For Camara Phyllis Jones, M.D., Ph.D., M.P.H., the truth lies in plain sight: “Racism saps the strength of the whole society through the waste of human resources.”
During her two days in Portland last week, culminating with her OHSU Mark O. Hatfield Lecture before a packed audience of 400 people at Robertson Life Sciences Building, Jones flipped the switch to illuminate the societal structures that harm so many, yet are visible to too few.
In meetings with students, faculty and public health officials, and in her lecture “Achieving Health Equity: Tools for a National Campaign against Racism,” she named racism like you would name smoking as a contributor to poor health and as a formidable villain worthy of, and ripe for, defeat.
“The timeliness and urgency of her topic – the intersection of racism, health and health equity – and the actionable tools for improvement that she will share create a call to action for each one of us,” said OHSU President Danny Jacobs, M.D., M.P.H., FACS, in his welcome at the lecture. “I ask you to join OHSU in addressing the persistent and unacceptable health disparities that are at the heart of Dr. Jones’ work.”
Jones is past president of the American Public Health Association, adjunct professor in the Rollins School of Public Health at Emory University, senior fellow and adjunct professor at Morehouse School of Medicine and an Evelyn Green Davis Fellow at the Radcliffe Institute for Advanced Study at Harvard University. Previously, she was the research director on social determinants of health and equity at the Centers for Disease Control and Prevention and an assistant professor at the Harvard School of Public Health.
Jones defines racism as “a system of structuring opportunity and assigning value based on the social interpretation of how one looks [which is what we call ‘race’], that unfairly disadvantages some individuals and communities.” These forces combine to "sap the strength of the whole society through the waste of human resources."
Famous in public health circles for her use of allegory to talk about difficult topics, she shared her well-known Gardener’s Tale, an allegory for institutional racism.
The gardener plants red flower seeds in a box with rich soil and pink flower seeds in a box with rocky soil, noticing that every year the red flowers are far more robust than the pink and ultimately deciding that she was right to prefer the red. She explains:
- Separating the seeds into flower boxes with different quality soil is the historical harm.
- The flower boxes are the structures that sustain the harm.
- The gardener’s inaction in the face of need perpetuates the harm.
- Yet, rather than seeing the cause and effect and her agency in the process that caused the forever anemic pink flowers, she views the pink flowers as subpar and faults them for their failure to thrive.
- The red flowers, meanwhile, are blind to the advantages that fueled their success.
In health care, this dynamic plays out with poorer health status for communities of color that become accepted as part of the human condition for those communities, yet have been directly linked to a high degree of stress and a lack of access to quality housing, diet and education that are the manifestation of institutionalized racism.
“It is difficult to recognize a system of inequity that privileges us,” she said, “yet those on the outside are very aware.”
Making good use of time
On Monday, Jones lunched with the second cohort of the Wy’East Post-baccalaureate Pathway, which prepares American Indian and Alaska Native students, already on the road to a health profession, to get accepted and succeed in medical school, and met with medical and nursing students in the new student-led Health Justice Co-op in RLSB.
She exchanged research interests and perspectives with Kent Thornburg, Ph.D., professor of medicine and director of the Bob and Charlee Moore Institute for Nutrition and Wellness, and Bert Boyer, Ph.D., and Scarlett Hopkins, R.N., M.A., who lead the new OHSU Alaska Native Health and Wellness Center, affiliated with the Moore.
The Multnomah County Health Department hosted her for breakfast Tuesday, and she met Raina Croff, Ph.D., assistant professor of neurology, OHSU School of Medicine, at a North Vancouver Avenue café to learn about Croff’s research on the impacts of gentrification – and of retelling and reclaiming the neighborhood’s history – to the cognitive health of African Americans. Together they walked the rapidly changing neighborhood with Croff’s colleague, Sara King, Ph.D., postdoctoral fellow in neurology, OHSU School of Medicine, and two research subjects, longtime Portlanders Gahlena Maxey-Easterly and Sharon Steen.
Before her evening lecture, she fit in guest-teaching at the OHSU-PSU School for Public Health.
In all of her discussions and at her lecture, she ended with a range of tools for change, including these:
“Racism is most often passive,” she said. To dismantle it we must:
- Name racism.
- Ask: how is racism operating here?
- Organize and strategize to act.
And when a young woman asked how she keeps going in the face of so many barriers, Jones summoned the image of a flock of geese flying in a “V.”
The lead goose breaks the wind for the others, who break the wind for those behind them. When the lead goose gets tired, she flies to the back of the path. Another takes her place.