Addressing Inequality & Racism in Health Care Today
In the US, people of color have long experienced inequalities in health care. In this special Charged episode we discuss these inequalities and racism in health care.
PodcastJul | 21 | 2021
The Stop AAPI Hate Organization released a staggering report in 2021: Asian Americans and Pacific Islanders (AAPI) have faced more than 6,000 hate incidents since the start of the COVID-19 pandemic, which is about a 149% rise since the previous year. The racially motivated incidents ranged from verbal harassment, including hateful rhetoric about the COVID-19 virus, to physical attacks, such as the March 2021 mass shootings in Atlanta, Georgia.
In this special episode of Charged, a panel of three guests discuss the history of racism against the AAPI community, how the pandemic has fueled it and why this group has been widely excluded from conversation, data and policy intended to foster racial equality.
Juliana Chen, MD, is a child and adolescent psychiatrist at Mass General and Newton-Wellesley Hospital, and the associate director of the Mass General Center for Cross-Cultural Student Emotional Wellness. In both areas of her work, Dr. Chen has a strong interest in increasing mental health support for Asian American families, eradicating stigma and helping children achieve resiliency and better emotional health.
Aswita Tan-McGrory, MBA, MSPH, is the director of the Mass General Disparities Solutions Center, and leads projects focused on addressing racial and ethnic disparities in health care. She is also the administrative director of the Mongan Institute, an entity that supports population and health care delivery-focused research across Mass General.
Kimberly Truong, PhD, is the chief equity officer at the Mass General Institute of Health Professions and a faculty affiliate of the Mass General Center for Cross-Cultural Student Emotional Wellness. Throughout her career, Dr. Truong has been deeply engaged in advancing policies, research and practices that prioritize equity, diversity and inclusion.
KELSEY DAMRAD: The Stop AAPI Hate Organization released a staggering report in 2021. Asian Americans and Pacific Islanders have faced more than 6,000 hate incidents since the start of the COVID-19 pandemic, which is about a 149 percent rise since the previous year. The racially motivated incidents ranged from verbal harassment, including hateful rhetoric about the COVID-19 virus, to physical attacks, such as the March, 2021 mass shootings in Atlanta, Georgia, an event that drew national attention to the violence and racism that targets the AAPI community.
Yet despite the known history of this racism, this group has been widely excluded from the racial justice conversation, as well as the data and policy intended to foster racial equality. I'm joined here today with three very special guests for an episode of Charge that discusses racism against the AAPI community. Aswita Tan-McGrory is the Director of the Mass General Disparities Solutions Center, and leads projects focused on addressing racial and ethnic disparities in healthcare. She is also the Administrative Director of the Mongan Institute, an entity that supports population and healthcare delivery-focused research across Mass. General.
Dr. Kimberly Truong is the Chief Equity Officer at the Mass. General Institute of Health Professions and a faculty affiliate of the Mass. General Center for Cross-Cultural Student Emotional Wellness. Throughout her career, Kimberly has been deeply engaged in advancing policies, research, and practices, that prioritize equity, diversity, and inclusion.
Dr. Juliana Chen is a child and adolescent psychiatrist at Mass. General and Newton-Wellesley Hospital, and the Associate Director of the Mass. General Center for Cross-Cultural Student Emotional Wellness. In both areas of her work, Juliana has a strong interest in increasing mental health support for Asian American families, eradicating stigma, and helping children achieve resiliency and better emotional health.
So thank you all for being here today. And it’s just such a pleasure to have you as part of this special episode.
__: It’s a pleasure to be here.
__: Thanks for having us.
__: Thank you for inviting us.
KELSEY DAMRAD: So there's no doubt, I think that the conversation and action around racism has become so prominent over the past year. But specifically, with the COVID-19 pandemic, it led to Asian-Americans being so harassed and attacked, and often blamed. And it feels like it hasn’t been as widely discussed until recently. So I just wanted to open up with a question for the group. What are the health effects of this?
