Considering the dynamics and representations of oversexualized black women

In this blog entry, Trimiko Melancon, author of Unbought and Unbossed: Transgressive Black Women, Sexuality, and Representation, discusses contemporary dynamics regarding race, gender, and sexuality.

A week ago I served as an invited moderator for a college student forum, “Freakum: The Hypersexuality of Black Women.” What the event and the students organizing it sought to explore, in part, were representations of black women. More specifically, how today’s portrayals of black women are images of them as the event flyer and prompt indicated, “oversexualized to the point where a black woman cannot just be portrayed as a woman, but as a sexual being.”

Questions from students ranged from inquiries attempting to ascertain the history of such images and if black women and blacks generally are in control of media representations of their sexuality. There were also discussions of black female pop cultural icons, including mega superstar Beyoncé Knowles and leading televisual personas Olivia Pope (ABC’s Scandal) and Mary Jane (BET’s Being Mary Jane). While the forum was stimulating, and the students were very intellectually engaged, I was struck by how, even in the twenty-first century, their understandings of these dynamics and representations of black women were punctuated by, and articulated through, binaries. Either they expected black women to uphold respectable representations always, or to do the diametrical opposite: be both carefree and, indeed, free to not at all worry about or contend with how they carry themselves or are perceived and, ultimately, portrayed.

Unbought_smIn these very notions of black womanhood and representations—and the still, at times, limiting or narrow roles or characterizations confronting them—reverberates the precise motivation and premise behind my book, Unbought and Unbossed: Transgressive Black Women, Sexuality, and Representation. My book idea actually started during my very own matriculation as an undergraduate English major struck by and grappling with representations of black women in literature. These interests became the groundwork of my college senior honors thesis, doctoral dissertation, and now this first book—a reflection, of course, of the evolution and intellectual maturity of those formative ideas over the course of more than a decade of research, critical thinking, and writing.

In Unbought and Unbossed, I examine post-civil rights representations of black women in literary and cultural texts of the 1970s and 1980s, informed by and produced during consequential political movements: civil rights, feminism, black nationalism, gay liberation, and the sexual revolution. This is a particularly significant era precisely, in part, because of the ways in which black women’s texts of the era embody and embrace a shift in terms of representations. Unbought and Unbossed explores how these moments create a space, cultural and political, for “the transgressive:” representations of black women who transgress and challenge racial, gender, and sexual circumscriptions or mandates that impose particular roles and circumscriptions of female identity on black women. Ultimately, I argue for far greater complexity (and complex understandings) when it comes to black women, representation, and sexuality—especially in terms of what constitutes “woman” and “normativity.” But I also illuminate how certain behaviors/actions operate as strategies in these literary and cultural texts. Sexuality becomes representative of not simply intimacy but, more broadly, of a larger aspirational desire for more complex understandings, renderings, and notions of race, gender, and sexuality as it relates to black (female) bodies. These women exercise their rights to be full citizens, in the racial and sexual sense, reminding us not to falsely mark any, every, and all expressions of black sexuality as perverse, illicit, or pathological but, rather, to afford blacks the range both allowed their white counterparts and reflective of the human (sexual) condition.

Unbought and Unbossed explores various moments, literary and cultural, post-civil rights and contemporary—from Toni Morrison’s novel Sula and Nelly’s rap video Tip Drill and tons in between. It does so to illumine not only the racialization of sex and the ways race, gender, and sexuality intersect. But, it also enables us to better understand the black sexual revolution, representations in the age of First Lady Michelle Obama, and the complexities surrounding black sexuality. And so, just as I asked the students to consider what black sexuality might look like unencumbered by stereotypes and either/or binaries, so, too, does Unbought and Unbossed ask all of us to contemplate this notion, as well as transgress simplistic conclusions regarding black women and black sexuality. After all, it is the twenty-first century and time to allow blacks the full measure of their humanity, sexual and otherwise.

Trimiko Melancon is an Assistant Professor of English, African American Studies, and Women’s Studies at Loyola University New Orleans. Learn more about her work on her website www.trimikomelancon.com or connect with her on Facebook (Trimiko Melancon) or Twitter (@trimikomelancon).

What we know about gender, race, and STEM – African American women

Sandra Hanson, author of Swimming Against the Tide explains that African American women are interested in Science, Technology, Engineering, and Math.

