Race & Public Health in America

Transcript for Student Voices

Lundy Braun/Eric Jones

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You’re listening to Student Voices, a podcast featuring student-led interviews of Brown University faculty based on the Race & in America panel discussion series, curated by the Center for the Study of Race and Ethnicity in America in partnership with the Office of the Provost.

Eric Jones: I'm Eric T. Jones, a third year doctoral student in Africana Studies, and I'm speaking with Professor Lundy Braun about the recent panel discussion on Race & Public Health in America. Professor Braun is the Professor of Medical Science, Africana Studies, and affiliated faculty member of the Science and Technology Studies Program.

First, Professor Braun, I would like to thank you for your insights you shared on the panel.

One of my takeaways from your talk underscored the high morbidity and mortality of Covid-19 in the Black community. While these statistics were greeted with shock, as we both know, you state something very important. You state “Black communities live such statistics. The experience with Covid-19 is nothing new.” This statement echoes your main point of understanding the importance of history and how it underlines the social order in health, which brings me to my opening question with language.

You discuss that the language of underlining conditions fails to capture the lived reality, and this really reminded me of [W.E.B] Du Bois’ article, “The Health and Physique of the Negro [American]” where he claims Blacks are not suffering from "a racial disease," instead they are suffering from "a social disease.” So with that being said, can you speak on the importance of language and its effect on the biomedicalization of race.

Professor Lundy Braun: Okay. Thank you, Eric, for consenting to have this discussion with me today. Language, like statistics, [is] never simply about decontextualized words. Language is one -- I mean it's just one -- but one important way in which we express ourselves. [It's] how we communicate meaning to others, including how we express racial ideology in daily life, but also in biomedicine. I think this last comment about communicating racial ideology through language in medicine is hard to accept, because our view right now is that biomedicine is pretty much value neutral and not racist in its language. But as we're beginning to see -- I mean really in the wake of George Floyd and many other murders: Breonna Taylor, but the list is long-- biomedicine has been examining the invisible ways in which racism operates, in particularly articulated through language. Language always reflects the context and consequently language changes over time. In the context of race and racism language reflects the racial ideology, which to my mind is exactly, as you were saying Eric, what Du Bois meant when he contrasted the health in Black people as not a racial disease, but a social disease. And we are still struggling with this notion. Du Bois was writing in the late 19th and early 20th centuries particularly about racism in medicine, and he pointed us in the direction of seeing this as a social disease, and we still look at health inequalities, as we'll get to in a minute, as inherent to Black people; that Black people and white people are inherently different.

Eric Jones: Thank you for your answer. My second question really wants to look at the significance of history. I wanted to open up with language just to get us grounded in what's problematic with it, but understanding that this language is rooted in history and it's something that we inherit through our predecessors. And although some scholars will say that there was a break between pseudoscience and modern science in the early 20th century, the question remains, was it a clean break? I'm reminded of an article that we had to read in the class that I TAed for you -- Health, Inequality, and Historical Perspective -- the Professor Evelyn Hammonds/Professor Susan Reverby article where they emphasize the need for an historically informed analysis.

And that reminds me of your article, “Theorizing Race and Racism: Preliminary Reflections on the Medical Curriculum,'' where you highlight a significant challenge for an historically informed analysis; that is, the interpretation of evidence. I would like to quote you at length, because I think there's just so much in this particular quote that really grounds this question I'm going to ask. You state, “medicine locates its claim to authority in its reliance on the value neutrality and objectivity of science," which you did mention. And you go on to state, "not only is quantitative knowledge privileged in medical education, but it also defines what students consider to be legitimate evidence. Humanities and social science disciplines, on the other hand, problematize the assumptions embedded in quantitative knowledge in the objectivity of such truth claims. The epistemological issues raised by scientific claims to neutrality, are also found in biomedical journals whose reviewers, readers, and editors are unfamiliar with other epistemological frameworks.” So I say all that to ask this: why is history important and how do we negotiate an epistemological shift that merges the sciences and humanities?