JULIANA CHEN: I can begin. Racial trauma is real, perhaps stating the obvious. But I think it’s perhaps lesser known in the larger community. It's the psychological and emotional harm caused by acute and chronic racism. It can affect those who are victims of discrimination and violence, or racist attacks. But it also, important to note, impacts larger communities, and can impact those who are bystanders, or even witness to racism.
Racial trauma can lead to anxiety, depression, PTSD or trauma-related symptoms, like intrusive thoughts, flashbacks, nightmares. It can lead to mood changes, things like anger or irritability, sadness, or feelings of numbness. It can cause physical symptoms, like a racing heart, sweats, dizziness, changes in sleep, and appetite. And then it can cause cognitive changes, things like difficulties with concentration or memory.
So, in so, so many ways, racial trauma can impact a person’s daily functioning, their work, their relationships, their ability to perform at work or school. And individuals often can feel a sense of a loss of safety, or I think a very understandable feeling that the world is a dangerous place. So the impacts we know very well can be significant and wide-reaching.
KELSEY DAMRAD: Yeah. And so you had mentioned, too, that this can impact bystanders. So since these attacks and this racism is targeting a specific community, is it safe to say that people who are just witnessing this on the news, are feeling the effects of this.
ASWITA TAN-McGRORY: I would just say that there's a lot of triggers for folks, right. It’s hard to watch. It’s hard to see. And knowing that that could happen to you at any stage, can add to the stress.
And then I think, for the three of us, we just have additional roles. It’s part of the work that we do. And so, like, when you see it then playing out in your personal life, I think it feels like you’ve just taken your work home in a way that you really didn’t want to.
KIMBERLY TRUONG: And so in my own research on vicarious racism, on the experiences of doctoral students of color, one of the things that I found was that vicarious racism actually impacts how students might experience racism or racial trauma. So seeing all of these images actually helps them to also normalize racism, and be able to connect their own racialized experiences with observing that of others.
KELSEY DAMRAD: And I think, more of the attention that’s being put on this racism, for some people it might feel relatively new. Is that necessarily true for people in the Asian American community?
ASWITA TAN-McGRORY: In this country, there's been so many policies that were implemented to either keep people out, or to separate them, especially from this community. I think people aren’t really aware of that.
So I do think it’s important for us to talk about that a little bit more openly, that this is not new news. And it’s definitely not for the AAPI community. It's just sort of a validation of everything that we've experienced before, in a very public way. And I don’t think this is unique to our population, right. I think the other communities of color have experienced the same thing.
JULIANA CHEN: I couldn’t agree more with everything that Aswita just said. I mean of course, there are so many layers and dimensions. But there's no question this is not new. Oppression has been here since Asians first came to the United States. I think it just hasn’t been acknowledged or understood. And Aswita, I've had the same exact experience, from like, this isn't new. It’s just revealing something. I think that’s probably always been there.
You know, I come to this with the lens of a child, an adolescent psychiatrist. I'm always thinking about families. And a good comparison, I think, is looking at a lot of African-American families. I think in those families, racism and oppression, it’s widely known. So older generations will talk explicitly with younger generations, right, about what they're facing, starting from a very early age, perhaps, what to expect, how to carry yourself, how to keep yourself safe, and maybe what to do when faced with someone who is telling you—and whatever explicit or implicit ways you don’t belong here.
And I think, for most Asian-American families, racism just isn't talked about. And I think, really, all our generations are ill-equipped because, as Aswita was saying, I think a lot of people don’t know the history. And I think Asian-Americans often don’t even know our own history in this country. So we don’t have the tools to know what to do when faced with racism.
KIMBERLY TRUONG:
I think the lack of knowledge about Asian-Americans, and how Asian-Americans are seen as the model minority, have helped to render us invisible when it comes to some of the challenges that we do have, and the ways in which we experience marginalization. For instance, in the workplace, Asian-Americans are the least likely racial group to be in middle management and executive leadership positions. But that’s not something that we talk about, because we’re seen as doing really well.
