I’m white. All my ancestors came from one western European country or another, and I don’t tan in the sun—I just burn. I’ve never been discriminated against because of the color of my skin. Racism wasn’t something my family talked about, even though I grew up in the Deep South.
Now, though, we’re seeing the beginnings of a national conversation about race, like this one captured by the New York Times. It’s a topic that’s in our newspapers, our social media feeds, and on our TVs. But, like many Americans, I’m afraid of talking about race. And I know I shouldn’t be.
Racism causes deep emotional scars, whether due to openly hostile acts or because of micro-aggressions. In a recent gathering of health equity advocates, hosted by The Colorado Trust as part of their Health Equity Advocacy work, we explored how health inequities are often rooted in poverty, racism, sexism, and other uncomfortable social issues. We explored how inequities have deep historic root causes that continue today, and how we all need to be part of the conversation and the solution. It’s a welcome experience for me to be able to explore these issues. However, it is in stark contrast to the other projects I am a part of in health systems change, where race and its impact on health are not even mentioned.
There are a number of efforts across the state occurring simultaneously to change the way health care is delivered and paid for, such as the Colorado SIM Project and the Medicaid Accountable Care Collaborative re-contracting process. Through these projects, there is great opportunity to improve the lives and the health of the most vulnerable. Last fall, we wrote about how Coloradans of color consistently experience worse care and outcomes than white Coloradans, so in many ways, they are the most vulnerable. Shouldn’t we be having conversations about why that is and what we can do about it as we gain momentum in changing the system?
Stories are some of our most powerful tools for creating change. We need to seek out and listen to the experiences of patients who have received different or worse care because of the color of their skin, and understand how our systems of care may perpetuate that inequity. We need to involve them in the systems change process. We also need to understand what our own unconscious biases may be, no matter how uncomfortable it is, so we can be more aware of our own behaviors.
We can’t be afraid to have this conversation. Coloradans’ lives depend on it.