A recent publication (in Cultural Diversity and Ethnic Minority Psychology) by a group of psychologists found that race and gender intersect in understanding Science, Technology, Engineering and Math (STEM) attitudes and participation. The research team was headed by Laurie T. O’Brien and focused especially on African American women. The researchers and subsequent media reports on the findings (e.g. in Inside Higher Ed and The Chronicle of Higher Education) expressed surprise at the high interest and participation in STEM among African American women. Several decades ago I began doing research on African American women in STEM funded by the National Science Foundation (NSF). Although some researchers have not focused on the way that race/ethnicity and gender interact to affect STEM experiences we have known for some time that we can expect the unexpected when it comes to African American girls and women in STEM. Some have argued that because women do less well in STEM and minorities do less well in STEM, there will be a double disadvantage for African American women.

Layout 1The argument of double jeopardy sees race and gender as additive. My findings from a representative sample of young African American women (published in a number of journal articles and in my book, Swimming Against the Tide: African American Girls and Science Education) suggested otherwise. Quantitative data from my sample and larger NSF surveys as well as open-ended questions and responses to vignettes were critical in measuring the young women’s experiences. They loved science. The young African American women signed up for science classes, loved doing experiments, went to science camp, and had posters of scientists on their walls. One young woman said that “science was like opening up a present from your favorite aunt.” My findings provided considerable evidence for the African American family and community as key in understanding this love of science. African American families have always made considerable investment in and had high educational and occupational expectations for their daughters.

African American women have historically combined work and family roles. The answer to young African American women’s high level of interest and participation in STEM does not come from schools and teachers. In fact, the young women in my sample experienced considerable difficulty in the STEM classroom. One young girl reflected the opinion of many when she described the attitude of science teachers –“They looked at us like we weren’t supposed to be scientists.” The young women reported not being called on in the classroom and not being chosen as lab partners. Somehow, in spite of the chilly classroom climate, a disproportionate number of African American women manage to “swim against the tide” and persevere in STEM education and occupations.

Data from NSF show that African American women persist in many areas of STEM at a higher rate than do white women. My recent research on the male dominated area of engineering shows that even here African American women earn the largest share of doctorates relative to men (when looking within race/ethnic groups). In my testimony to the U.S Congress (Subcommittee on Girls in Science) I suggested that we need better teachers, science classrooms, and science textbooks. When young African American women look around them and see white teachers and white scientists in the science textbooks, they do not feel welcome. The considerable agency that African American women show in the context of a white, male STEM culture is encouraging. One can only imagine the increased number of talented African American women who would participate in STEM education and occupations in a more welcoming climate. The major science organization in the U.S. – the National Science Foundation – has recognized the problem and is funding a good number of programs to encourage minorities and minority women in STEM. After all, diversity in science makes for better science.

Celebrating October as Mural Arts Month

This week in North Philly Notes, we celebrate the 30th anniversary of Philadelphia Mural Arts with events all month long.

Each October brings Mural Arts Month, a celebration of public art from the City of Philadelphia Mural Arts Program. This year the festivities include a diverse array of events including a photo exhibition, mural dedications, tours and artist talks centered on the theme of Art Ignites Change. Highlights include a TED-inspired event headlined by artists and activists, a block party with Philadelphia’s hottest DJ’s and a concert series featuring original music inspired by murals.
Phila Mural Arts 30_smThis Mural Arts Month is the capstone to the program’s 30th anniversary year, which also included the publication of a new book about the Mural Arts Program, Jane Golden and David Updike’s Philadelphia Mural Arts @ 30. The new book traces the program’s history and evolution, acknowledging the challenges and rewards of growth and change while maintaining a core commitment to social, personal, and community transformation. It’s a celebration of and guide to the program’s success, and includes essays by policy makers, curators, scholars, and educators.

Here are just a few of the ways you can join us in celebrating Mural Arts Month this year:

Photo Exhibition Reception: The border is an invitation
02 October 2014, 06:00 PM – 08:00 PM
The Lincoln Financial Mural Arts Center at the Thomas Eakins House
1727-29 Mt. Vernon Street (19130)
Mural Arts hosts an exhibition of renowned photojournalist Martha Cooper’s photographic preservation of graffiti and Steve Weinik’s documentation of psychylustro by Katharina Grosse. psychylustro is an episodic painting of massive abstract fields of color installed along passages of the Northeast Rail Corridor between Philadelphia’s 30th Street and North Philadelphia Stations, the same passages where Cooper documented graffiti before psychylustro was installed.