And so I think that the shootings in Atlanta really shed light on how Asian-Americans are people of color. Because before that, a lot of the work that I did in justice, equity, diversity, and inclusion, was to make a case that Asians are people of color.
In terms of the March Atlanta attacks, it really helped to shed light on how we experience marginalization and violence.
It’s changed the conversation that we’re having within higher education, in that we are now starting to look more closely at how Asian-Americans experience racism on a daily basis.
KELSEY DAMRAD: So that’s a relatively new change in conversation, then, if it’s being triggered by the March attacks. What has that been like for you to experience and be part of, through the perspective of the work that you're doing?
ASWITA TAN-McGRORY: I think we have to question the inherent bias that we have in our system about who’s successful and who’s not. You know, there is internalized racism. And I think this whole idea of the model minority, to a certain extent, was bought by the AAPI community.
And the truth is, if you look at who is in the senior VP level of suites, who is the CEO, even who, like Kimberly said, middle management, it is not us. And so if we’re such a model minority, then how come it doesn’t translate to success at the top, where people can influence change and make decisions? It's because we are still, you know, experiencing discrimination and racism.
I think we need to not so over-simplify racism. I think it’s really complex.
JULIANA CHEN: Despite the model minority that Asians supposedly are, we definitely are not represented in higher levels.
I think for me, personally, this time, has been a time of a lot of really mixed emotions for me. It’s been, terrifying, and disheartening, and maddening.. I think it’s been a time of real self-reflection, thinking about all that has happened in my life. And perhaps looking at it through a different lens. And I think that’s been pretty powerful.
So many of us who do this work, in whatever area, we've just, come across disciplines, sectors, geography, to really come and mobilize together, and think about ways to support our larger community, and address these real discrepancies and barriers.
The work, as I think it has been always for minority populations, is also exhausting, when you are trying to educate, dismantle racism, or change larger systems. It’s definitely been hard. The work is slow. It’s often not rewarding. And I think burnout among those of us who are doing this work is real.
KIMBERLY TRUONG: And one thing that I really appreciate about being able to talk about the experiences of Asian-Americans with racism is to talk about it in solidarity with other marginalized and minoritized groups. Because I think we can't really talk about anti-Asian racism if we can't talk about anti-Black racism.
ASWITA TAN-McGRORY: I've been doing this work over a decade and a half. And it’s really about racism and healthcare. And it was a little tough to realize that most people don’t include me in that picture. And you know, it was like the silence that I heard from my colleagues after the Atlanta killings. I was like, “Wait, you don’t think that’s a hate crime? And you are not upset? Like how many more do there have to be killed for you to think that it is related to race? I know it’s related to race.”
This is what we do in this work, things are always changing. You always have to self-reflect. And the hard work starts with you. So I had to like just stop and take a moment and be like, “Oh, okay. So I can speak on behalf of other folks. But other folks can't speak on behalf of me, right.” That was like sort of mind-blowing in my head.
And then I was like, “I think, why? Why is that? Why is it that we aren’t naturally included?” It’s a lot of the things that we just talked about. It’s the history. It’s also people’s bias and who they think experiences racism. It’s the lack of good data. It’s the fact that the three of us are probably not the same ethnicity, but we’re lumped in the same category, right. I'm Indonesian.
So I think we are expected to have the same experience, even though we’re not the same. So like all of these things contribute to this perception. And I think that was a little tough news to swallow for me.
KELSEY DAMRAD: I think that’s really interesting that a point that someone made about how the Asian-American community internalizes the model minority myth. So working in the fields that you do, how have you seen that impact people who might not have been aware of it until recently? What does the reckoning of that internalization look like?
