Identity and Inclusion during COVID19

like many people my age

i grew up watching a tv show called mr

rogers neighborhood

and the theme song of that show started

with the words

it’s a beautiful day in the neighborhood

however in 1968 when that first show

aired

there were many neighborhoods not

singing that song

because the jim crow era laws that

mandated racial segregation

made it such that the neighborhood in

which you lived determined the life that

you had

the golden rule tells us to treat your

neighbor as yourself

but it doesn’t tell us who you should

consider your neighbor or that you

should ignore the people that aren’t in

psychology there’s a phenomenon that

people call the familiarity principle

put simply that means that people tend

to be more comfortable

with things that they’re familiar with

therefore jim crow era laws that

mandated racial segregation

exacerbated an already problematic

societal structure

that made it such that people did not

get to know each other because they

weren’t around each other

but that was 50 years ago so therefore

we should think that

the neighborhood in which you live now

should have no bearing on the impact of

the covet 19 pandemic

but unfortunately the neighborhood in

which you live

has more of an impact on your survival

than you may even know

i first want to start with getting you

more familiar with my story

my family moved to the states from

nigeria when i was young

both of my parents were physicians but

they had to redo their residency in the

states when they got here

so they did so at johns hopkins

georgetown and howard university

we then moved to indiana where i went to

elementary school and junior high

before i attended high school at a

boarding school in western massachusetts

called deerfield academy i then went to

stanford university where i was on the

captain of the track team

president of my class and graduated with

honors

before matriculating to the university

of michigan medical school

and matching into the department of

orthopedics at yale

i went on to get a master’s degree from

notre dame was appointed to the saint

joseph county indiana board of health by

pete boutige

and then did a family medicine residency

in south bend before going back to

michigan

to be on faculty in the departments of

family medicine and physical medicine

and rehabilitation

as a physician i can appreciate the

level of privilege that i have

however i do know that that level of

privilege changes

because even though i have all of these

degrees on the pedigree

if you know nothing about those i know

that people still just see me

as a young black man whether i’m driving

in my car

trying to pay with cash at a convenience

store or going for a run

no matter how long my white coat or how

visible my stethoscope

i know that there are still some people

that are not going to see beyond the

color of my skin

it has become brutally obvious to me

that the perceptions other people have

of me

are based more on their perceptions of

what neighborhood i belong in

and less to do with the intersectional

framework with which i see my own life

now you may think that that level of

privilege

and the life that i lead doesn’t impact

things at all but once again i tell you

that today

we now see that the covert 19 pandemic

has had a disproportionate impact

on communities of color all over

now the world health organization

describes the social determinants of

health

as the conditions in which people are

born live work

and grow those are the conditions that

are responsible for these health

inequities

these health inequities which are the

unequal uneven

and unfair factors that lead to the

determination of your health

national data have shown that the covet

19 death rate

is six times higher in communities that

are non-white

when compared to communities that are

white

a colleague of mine dr malika fair

recently talked about the fact that

these social determinants of health

are the reasons and the differences

between the health that we see in our

populations

now i just recently had a conversation

with a group of my students

about the tuskegee experiments of

untreated syphilis in the

african-american male

which happened all too recently in our

history

those are the reasons why people still

have a mistrust for the health care

system

because in those experiments the

national health service

intentionally withheld treatment and

diagnosis of syphilis

for the black men that were enrolled in

that study

now if we want to consider death the

ultimate example of a lack of health

then the recent deaths of george floyd

ahmad aarberry

and brianna taylor should be a striking

example of the fact that

black people are not valued equally as

others in our country today

now after those conversations about

tuskegee a lot of my students left

discouraged

wondering how they were ever going to be

able to dismantle the structures

that had been built upon long before

they came here

but in order to change the culture of

all of these institutions

we must first start by changing

individuals

and that is precisely what a group of

university of michigan medical students

are doing

with steer hd steer hd stands for

students

teaching educating and evaluating to

reduce health disparities

we have partnered with walgreens and

omron health to deliver blood pressure

cuffs free of charge to communities in

our area

as well as teaching them about

educational practices to manage their

blood pressure

each individual has an ability to make a

difference and to change the cultures

and the structures that we are in

now the disabled community is another

one that has been disproportionately

marginalized for quite some time

the describes certain populations of

disability

as having an increased risk of being

affected or