Professor Lundy Braun: Okay, I think that's a wonderful question that we actually need to keep asking over and over. This article that you quote from was written about medical education. I tease apart what students think specifically in medicine, because they're future providers, they're future doctors, and they're going to have a huge impact on the health of all peoples. But if they see Black health as inherent to Black bodies, they are going to miss the...Their care for patients--Black patients in particular--is going to be, let's say, problematic, even with the best intentions.

Let me just emphasize that most clinicians want to help people, but to help people -- all people -- what more do they need to know? Recently students have been really pushing for history in Medical School. That's coming from the students. We could ask why: what do they think they're going to get by learning more history? But I think the basic thing is the entire society tends to ignore history. When I was in South Africa, people there told me that the younger people didn't want to know about the history of apartheid and were forgetting about that history. So why does it matter? The past shapes the present, as many scholars have written, and the present shapes the interpretation. It shapes the past in a dynamic, dialectical way, so we are always embedded in the past.

But this is also a deeply political question because it forces us to ask: do we want to ignore it -- the past -- or do we want to enhance certain parts of the past -- and we see both these things happening right now. Or do we want to actually learn more history so that we can start to see what is invisible about “how the past lives in the present” to quote Michel [-Rolph] Trouillot. And there is activism around that point as I said.

But the way, as I've just thought about this question over and over and over, is only with history can we analyze the how and the why about why we're in this present, why our society looks the way it looks, and why biomedicine looks the way it looks. Racialized algorithms have taken people by surprise. Then, when you dig in there, it's actually not a surprise at all. So I think I just want to emphasize -- and then we can go on -- [that] only with history can we actually analyze the how and the why.

I guess I'll just make one other point. And again this is the value for all of us to reading Du Bois. Merlin Chowkwanyun wrote a terrific article on “The Strange Disappearance of History From Racial Health Disparities Research” in the Du Bois Review in 2011. What they make a case for -- and it's a very long and detailed article -- is the absence of history leaves the explanatory power of health disparities research deeply impoverished, basically a mishmash of documentation of variables.

Eric Jones: That's powerful. There's so much to talk about in terms of how history is important to our present moment. And going back to Trouillot, as you’ve mentioned, I recall within his book he talks about "the event," right? There’s an "event." There's an historical event that happened, but it's the narrative, how that event is interpreted -- right? -- that matters.

Going to my last question...and I want to ground this with what we're currently facing, that is, Covid-19 and its link to language and history. Considering the importance of language and how it's interwoven with the history, I want to evaluate the lessons this pandemic has taught us thus far. For me, it has revealed the insecurity and uncertainty of public health in medicine. It has also shed further light on the social, political and economic hurdles we face and continue to face in the foreseeable future. I guess my question is trying to point us in a positive direction, even though we're facing a lot of stress and strain, to say the least. Where is hope amid despair, and are you hopeful that we can reimagine something new and move forward in a meaningful way as it pertains to public health and medicine?

Professor Lundy Braun: I think in many ways history helps me reimagine: to see all the people who have struggled to imagine a different world. Even what I have learned over time: I was in college in the late [19]60s; that was a moment of great hope for changing society. People could say we were naive, etc., but we were hopeful, and that idea that we need to struggle for sustaining hope has never left me. I do see it as a struggle to end racial capitalism, and biomedicine is very powerful in how society works. I mean to just go back to the notion of evidence again, when I talk to my students about what evidence they weigh as being more authoritative, they struggle to see history as evidence at all, and these are very open students. So the society by and large wants to move on, and yet we haven't moved on. I find hope in oppressed peoples to not want to accept what...the limited things that a capitalist society has thrown out forever. So I do find hope in the people.

Eric Jones: Yeah, it's such a dark moment, but I think the belief that there's light at the end of the tunnel is important. But I also think what's important is...there's a quote that I learned back in undergrad. The quote went: “when you lose, don't lose the lesson.” I'm hopeful, when all is said and done with Covid-19, that even though there was loss, that we don't lose the lesson behind that loss. And we can actually move forward. Thank you, Professor Braun.

Professor Lundy Braun: Thank you, Eric. Those were terrific questions, and I really appreciate engaging with you.

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Student Voices is a feature of the Race & in America digital publication series developed by the Brown University Library. Our theme music is “see the unseen” by Butter. Explore the series at DigitalPublications.Brown.edu