KIMBERLY TRUONG: What I often find is that folks who internalize this meritocracy, just the false belief that, if you work hard and do well in life, you’ll get rewarded, and not understanding systemic barriers. So some of it, it has to do with socialization.
So before I do work with my students, I also do work at home, right. So I have these conversations with my children about barriers that they might experience.
For my graduate students, we talk about patterns. We look at the data to help us better understand about systemic barriers. So we also look at the history within our country.
And then, we also see it through like the COVID pandemic, and the different health disparities, too. So any time we see disparities, we should look into it, to better understand what the causes are. Most of the time, when we research, people say that it’s because race is a predictor. Race is not a predictor. It’s racism that predicts different health disparities. I think everything goes back to like being able to understand things with a racial lens.
JULIANA CHEN: In terms of what would that reckoning look like, I think it can look like a lot of things.
And even in the brief time we've been talking so far, I think the three of us have brought up different emotions and reactions in our professional life and our personal life. And I think that’s what reckoning looks like.
You know, my hope is that reckoning can also look like talk and action, right.
ASWITA TAN-McGRORY: The way this internalized, is that we feel like we don’t have a voice. Like we can't speak out. So we’re literally following the model minority, right, stereotype. Put your head down. Be a good worker. Don’t create waves. Which is sort of tied to also like the immigrant experience, right. As an immigrant myself, that’s sort of what you do to fly under the radar.
And one of the things that has been really great is these kinds of conversations, where I normally wouldn’t really talk with my Asian friends, or my Asian colleagues, about these, in a really, like, frank and heartfelt way, about how we’re all struggling.
So if we’re not talking about it with each other, I don’t know that we’d do a great about educating other folks outside of our community, about the struggles that we have.
KELSEY DAMRAD: And Juliana, I have a question specifically for you as a mental health provider. So I know you mentioned earlier that this community is less likely to receive mental health services than any other racial group, in part because of that, perhaps, a culture of not necessarily talking about this in depth. Can you talk a little bit more about why that is.
JULIANA CHEN: I think lots of research has shown that Asian-Americans are three times less likely to seek mental health treatment than any other racial group in the US.
Mental health stigma, it’s very, very real and pretty powerful within the AAPI community. So there can unfortunately be a lot of misunderstanding about what mental health is. Related to this, there can be a lot of shame about mental illness. And in the Asian community, even I know we just finished saying that it’s not a monolith, so forgive me for making these broad statements. But there is, I think, pretty commonly culturally a high value placed on family and community.
And so thinking about it for Asian youth, it can often feel like, you know, like their successes are their family’s success. Their failures is their family’s failure. So there can be a lot of pressure, right, to succeed, to do well, to look like you're doing well.
Asian Americans, I would say, also generally don’t necessarily have the vocabulary to talk about mental health or feelings. It’s just not what we’re accustomed to. And this, I think, can also lead to an underreporting of mental health symptoms. And then that high premium, on saving face, not making waves.
And so mental health treatment, I think, is often seen as a last resort. There are, of course, so many system level barriers, language barriers, cost, a real need for disaggregated health data on Asian-Americans, because we are not a monolith, a priority, I would say, on cultural competency and diversity among medical and mental health professionals.KIMBERLY TRUONG: And one thing I was just also thinking about, too, right, and some of the Asian-American or Asian communities, like Southeast Asians, who have experienced collective trauma, they might not access mental health services because they just see their issues as like a part of surviving, and not necessarily understanding that they could seek treatment and access it, and find out more information about that.
ASWITA TAN-McGRORY: In my own family, you know, there were a lot of mental health issues, really severe issues. And I don’t know that any of my family members ever got treatment until it was so severe that they had to be hospitalized.
So there's habits and things that we pass onto the next generation, and messages that we probably inherit from our parents and our grandparents. And it’s all about just powering through, where you don’t talk about it. Or it’s just part of like what happened to us.