Presented in cooperation with Amtrak, psychylustro has been supported by: The Pew Center for Arts & Heritage, National Endowment for the Arts, John S. and James L. Knight Foundation, The Fierce Advocacy Fund, PTS Foundation, AT&T, Philadelphia Zoo, Joe and Jane Goldblum, David and Helen Pudlin, halfGenius, and The Beneficial Foundation with support for the exhibition publication from the Elizabeth Firestone Graham Foundation. Media Partners: WHYY’s NewsWorks.org, Metro Newspaper.

DesignPhiladelphia 2014: Not My Outside World
10 October 2014, 06:00 PM – 07:30 PM
Caplan Recital Hall, Terra Hall, 17th Floor
University of the Arts, 211 S. Broad Street (19107)

A conversation on abstraction and social imagination with psychylustro curator Elizabeth Thomas and artist and writer Douglas Ashford, Associate Professor at Cooper Union and former member of Group Material.

How can a train ride become a voyage of the imagination? psychylustro, a collaboration between artist Katharina Grosse and the City of Philadelphia Mural Arts Program, is an episodic painting of abstract fields of color along the Northeast Rail Corridor’s natural and built environment that will transform over time as the elements gradually reclaim the space.

Presented as part of DesignPhiladelphia, a Center for Architecture Event. Presented in cooperation with Amtrak, psychylustro has been supported by: The Pew Center for Arts & Heritage, National Endowment for the Arts, John S. and James L. Knight Foundation, The Fierce Advocacy Fund, PTS Foundation, AT&T, Philadelphia Zoo, Joe and Jane Goldblum, David and Helen Pudlin, halfGenius, and The Beneficial Foundation with support for the exhibition publication from the Elizabeth Firestone Graham Foundation. Media Partners: WHYY’s NewsWorks.org, Metro Newspaper.

DesignPhiladelphia 2014: Southeast by Southeast Walking Tour -and- American Composers Forum: If You Could Hear These Walls Concert Series
11 October 2014, 01:00 PM – 05:00 PM
1927 S. 7th Street (19148)

Celebrate Philadelphia’s diverse and creative voices in the Southeast by Southeast Project – a collaboration between the City of Philadelphia Mural Arts Program, the Department of Behavioral Health and Intellectual disAbility Services, and the Refugee Mental Health Collaborative. First, enjoy a guided walking tour and book release to learn about the vibrant Burmese, Bhutanese, and Nepali communities and the community’s stunning public art. Then, enjoy a concert by the American Composers Forum featuring original music.
Presented as part of DesignPhiladelphia, a Center for Architecture Event. Project sponsors: Department of Behavioral Health and Intellectual disAbility Services, Hummingbird Foundation, Philadelphia Refugee Mental Health Collaborative Event partner: American Composers Forum – Philadelphia Chapter Concert funded by: William Penn Foundation – Community Partners Program through a grant to American Composers Foundation

muraLAB: Live, a TED-inspired event
14 October 2014, 06:00 PM – 08:30 PM
WHYY, 150 N. 6th Street (19106)

Philadelphia is a fascinating place, with many assets, a variety of challenges and great ambitions. In order to meet the challenges facing our city, we need to connect with a diverse group of committed citizens and to nourish everything we do with imagination, creativity and collaboration. Together we can transform public spaces and community expectations, using art and design to improve Philadelphia. That is why we are expanding our muraLAB initiative with an exciting new annual event. On October 14th, please join us for muraLAB: Live, where we will hear from an inimate group of unique and creative people who understand, in their own way, the role art plays in improving the civic landscape of cities.

For thirty years, the City of Philadelphia Mural Arts Program has cultivated the work of artists who undertake community-based public projects, developing our own unique blend of social practice art making. muraLAB is the Mural Arts Program’s creativity hub for investigating muralism in the twenty-first century – a think-tank for advancing Mural Arts’ vision for art igniting change in communities, city systems and artistic practice. Through muraLAB, we highlight how other artists and types of institutions – artist collaboratives, museums, city agencies, universities – are developing their own social practice projects and using art to ignite change in their communities, and we build on the last 5 years of redefining, broadening and deepening the scope of our own artistic and social practice. Event partner: WHYY

Philly DJ Mural Block Party
17 October 2014, 06:00 PM – 08:00 PM
13th & Chestnut Streets (19107)
It’s an all-ages block party with live entertainment, food and fun! A line-up of the city’s best DJ’s will provide sounds, alongside the best of Scratch DJ Academy.