being unintendedly and not known to be

affected by this pandemic

individuals with physical mobility

problems that are not able to socially

distance well because they rely on other

people’s care

people with intellectual or

developmental disabilities that may not

understand things like washing your

hands

and then people that that that may rely

on other people

people that cannot communicate and

address people and tell them that they

have these things

because they cannot see people’s faces

because they’re deaf and everyone is

wearing a mask

now people with disabilities and with

chronic health conditions

have already been long marginalized they

already felt as though their lives

weren’t valued before this

and now they fear going to the hospital

because they think that when they get

their care is going to be rationed

in favor of saving a life worth living

now this has a silver lining however

because due to the familiarity with

inaccessibility of our world

the disabled community is keenly aware

of how to create solutions to problems

by our ability to then adapt to any

environment

i often tell a story that that a man

told me about his son

he said his son was in kindergarten was

colorblind

and his homework would say color the

circle blue

he used to ask his son’s son how do you

get your homework done

it says color the circle blue but you’re

color blind

and his son looked back at him with this

perplexed look and said

dad i never use crayons that aren’t

labeled

now this is just one indication of the

fact that the solutions to problems that

we see

are sometimes much easier than we would

know especially when we involve the

people who were impacted

by those problems in the first place

now we then ask the question who is

actually impacted by the problems that

we see today

that goes back to the question of who

you think your neighbor is

now if you think that perhaps your

neighbor you may know someone

you may know someone and if your

neighbor’s house is burning down you

feel like that impacts you because you

know them

you feel like that impacts you maybe

because you may even love your neighbor

or that may only impact you because you

then fear that your house will be

burning down next

i didn’t fully understand the plight of

the disabled population

until seven years ago when i myself dove

into a pool

and broke my neck paralyzing me from my

chest down

thrusting me into this world of

disability and then instilling in me the

conviction

to then approach the intersections of

disability and race

to realize the implications that those

intersections have on life

this neighborhood that i now live in

this neighborhood that i now understand

the things that others are going to

even though had you asked me before i

would have thought that i was treating

them as my neighbors

i would have thought that i understood

the things that they were going through

but i did not and not because i had some

intentional desire

to exclude them but because i just did

not know the needs that they had

sit in front of you here today in a

standing frame wheelchair

that has allowed me to do medical

procedures and surgeries that has

returned me to getting access to the

world of medicine that i love

it is with this simple solution that

i’ve been able to then return to this

world

and be able to participate in a way that

i once used to

now people often wonder how one

individual or one group

can create any difference in this

extremely difficult situation that we

see ourselves in

but both of these pandemics covet 19

and racism have demonstrated to me that

institutions that have created these

rules

are only built upon the individuals that

have the power to move the needle

right now a group of medical students

all across the country

are demanding change they are reaching

out to their institutions and saying

that the time for change is now

they’re saying that we must dismantle

the structures of institutional racism

and segregation that the foundation of

medicine and healthcare has been built

upon

in order to eliminate race-based medical

practices

in order to create anti-racist

curriculum for their patients

for the students for the faculty and the

staff

and in order to demonstrate that we need

to create a culture

that is intolerant of any type of

prejudice

i must admit that prior to me having

that accident seven years ago

i had not had this radical change that

is needed right now

i did not fully acknowledge and know

that there were people that were not

being treated the same as others

even though i thought i entered a

profession where that was the reason why

i was there

now not all of you are going to be able

to be disabled black men

but it shouldn’t take you having the

lived experience to be able to

acknowledge that racism

and ableism are the reasons why people

that you may not consider your neighbors

are having a devastating time right now

so while you may not have seen them as

your neighbors yesterday

my hope is that after this you will see

them as your neighbors tomorrow

because even though you may not

understand what people are going through

i sure hope it doesn’t take you breaking

your neck to realize that this problem

affects you as well we are all only as

healthy as our most vulnerable neighbors

and if we cannot find a way to care for

those neighbors

then you too someday will be sitting in

a neighborhood

on top of rubble in what used to be a

beautiful day in your neighborhood

the future will be your fault

even if the past is not we are all

in this together and therefore i want to

end

with just an invitation the same way

that mr rogers always began his

we are all in this together and so

let’s make the most of this beautiful

day

since we’re together we might as well

say

would you be mine could you be mine

won’t you be my neighbor

thank you