And I would underscore the challenge of providing mental health services in other languages besides English and Spanish. There's a real gap there. And so even if you wanted to get those services, like how would you, you know? Is there a provider available? And is it available in your area? So I think those are all really complex issues.
JULIANA CHEN: Within a mental healthcare system that is already pretty broken, right? So it’s already—it’s like layering issues upon issues.
KELSEY DAMRAD: And Aswita, I’d love to hear more about, what's shifted in your work at Mass General in response to the current events?
ASWITA TAN-McGRORY: Well, I've had to be kind of vocal about it, right, this lack of response. So I have been very vocal about it with my colleagues. I have sort of named that elephant in the room.
I just think it’s important that, you know, that our own community can say, “Yes, I totally agree with that. And even though I haven't said it out loud, it feels good that you're saying it out loud.” And then I also think that we need to hold each other accountable.
And it really was a catalyst for change in this group that I sort of spoke to, and to really say, “You know, I think there's a bias in who you think experiences racism. And I think that we are not fully committed to racial justice until we talk about that. I don’t feel like you're really seeing me, right, because this is what this is about. Do you see me? And do you hear me? And do you understand my experience?”
And so I think it’s just being more vulnerable, actually, I would say, with my own experience, you know, in academia, especially in a Harvard Institution, that is not something that we are encouraged to do, be vulnerable and share our own experience. But it is often the thing that resonates the most with our patients and our colleagues and folks that we are educating.
ASWITA TAN-McGRORY: And I will say, it’s not easy. And so the hardest things are the things that probably relate to change.
KELSEY DAMRAD: And so you’ve made reference to, how the conversation has picked up in your personal life too, and this is really a question for the group. But I know, Aswita, you had mentioned this earlier in the conversation. So can you talk a little bit more about what the conversation has been like in your personal life, perhaps with your family, where maybe this wasn’t as talked about in the past?
ASWITA TAN-McGRORY: I think all three of us probably picked up the phone and called our elders and said, “Please do not leave the house.” And that was kind of ridiculous, when you think about it. I mean yes, don’t leave the house because of COVID. But now I'm telling you, on top of that, don’t leave the house because you might get attacked.
I don’t know that I've really had good conversations with people who are not Asian. And that’s still hard, right. Is this a moment where I stop and say, “have you considered, by your inaction, you are also sending the message that hate crimes against Asians are not important, and not on your radar?” And I think it’s tough to have those conversations in our personal lives.
But with family, it’s so deeply personal. And we care so much about them, it’s a little harder. Because what if they don’t self-reflect. They just move on. That’s a strong message to send to somebody else.
KIMBERLY TRUONG: So when the shootings happened, I started getting emails from colleagues, as well as like faculty, like faculty, staff, and students.
And I actually got them from a lot of people in my personal life, and for me, it was just like, oh wow. I knew that the situation was different. Because I never receive these types of emails.
So the conversations, personally, with my family, I knew that these things were going to happen when people started using different names to name the COVID-19. And so just like having the conversations with my parents, trying to warn them that, like, stuff is going to happen. And I remember them not really listening to me. And we haven't had conversations about that, too, because I think there's a lot of things that they are misinformed about, when it comes to like information about the pandemic.
And so sometimes, they’ll read misinformation and like feed into anti-Asian racism, even though they're Asian themselves. And it's a lot harder to have these conversations with them, given, like, their experiences with trauma, and having seen things that have happened in the past, in our home country. And so they are often really afraid of authority. And also, they listen to authority in a way, too.But yeah, my conversations with BIPOC friends have been a lot better, just that I don’t have to—Like there are times that I don’t have to share any information with them. I don’t have to teach them anything. But they're just there to support. And I really appreciate that.
KELSEY DAMRAD: Juliana, I am curious, from your perspective working in mental health, do you have any advice for listeners who might be wanting to start these conversations with family, peers, colleagues, but don’t know how?