Looking at Slum Clearance in the Southwest

In this blog entry, Robert Fairbanks, author of The War on Slums in the Southwest, writes about how religious leaders campaigned for slum clearance in San Antonio and Phoenix.

The War on Slums in the Southwest traces the history of slum clearance and public housing in the Southwest and reminds us of the important role religious leaders had in the campaign to eliminate slums in the Southwest.

In two cities, San Antonio and Phoenix, Roman Catholic priests were the major actors in securing public housing for their cities. Father Carmelo Tranchese served as priest at Our Lady of Guadalupe on the San Antonio’s west side within its principal Mexican barrio characterized by a Works Progress Administration report as “one of the most extensive slums to be found in any American city.” Even before Congress approved the Housing Act of 1937, the priest campaigned for federal help in clearing the slums and the erection of needed public housing for his congregation. He worked hard to publicize the ill effect slum housing had on the city and finally, after teaming up with Congressman Maury Maverick, lobbied directly with Eleanor Roosevelt to secure the much needed slum clearance and public housing projects for his Mexican parishioners, as well as other needy groups throughout the city. The mayor rewarded him for his efforts by appointing him the chair of the city’s initial housing authority.

War on Slums_smIn Phoenix, Father Emmett McLoughlin, a Franciscan priest took on a similar role in securing public housing for that desert city. The headstrong priest arrived in Phoenix in 1934 to serve as one of several clergy in St. Mary’s Catholic Church, the oldest in the city. Working with Mexican Americans and especially with African Americans in the city’s slums southwest of the downtown proved an eye opening experience for the priest. There he found unfathomable slum conditions that were in the words of one observer   “fully as bad as any he had seen in the tenement districts of New York.” African Americans often lived in wooden shacks, trailers sheds, and abandoned stores without water or sewage. His compassion for those slum dwellers led him to lobby Phoenix civic leaders for slum clearance and public housing. By publicizing those horrendous conditions and emphasizing their relationship to sickness, crime and bad citizenship, he convinced city fathers to support his effort to secure public housing for Phoenix. When state legislators final passed the necessary enabling legislation allowing Phoenix to form a housing authority, officials named McLoughlin chair of that body. As a result of McLoughlin’s efforts, Phoenix civic leaders embraced slum clearance and federal public housing by completing three projects before the end of World War II.

Even though both priests experienced physical threats and were slandered by slum landlords and others fearful of the public housing program, they were major warriors in the war of slums in the Southwest. Clergy played significant roles in other southwestern cities public housing efforts too. Almost every housing authority in the Southwest included either a Catholic priest, Protestant clergy or Jewish rabbi (and often several) on its initial housing authority. Such stories remind us that those who are passionately committed to responding to the plight of the poor could and did make a difference in the booming cities of the Southwest.

We’ve Got a Book on That!

This week in North Philly Notes, a rundown of recent news articles that relate to topics in Temple University Press books.

The Meaning of Emancipation Day in the Opinionator column of the August 4, 2014 issue of the New York Times

Korb writes about abolitionist writer and former slave Harriet Jacobs, who published Incidents in the Life of a Slave Girl.

Envisioning Emancipation_smJacobs was featured in Envisioning Emancipation: Black Americans and the End of Slavery by Deborah Willis and Barbara Krauthamer. The authors quote Jacobs about fleeing her North Carolina master in 1842, and making her way to Brooklyn:

“What a disgrace to a city calling itself free, that inhabitants, guiltless of offence, and seeking to perform their duties conscientiously, should be condemned to live in such incessant fear, and have nowhere to turn for protection. This state of things, of course, gave rise to many impromptu vigilance committees. Every colored person, and every friend of their persecuted race, kept their eyes wide open.”

Willis and Krauthamer write that activists like Jacobs, “portrayed themselves as intelligent, empowered, sensitive, and dignified women.”

