Like many of you, I have experienced the events of the past weeks with a profound sense of anguish. My heart goes out to the families of George Floyd, Ahmaud Arbery, and Breonna Taylor. My heart breaks at the incomprehensible number who have been harmed by racist violence and by the inaction that has allowed those harms to take place.
The images of protesters wearing face-masks in the streets, carrying signs that say “Black Lives Matter,” provide a stark juxtaposition. They contrast the heroic efforts we are all making to protect our communities from coronavirus against our feckless efforts to curb the sickness of racism that has infected America since its birth. In those images is also a reminder that the disproportionate death rate of black and brown people from COVID-19 is no coincidence. It is directly related to the history of racial oppression in our nation.
As a doctor and a policymaker, I often hear the question “what it is about black and brown people” that makes us more vulnerable to the virus? That question infuriates me. The science makes clear how powerfully our experiences and environments shape our biology. It has been clear for decades. Our daily experiences activate cascades of biological pathways. When those experiences are nurturing and enriching, they put us on a trajectory of wellness and resilience. But when those experiences threatening and adverse, they accelerate us down the path of early disease and death. Racist oppression ensures that black and brown children bear a disproportionate burden of dehumanizing and traumatic experiences. Science shows it is sickening them and killing them.
In my book “The Deepest Well: Healing the Long-term Effects of Childhood Adversity” I describe a scene that all too many black parents can identify with. It’s 2014, before our youngest was born. I’m on vacation with my husband and our three boys. We are waiting for a table outside a restaurant in rural Nevada. As I round the corner returning from a quick trip to the restroom, I take in a scene that stops me in my tracks. Two burly Caucasian men with steel-toe boots, shaved heads and dark grey neck tattoos are glowering at our three black boys as they play, unsuspectingly, on a bench in front of the restaurant. My husband, a few feet away has eyes trained on the two men. His fists are clenched. He is clearly in full-blown fight or flight mode.
The twist in this story is that my husband, the father of four black boys, is white. Our two big boys are adopted, their handsome complexions are a darker chocolate than mine, and our two little ones are caramel-brown. Thankfully the situation dissolved when our smiling hostess announced our table was ready. The purpose of the vignette is to invite the reader to understand that the answer to the question “what makes black and brown people more vulnerable?” is, at least in part, our experiences.
As California Surgeon General, I am proud to lead a first-in-the-nation effort to train medical providers to recognize and respond to the ways the experiences of trauma and adversity increase our risk for chronic disease and early death. I have spent my life on this work. What this moment makes clear, however, is that addressing health disparities in America through changes to medical practice alone is not enough. It requires us to address the systemic racism that profoundly hurts our children and our health by immersing them in sustained, dehumanizing trauma.
It is crucial that we, as a society, uncover our ears to the fact that systemic racism, institutional racism, neighborhood segregation and employment discrimination didn’t just come out of nowhere. They are the result of twenty generations of policies and decisions communicating what and whom we value. And it’s costing our brothers and sisters, our neighbors, our friends, our co-workers, and our children their health and their lives. It is our collective responsibility to acknowledge and take steps to mitigate the enduring harms of these wrongs.