JULIANA CHEN: I love this question. Thank you, Kelsey. It’s both hard and easy at the same time, I would say. My advice is really the short answer, would be not to be afraid. I think a lot of people can think, “Oh, we don’t want to talk about this, because it’s too scary, or it's too hard, or it's too complicated.” But, as I said earlier, kind of the harder, more complicated it is, I think then lets us know it’s that much more critical to have the conversation.
Talking really is a pathway to healing. It’s a pathway to learning. For parents, especially, I think they want to protect their kids. And so I want to let them know that they don’t have to worry about that. That the reality is, your kids, most kids especially these days, in the social media, are far more savvy and knowledgeable than we can ever imagine. So it’s especially critical to have those conversations.
It’s okay to not have all the answers. I think that also is a beginning and an opportunity to learn more. And I think the most important part, at the risk of sounding overly simplistic, is really just, you know, to be present, to listen, to be supportive.
As these conversations begin, and hopefully continue, if there are ever bigger, bigger worries, or you know someone, or you yourself is struggling more significantly in some way, just to not worry alone. There are so many 24/7 help lines, and text lines. People can get support from a mental health professional. Or, if that’s difficult to access, as a first step, a lot of people don’t realize they can get care through a primary care doctor. And I just really want people to know that they're not alone. And so please don’t carry any worry alone.
ASWITA TAN-McGRORY: I love what you just said, like talking is a path to healing. I might have to steal that. I just love that, because I don’t think we do enough of that, right. And I mean not just between us, but I mean, like, in the boardrooms, you know, in the C-suite, in staff meetings. Like we just shy away of these difficult topics. And like, you know, I always say, you need to get comfortable being uncomfortable. It’s not going to be easy. And you can't let the perfect be the enemy of the good.
People often want to get it right on the first try. And they're so afraid of getting it wrong, that what they do is they say nothing. And nothing is still a message. And is that the message you want to leave? It may not be perfect. And that’s fine. But you need to start talking.
KIMBERLY TRUONG: Aswita, what you said really resonated with me, because I have been at the IHP for a couple of years now. And one of the things that I first noticed was, when I came onboard, people did want to be perfect. And they were afraid of feeling uncomfortable. And so we had to develop in our infrastructure and normalize having uncomfortable conversations.
We also normalized making mistakes as part of a learning process. People are always making mistakes. Everybody has biases. We’re committing micro-aggressions on a daily basis. Like each one of us. And so it’s just really important for us to recognize that, and then learn from it, and move forward from it.
KELSEY DAMRAD: And so there's been some reference to kind of exclusion of Asian-Americans from research, both academic and healthcare related. I wonder if we can talk a little bit about that. What historically has been the inclusion of the AAPI community in research? And if it's been very limited, what that tells us?
ASWITA TAN-McGRORY: There's a lack of good data for Asian communities, partly because we’re sort of all lumped together. But partly, I think that, like, if you look at CMS data, it’s mostly focused on black and white experience.
And so that I think that’s part of the challenge, right, is not a lot of good data. So that feeds the perception. Because if there's no data, there's no problem, right. I do think also, what contributes to this, is this sort of weird dichotomy that we have, where we talk about how Asians are not underrepresented in medicine, right. But like we said, they're not in leadership positions. Sure, we made it through the door. But like that doesn’t translate into success and up the ladder.
And so consequently, we’re not included in a lot of diversity and equity and recruitment efforts. And I think that’s a real shame, because you know, we’re still being discriminated against. We still experience structural racism.
I think one way that we've been able to do some research on Asian patients is really through language barriers, right. Because we can sort of accept that folks with language barriers might not have good health outcomes. I think we need to question that under representative medicine model.
And I had a colleague say to me, recently, she was like, “I don’t know how I feel about having to lead equity initiatives if it doesn’t include me.” And I was like, “Yeah, that’s a really good point.” And I bet you, nobody has an answer to that one, because it’s tough, you know. It’s like, wait, wait. We know there's videos online, now, of people getting beat up for being Asian. But yet somehow, we’re not included in this definition.