Another New York Times piece, Bright Passages, Along the Northeast Corridor, published on July 24, celebrated the Philadelphia Mural Arts Program. The article showcased the five-mile stretch in Philadelphia that features, what the article described as  “Christo-esque installations of seven enormous works of art by the Berlin-based visual artist Katharina Grosse, entitled, ‘psychylustro'”

Phila Mural Arts 30_smJane Golden, Executive Director of the Philadelphia Mural Arts Program for 30 years, co-edited Philadelphia Mural Arts @ 30, with David Updike, an editor in the Philadelphia Museum of Art’s publishing department. Their book showcases the results of 21 projects completed since 2009 and features essays by policy makers, curators, scholars, and educators that offer valuable lessons for artists, activists, and communities to emulate. Philadelphia Mural Arts @ 30 traces the program’s history and evolution, acknowledging the challenges and rewards of growth and change while maintaining a core commitment to social, personal, and community transformation.

In other local news, Timothy Cwiek reported on SEPTA (Philadelphia’s transit agency) denying union workers same-sex marriage benefits in the Philadelphia Gay News on July 31.

Cwiek writes, “Due to an impasse with union representatives, SEPTA’s management only recognizes the same-sex marriages of its non-union workers for the purpose of workplace benefits.”

Out in the Union_smMiriam Frank’s recent publication, Out in the Union: A Labor History of Queer America, chronicles the evolution of labor politics with queer activism and identity formation, showing how unions began affirming the rights of lesbian, gay, bisexual, and transgender workers in the 1970s and 1980s.

Frank provides an inclusive history of the convergence of labor and LGBT interests. She carefully details how queer caucuses in local unions introduced domestic partner benefits and union-based AIDS education for health care workers-innovations that have been influential across the U.S. workforce. Out in the Union also examines organizing drives at queer workplaces, campaigns for marriage equality, and other gay civil rights issues to show the enduring power of LGBT workers.

 

 

 

 

 

 

 

 

 

Inclusion in the Creative Economy?

This week in North Philly Notes, Tarry Hum , author of Making a Global Immigrant Neighborhood, writes about the re-branding of Brooklyn.

New York City Mayor de Blasio was elected with a mandate to address the city’s deepening crisis of income and wealth inequality. Mr. de Blasio’s 2013 victory was echoed across the country as progressive candidates won mayoralties in cities such as Boston and Seattle. In light of federal inertia, the political will to tackle the troubling persistence of poverty and a diminished middle class has shifted to local municipalities. The first six months of Mayor de Blasio’s administration has been defined by important achievements in universal pre-K, paid sick leave, and a municipal ID. Moreover, Mayor de Blasio has stated that his approach to economic development will be premised on creating opportunities for all New Yorkers in the city’s high growth sectors including the technology industry which is essential to NYC’s creative and knowledge economy.

Making a Global Immigrant_smAn example of the events that are taking place to engage in a public dialogue on New York City’s economic future took place last week at a half-day conference titled, Onramps of Opportunity: Building a Creative + Inclusive New York, with NYC Comptroller Scott Stringer and NYU-University of Toronto Professor Richard Florida, the “rock star” author of The Rise of the Creative Class. Presenters described how the spatial geography of New York City’s creative economy is increasingly centered in the industrial waterfront neighborhoods of Brooklyn and Queens where factories and warehouses are retrofitted, wired, and modernized to accommodate tech, media, entertainment, and artisanal manufacturing. Almost a mantra, conference attendees were told repeatedly, “every future job is a tech job”. Tensions between the creative class and neighborhood gentrification were alluded to as several presenters emphasized the need for affordable housing. However, it’s clear that meaningful inclusion extends beyond the provision of affordable housing as evidenced in the Extell Development Company’s project which will have separate entrances for tenants of its luxury and affordable housing units.

IstanbulThe re-branding of Brooklyn as an epicenter of creativity, innovation, and artistic production has achieved international success. On a recent trip to Istanbul, I was astonished by the prevalence of Brooklyn branding in clothing and cafes. Numerous Brooklyn neighborhoods such as Williamsburg, DUMBO, and Fort Greene are exemplars of the clustering of skills and talent and urban amenities such as bike paths, parks, and good coffee shops that support a creative economy and the lifestyle preferences of the creative class. The potential of this economic revival was recently explored in the PBS NewsHour clip “Could Brooklyn hipsters help save the middle class?”

