thought, helping to tear down barriers and to build up understanding. Empowering others to rise above the cruelty.

It is time for a new concept in America – equal justice under the law. And equal justice in all of our institutions. Just mercy.

We will make a collective statement that we reject and denounce all violence, bigotry and hatred, and that we will stand up against violence and brutality against African Americans, and that we stand by our African American colleagues and grieve with them and fight for them. 

We will restate and recommit to our pledge to be an anti-racist organization, as articulated in our new strategic plan: “Anti-racism is the active process of identifying and eliminating racism by changing systems, organizational structures, policies and practices and attitudes, so that power is redistributed and shared equitably. An anti-racist organization is one in which racism is actively opposed and in which justice and fairness are actively promoted. SIU Medicine will become an organization that fully embraces and promotes equity and inclusion in race, ethnicity, gender, sexual orientation and socio-economic status; SIU Medicine will identify, address and minimize overt and implicit bias, SIU Medicine will become an anti-racist organization.”

We will engage our partners in the community to amplify the effectiveness of our efforts and become a more powerful voice for action.

We grieve with all the families and friends of the COVID-19 victims.

We grieve with the families and friends, and the greater community, of George Floyd, of Ahmaud Arbery, and of all those who have lost their lives from senseless acts of racism.

We stand beside our African American sisters and brothers. We support you. We will fight for you – and with you.  

Jerry Kruse, MD, MSPH
Dean and Provost, SIU School of Medicine
CEO, SIU Medicine

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