During Black History Month, the Office of Diversity, Equity & Inclusion’s Insight into Identities series encourages you to learn how you can support inclusivity across our system. Read the powerful introduction by O’Neil Britton, MD, Chief Medical Officer, Massachusetts General Hospital.

Then, you are invited – either on your own or with others on your team – to review the information and resources in this month’s Insight into Identities newsletter, which can be found on Partners Pulse, and reflect on how the Black / African American identity impacts not just ourselves, but also our patients, colleagues, institutions and our health care system.

Dear Colleagues,

I have ruminated for some time about how to summarize my experience of the black identity. I have found it to be a considerable challenge with many tentacles (culture, cuisine, arts, music, family, race, history, etc.), so I will do my best to summarize one aspect, my racial identity, at a high level.

Before I begin, I would be mistaken to not point out that my observations are personal and not meant to be universal, as the black racial experience can have so many nuanced journeys amongst the diversity of people who identify as being black. Even though there are many commonalities of how black people view themselves collectively, there are also many differences in how we see ourselves as individuals (as it should be) or subgroups. I am also using the less than ideal term “black” versus African American given my mixed heritage of living in the Caribbean and the United States.

Finally, even the assumption of who is “black” or where the notion of being black comes from does not have a straightforward answer, with many embracing the identity while others working to avoid being labelled as such or seeking a more accurate description of skin tone or ancestral origin. In some ways, the collective term “black,” represents a lost or stolen history of who we are as individuals and as a people. Our ancestors were conveniently lumped together, dehumanized and commoditized and too many of their descendants today have no idea about our origins. In many ways we have been forced to assume new identities and new lands, with the natural chain of lineages broken. Therefore, it’s complicated.

So what does it mean to be racially black from my perspective? There are so many answers to this question. As we know, skin color has no biologic or genetic purpose but simply represents varying pigmentation expression. The widespread thought that meaningful biologic differences and genetic superiority/inferiority exists between people of different races were propagated by people (almost all of whom were quite prominent “influencers” of their time) who had little or limited understanding of human biology, and also by those who stood to profit from having tiered “racial value” to protect their commercial interests or preservation of power and privilege. As decades and centuries past, these folklore beliefs were widely adopted globally, often published in books and scholarly papers and quickly became mainstream common beliefs that unfortunately have persisted to present day views amongst too many people globally.

In the field of health care, this led to common misrepresentation of blacks having more pain tolerance, or labeling race as risk factors for biologic conditions such as hypertension, that has harmed black patients and led to widespread health disparities. In addition, science was misused to justify racism, often declaring black people as a separate species unable to participate in sophisticated thought processes and creating bias testing platforms to prove intellectual superiorities of whites versus others such as the IQ test and just about every standardized test that followed. These views were further reinforced by religious teachings of enlightenment of “barbaric” peoples, which justified the immoral acts of slavery, colonialism and all the forms of discrimination that followed these institutions.

In the historical and social context described above, my racial identity has been forged by being a child born in the tumultuous period of the late 1960’s when many Caribbean and African countries were bidding to become independent and civil rights leaders were being murdered across the US and the world by segregationists. As these tragedies and victories played out, the countervailing perception of the positives of being black was finally being celebrated by outspoken civil rights leaders, entertainers, artists and athletes, from the converted Cassius Clay, to James Brown, to Tommie Smith in the 1968 Olympics and to Bob Marley and the Wailers extolling us to “get up, stand up.” From my personal experiences to my many observations of daily life and society, embracing my blackness through music, culture, politics, history and sports was a rebellion against the centuries long put down of black people, and also an affirmation of our collective resistance and resilience.

So this year as I turned 50 and as I look across where I work, where I live and where my children go to school, I see both tremendous personal gains for some and a troubling lack of investment and empathy for far too many black people. These two worlds overlap frequently as I move through my day, usually conjoined due to my black identity. One day, we would all be so fortunate to be seen as individuals, rather than a group, and judged in a racially equitable manner, or as Dr. King put it, “by the content of our character.” It is estimated that at our current rate of racial progress in the post Obama era, the phenomena of racial equity, and with it the ability to be seen only as individuals, will take approximately 500 years to achieve.

Until then, ‘Say it loud, I’m Black, and I’m proud.’

O’Neil Britton, MD
Chief Medical Officer, Massachusetts General Hospital

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