The revitalization of Brooklyn may be the ultimate test for Mayor de Blasio’s vision of an inclusive urbanism. Acknowledging Brooklyn’s Sunset Park neighborhood as a nexus of the human and physical infrastructure necessary for equitable economic growth, Mayor de Blasio announced the formation of a Jobs for New Yorkers Task Force in front of the Brooklyn Terminal Army along Sunset Park’s waterfront. Heavily immigrant and working poor, Sunset Park’s Latino and Asian residents are largely concentrated in low paid service jobs. Sunset Park still retains a sizable number of garment factories that continue to rely on immigrant women workers. As Professor Florida described, these are the people that pour our coffee, take care of our kids and elderly parents, clean our homes, and make our food – jobs so essential to a creative city that Professor Florida extolled these workers as the “lifeblood of the city”. As one of New York City’s few remaining industrial neighborhoods, Sunset Park is now facing the challenges posed by a growing artisanal and creative economy. According to a recent New York Times article, the neighborhood’s extensive industrial building stock is being refurbished to accommodate a new Soho. Examples of tech and artisanal firms that now call Sunset Park home include MakerBot which manufactures 3-D printers, the internationally known Jacque Torres chocolatier, and the world’s largest urban rooftop farm on a former federally owned military warehouse. Even the Brooklyn Nets want to be in Sunset Park and are planning a 70,000-square-foot training facility with a rooftop terrace to enjoy the waterfront views.

deBlasioBATThe question of inclusion in New York City’s creative economy is essential to the future of neighborhoods like Sunset Park. Framing the afternoon’s discussion, Professor Florida stated that building an inclusive economy “will require all hands on deck” to formulate a new approach to economic development. Political will is just one of the necessary ingredients – policies that support unionization, affordable housing, living wages, worker cooperatives, workforce development and placement in jobs with avenues for economic mobility, and meaningful engagement in city planning and economic development decision-making are also essential. Working class, immigrant Latino-Asian Sunset Park is ground zero in testing the development and implementation of “onramps” for an inclusive creative city.

Do you want an American nurse?

This week in North Philly Notes, an interview with  Catheters, Slurs, and Pickup Lines  author Lisa Ruchti  from Al-Jazeera America‘s July 3rd morning news program. [She appears at the 2:00 minute mark in the video link].

 

In addition, we repost Elijah Wolfson’s July 3 article from Al-Jazeera America‘s website that features Lisa Ruchti.

The doctor won’t see you now

Patients in American hospitals often get away with asking for caregivers based on race

Tonya Battle had been working as a nurse in the neonatal intensive care unit (NICU) of the Hurley Medical Center in Flint, Michigan, for 24 years. Her employment record was spotless — by all accounts she was one of the most knowledgeable and capable care providers on the NICU floor. Even so, it wasn’t so surprising when, in the fall of 2012, one infant’s father asked to speak to Battle’s supervisor: Health is extremely personal, and no matter how skilled a health care provider, there will be times when communication with a patient breaks down. It’s common for a patient to ask for another doctor or another nurse.

What was shocking, however, was the note posted on the department assignment clipboard the next day: “NO AFRICAN AMERICAN NURSE TO TAKE CARE OF BABY.”

Here’s how the incident unfolded, according to allegations made by Battle in a lawsuit that followed: After she had finished her shift the day before, the father had come to the charge nurse (Battle’s supervisor) demanding that no black nurses attend to his (very sick) infant girl. To punctuate his point, he rolled up his sleeve to show off a swastika tattoo. The charge nurse, Deborah Herholz, then called her boss, the nurse manager Mary Osika, to ask what she should do. Osika said to reassign the baby to another nurse.

A staff meeting followed, in which the NICU nurses were told that Hurley Medical Center had decided not to allow any African-American employees to take care of this particular baby. The note was posted on the assignment clipboard for everyone to see.

The next day, Osika called Battle at home to inform her that the father’s request would be granted. Later that day, Battle reported to work, where one of her co-workers showed her a photo of the offensive note (which had since been removed).

Battle would go on to sue Hurley Medical Center for employment discrimination, settling out of court for an undisclosed amount, and with Hurley agreeing to hire an “employee advocate” whose role would be to forestall similar misadventures in the future.

It’s unclear how common these types of experiences are; there have been no major studies on the issue, so advocates and policymakers have had to rely on anecdotal evidence, the few isolated stories that leak out of the hospital wing and into the press. But many believe Hurley represents the norm and not the exception — that discrimination of this kind is endemic to the health care system.

