Discussing racism, inequality, and the impact this has on our health has crashed into the mainstream; but it’s a conversation that is getting confusing, particularly for those who have never needed to invest in understanding these issues. We need to get the conversations right. How we discuss these issues matters greatly with regards to public understanding, in preventing an increase in racial tension, and importantly, in securing change.  

We have opened up conversations about slavery and colonial history and where the racial hierarchies that exist today are rooted. We are talking about the post war treatment of West Indian and Asian migrants; the values and lives of people represented in statues across the UK, and about what structural racism is. Hopefully, 2020 will mark a modern awakening to the extent and impact of racism on everyday life for people. Despite the fear of covid-19, the Black Lives Matter protests around the world have given us hope for change.  

We are at a turning point in western society and we need these conversations to be wide ranging and inclusive; but in a society heavily influenced by social media, are we at risk of missing a wider range of essential narratives?

Social media enabled a video of George Floyd’s murder to go viral, widely exposing a vicious enactment of structural racism. However, social media also creates greater challenges in providing clear, measured information, and factual reporting.  

Much has been written about the disproportionate impact of covid-19 on ethnic minority populations in the UK and US. We must ensure that data is reported openly and transparently and not masked by political perspectives or reporting in the media. Rigour, transparency, and inclusiveness in the practice of scientific and social science research is vital. How findings are discussed, translated, and communicated is equally important for public understanding.  

The covid-19 pandemic has shone a light on many aspects of societal (dys)function and the dynamics of privilege, deprivation, and health inequalities. Emerging data suggest that there are multifactorial and complex reasons behind the impact that covid-19 has had on ethnic minority populations. New research findings, including data published via preprints, are being reported in the press on a daily basis.  Reckless or insensitive reporting of research may have detrimental repercussions on public understanding. 

Racism as a root cause of poor health is structurally, contextually, and scientifically informed; it may live well in academic discussions, but is less well translated to the general public.  Narratives that highlight lived experiences of adversity and structural inequity that the public can connect with may help.

The conversation on racism also requires open and honest discussions. Institutional racism is often not just about obvious racism, or actions that people can see and hear. Institutional racism is often subtle; it is also about how structures and systems function and how we all uphold a social contract that has embedded prejudice and racism (not only white people uphold this; where it is related to gender, not only men uphold this). We can’t call it out because we can’t always see it and what we feel isn’t always tangible, clear cut, and can’t be definitively proven. We all need to recognise the holes in society’s structure (e.g. of prejudice, fitting in, status, career progression) that we agree to fall in and our own complicity. 

Attempts to encompass diversity have come under many guises, e.g. equal opportunity measures (anonymised forms we all send when we apply for a job), diversity agendas, or even more boldly positive discrimination has led structures to appear as if they are inclusive and ethnically diverse. Such measures can single out races, enforce difference, and camouflage the need to actually understand racial stereotyping.

We compromise a “fight” against institutional racism if we only focus on how not be racist or solely on our own personal behaviour.  A conscious move towards anti-racism is welcomed, but we all need to dive deep to understand our own conditioning and what equality means.  

Conversations that involve narratives of lived experiences from an array of people representative of the UK’s ethnic diversity, that cross intersections of poverty/privilege, gender, religion, and other societal dimensions, are needed. 

Keerti Gedela, is a Consultant Physician at Chelsea & Westminster NHS Foundation trust, Chief Investigator UTAMA project, UK-Indonesia Joint Partnership Infectious Diseases and Honorary Senior Clinical Lecturer, Imperial College London.  

Much of her research focuses on addressing health inequalities, in particular for marginalised populations at-risk and living with HIV. 

Twitter @DrKeertiGedela

 

Competing interests: I have read and understood BMJ policy on declaration of interests and have no relevant interests to declare.