We Cannot Return to Business as Usual
The COVID-19 pandemic exposes systemic injustices impacting the Black community.
Posted May 04, 2020
By Douglas E. Lewis, Jr., PsyD and Naadira C. Upshaw, PsyD
As many States frantically move forward with plans to re-open their economies, members of the Black community struggle to manage substantial losses. For example, a recent study published by the Journal of the American Medical Association shows that Black Americans overwhelmingly represent COVID-19 hospitalizations and deaths in the United States. Preliminary research also suggests that the current national unemployment rate, having generally increased because of the pandemic, is still higher for Black and Latinx Americans (i.e., 40 percent versus 30 percent for White Americans).
Further, it is important to note that similar to the US healthcare system, jails and prisons face an influx of COVID-19 cases–notably, with fewer resources. Black Americans account for over 50 percent of the American jail and prison population, despite making up just 13 percent of the total US citizenry. What’s more, in spite of the failings of these systems, minorities constitute the greatest number of individuals designated as essential workers. The United States of America, namely we as citizens and providers, simply cannot return to business as usual.
Despite such visible injustices, members of the Coronavirus Task Force, specifically US Surgeon General Jerome Adams, a Black American male, stated to minority communities, “… avoid alcohol, tobacco and drugs... We need you to do this, if not for yourself, then for your abuela, do it for your granddaddy, do it for your Big Mama, do it for your pop pop.” Such a statement creates a ripple effect of continued prejudice and bias. Particularly, this reinforces stereotypes that are historically associated with these groups, such as the lack of personal responsibility and illegal drug use. It also sends a message that Black Americans and other minorities are unable to indulge in the legal consumption of recreational substances, often used as socially acceptable forms of relaxation or leisure, for concern that they cannot do so in moderation. Most, unfortunately, it fuels the idea that Black Americans can somehow, through personal responsibility, overturn the generations-long effects of systemic inequity.
Too often, when public health crises occur, the burden is placed on the Black community to remedy systems over which they have no control. In this context, it gives the illusion that the Black community has the power and capability to heal itself, despite there being no cure for this virus, insufficient and ever-changing facts about its transmission and impact on the body, and no proven indication that the use of substances prior to exposure significantly impacts recovery. Moreover, if that were true, all racial and ethnic groups should have received the same warning from our Surgeon General. It must be noted, however, that Dr. Adams did assert—after harsh criticism for his original remarks—that he was speaking to all Americans.
As clinicians, we are tasked with addressing the psychological concerns of our clients as well as those of the general public, and our duties are particularly evident during times of crisis. In practice, we tend to focus on topics like self-care and the limits of our control, and while these tools are effective, they are deeply rooted in western thought or perspective. Sadly, in essence, we, too, overly promote personal responsibility to minority groups rather than validate the uniqueness of their experiences. Our tactics work in managing acute emotional distress, but they do not address the chronic psychological impact of intergenerational health conditions, underemployment, and limited access to necessary resources that could significantly improve their quality of life. Therefore, we must adjust how we provide services to avoid minimizing or disregarding these truths.
Now more than ever, we must stay true to the fundamentals of our training by considering the societal context of those to whom we provide services while we weather this storm. It is equally important that we continue to develop how we serve our clients. Though the specific path to addressing new problems may be uncertain, it is abundantly clear that we cannot return to business as usual.