The ‘open secret’

“I think it happens a lot,” said Julie Gafkay, Battle’s attorney. “I have 20 plaintiffs in the last year who have been subjected to this type of discrimination.” According to Gafkay, after Battle’s case was made public, dozens of other health care workers (nurses, social workers, home health aides, etc.) reached out to her with similar complaints.

Some situations were even more outrageous than Battle’s. In one case, the plaintiff is a human resources employee who says she has direct knowledge that an African-American nurse was fired under false pretenses; the real reason for the firing, she alleges, is that a patient had made the request that no African-Americans care for him.

It’s an “open secret” that “patients routinely refuse or demand medical treatment based on the assigned physician’s racial identity, and hospitals typically yield to patients’ racial preferences,” wrote Kimani Paul-Emile, a professor of law and biomedical ethics at Fordham University, in a 2012 study published in the UCLA Law Review.

So why aren’t more people outraged? Racism in health care settings tends to be much more insidious than the type of racism that would, say, make it onto the nightly news. Patients aren’t screaming racial slurs in the ER or spray-painting derogatory signs on the sides of hospital buildings. They often won’t even say outright that they don’t want a black doctor.

“Patients know it’s not PC” to directly request a white doctor, said Paul-Emile. “They come up with different ways to do it. I talked to this one doctor who said there are these older ladies who will say, ‘You know, I want a Jewish doctor, I just think a Jewish doctor is better.’”

Lisa Ruchti, a professor of sociology at West Chester University and the author of the book “Catheters, Slurs, and Pick Up Lines,” agreed. “Patients who want to fire their nurses based on race say things like ‘I want an American nurse,’” she said.

And hospitals comply. Health care providers are trained to be so patient-focused that even when they feel a request is amiss, many ignore their qualms — whatever the patient wants, the patient gets. In another of Gafkay’s current cases, two plaintiffs allege that an elderly white woman was being treated in the rehabilitation facility of a nursing home when she began to express fears that an African-American man was coming into her bedroom at night to “touch” her. The facility decided that, for the good of the patient, no African-Americans — male or female — would be assigned to her care, and it issued a directive to its staff saying as much. One female African-American nurse was even questioned for coming into the patient’s room at night, and suspended during the questioning.

“[The organizations] are so patient-focused,” said Gafkay, “that they ignore the civil rights of their own employees.”

Not just nurses

At particular risk is the nurse-patient relationship, which Ruchti believes is regularly informed by racism. In providing what Ruchti called “professional intimate care,” nurses are already at risk of being seen more as hired help than as health care professionals. And racist beliefs can exacerbate that misconception. “There are lots of examples of nurses of color being mislabeled as housekeepers by patients even when they are obviously doing nurse work — symbolically demoting them, if you will.”

But it’s not just nurses. Dr. Meghan Lane-Fall treats cardiovascular patients in the surgical care unit at the Hospital of the University of Pennsylvania.

“All of the things that are taught in medicine about being a care provider are to really not think about yourself or your characteristics,” Lane-Fall said. “Your gender and ethnicity are, in theory, erased when you walk through the doors of the hospital.”

But in reality, as an African-American woman, Lane-Fall is often subjected to racially based judgments.

“I can be walking the hallway wearing a white coat,” she said, “and someone will think I’m the janitor, and I’ll think, ‘Is that because I’m black?’”

Lane-Fall recently wrote about an experience caring for a coma patient. On the third day during which the man was under her care, she happened to be in a room when the nurses were changing his gown. Spread across his chest was a tattoo: 3- to 4-inch-high lettering spelling out the words “White Power.”

At that moment, Lane-Fall recalled how she had felt nothing but coldness from the tattooed man’s family; until now, she had thought nothing of it. Now it seemed sinister.

She thought: “Oh, you’re not just this nameless, faceless person taking care of a patient; you’re a black woman who has all these other characteristics that affect the way patients see you.”

Race concordance

On the flip side, Ruchti said nurses of color she spoke with told her that patients of color sought them out on purpose. And in fact, research suggests that your health outcomes can improve if you and your physician have what’s called in the literature “race concordance.”

A Johns Hopkins study published in 2002, for example, found that, when given the choice, patients would choose doctors of their own race. And, when treated by same-race physicians, the patients reported higher satisfaction. The results cut across all races and ethnicities. The study, led by Thomas LaVeist, was one of the first of its kind.

But others soon followed. A 2005 study published in the Annals of Family Medicine found that many African-Americans and Latinos believed strongly that the health care system was racist — and that they preferred to have same-race doctors as a result.

And more recently, a 2010 study published in the Journal of the National Medical Association confirmed the previous findings: Black patients were more likely to feel that white doctors were giving them subpar care compared with black doctors and, therefore, preferred same-race health care providers.

Some will even argue that choosing a doctor of the same skin color is no different from choosing a doctor of the same gender. Many women don’t feel comfortable talking to a man about gynecological issues; is it that much of a stretch to imagine an African-American man feeling he can be more open and honest about his lifestyle and behavior with an African-American doctor?

All things being equal, if you offered me a black provider I’d probably choose that.

Dr. Meghan Lane-Fall

Preferences like these aren’t driven by ignorance. Lane-Fall got her undergraduate degree in molecular and cell biology from the University of California, Berkeley, her master’s in health policy from the University of Pennsylvania and her M.D. from Yale. She’s about as well educated as a human being could ever be. And yet, “all things being equal, if you offered me a black provider I’d probably choose that,” she said, adding that she’d assume someone from a similar background would know more about her.

Because of these complexities, the legal issues here are legion. The 1964 Civil Rights Act prohibits discrimination based on race, gender, national origin or religion in public accommodations and in any place that receives public funding. On the face of it, this would appear to mean that a patient could not make race-based requests for nurses and doctors. After all, pretty much every health care institution receives some federal funding, whether directly or in the form of public health insurance reimbursements.

But, as Paul-Emile argues, those provisions of the Civil Rights Act are actually meant to preclude institutions from “prohibiting individuals from enjoying the benefits that the institution provides” — and by accommodating a patient’s preference, “you are actually allowing that patient to enjoy the benefits” provided by a federally funded hospital.

And, in fact, that is what is happening in the real world. A 2010 study, for example, showed that patients across the board will often make race-based requests with regard to their health care provider — and that providers will often accede to these preferences. In that same study, Dr. Herbert Rakatansky, the former chair of the American Medical Association’s Council on Ethical and Judicial Affairs, is quoted as saying, “In a life-threatening situation, you would have to abide by a patient’s request.” In other words, there may be both a legal and an ethical imperative to accommodate racial preference in the hospital.

The positive preference

None of this, however, is meant to justify racism.

Paul-Emile has highlighted an important legal distinction between doctors, who can usually decide themselves whether to treat a given patient or not, and nurses and other health care support staff, who are assigned their charges. She argues that hospitals run afoul of the law when they reassign African-American nurses at a patient’s request, no matter the potential health benefits.

Gafkay, the attorney in Michigan, pointed out that all her cases involve an “organization validating the discriminatory request” — a much different situation, since it puts nurses in the precarious position of being unable to express themselves for fear of organization retribution.

Second, while it may be both legally and ethically acceptable for a patient of color to seek out a doctor of color, what about a white patient who seeks out a white doctor?

The legacy of years of racial discrimination has led to a disproportionately low number of African-American doctors. A 2009 Health System Change report, for example, found that the physician workforce was about 74 percent white and 4 percent black, while the U.S. population as a whole was 69 percent white and 12 percent black during the same year.

And one major study a few years back had patients go to doctors presenting with the exact same symptoms (which suggested cardiovascular disease), identical in every way except race and gender. Across the board, African-American women received substandard treatment and poor diagnoses.

Studies like this suggest that it’s entirely rational for an African-American patient to feel wary of the medical system. And that, Paul-Emile believes, is what should drive a physician’s decision whether or not to accommodate a racial preference.

In other words, though it may be difficult to discern a patient’s motivations, the goal of health care professionals should be to distinguish between a positive preference, in which patients are seeking better care, and discrimination, in which patients are just expressing racist beliefs.

And even then, Paul-Emile said, accommodating these positive preferences is far from ideal.

“I don’t think this is a solution,” she said. “I think it’s a stopgap measure until we get to the more fundamental issues that are driving this. The medical profession must instead increase diversity among providers to encourage tolerance and understanding of other cultures, and expand cultural awareness at all levels of practice and training to enable providers to interact more effectively with their diverse patient populations.”

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