KIMBERLY TRUONG: And I think, when you think about over-representation, too, of Asian-Americans, it’s different groups of Asian-Americans who are over-represented in medicine, because I don’t think we’ll see a lot of those who are Southeast Asians or Vietnamese, Burmese, [00:50:51], Cambodian, Hmong, Lao, or Bhutanese folks, who are in the health professions, or in the medical fields, because we see in the research, if we disaggregate data, that there are subgroups who are underrepresented.
KELSEY DAMRAD: And Aswita, you had mentioned earlier, so that the AAPI community in the medical field does not advance to more leadership positions. Can you talk a little bit about the barriers that people are facing once they, to use your words, get through the door?
ASWITA TAN-McGRORY: I think the model minority really plays into this, right. And people sort of think that, once you're in the door, like that’s all you need in order to get to the top. They're not acknowledging the structural racism barriers that are in place, to only promote certain folks to the top.So if everybody at the top is white, how am I going to get in there? And so I think we look for certain experiences in our institution. And those experiences correspond to, you know, having a lot of resources, having a lot of educational support, having networks, meaning you know somebody who knows somebody who can forward your résumé for a position, and recommend you.
And then, the last thing I’ll just say is, I really had this light bulb moment, as an administrator. I started going to all these meetings of middle management and administrators. And overwhelmingly, they're white. And I was like, well this makes sense, then, that we have a hard time changing the diversity of our employees, because these are the folks that built the systems. And they’ve built them in their own likeness. So they are building the systems for people that are tech-savvy, that do speak English very well, that look like them, that might come from the same demographic that they are from.
In terms of my own experiences with the model minority myth, like the assumption that Asians do good, do well, they're good workers, they might not necessarily be good managers. In one previous position that I had, when I left, they had to hire three people to replace me. But, during that whole time, when I asked to be promoted, or for other opportunities, I wasn’t given those opportunities. But then I saw, like, how they were able to hire three people, because I wasn’t expendable.
And I developed a case study that now is being used for all of the managers. And it’s called universal management training. There is one case on implicit bias. And it’s written about how people of color are often asked to help onboard folks into roles that they themselves cannot get, even though they might have done this work already.KELSEY DAMRAD: And Kimberly, you had mentioned a little bit earlier, I believe, that concept of sort of invisible labor that faculty are experiencing. Can you talk a little bit more about what that is?
KIMBERLY TRUONG: Sure. There has been over 30 years of research on invisible labor that faculty of color perform, right. So because there are so few faculty of color, and usually in institutions that are predominantly white, the students of color will often go and seek support from faculty of color more informally, it’s not part of the service work that they engage in. And yet, faculty of color end up spending a lot of this time, like supporting and mentoring students. And not necessarily getting credit for it during tenure, promotion, or evaluation processes.
At MGH Institute of Health Professions, we actually implemented guidelines to take into account the invisible labor that faculty of color engage in during the work planning process. So that way, they are getting credit for the invisible support that they're giving to students, the invisible support they're giving to staff, and the invisible support they're giving to colleagues who might go to them with JEDI challenges.
We include Asian-American faculty in these conversations about the guidelines, because I do know a lot of our Asian-American faculty are engaging in invisible labor work. Especially now, too, after the pandemic, some of the international students will reach out to our Asian-American faculty for support, because they don’t know who else to go to, to ask about what's going on within American society, and the rise in anti-Asian violence and hate.
KELSEY DAMRAD: And so I wanted to circle back to one thing Kimberly, that I believe you said earlier, which was that Asian people have not been seen as people of color. What needs to be done, on an institutional level, to change that perception, and have Asian-American people be established as people of color, and subsequently included in policy, and research, and everything that goes into dismantling racism?
KIMBERLY TRUONG: A lot of these conversations are in a vacuum. And what we need is better education in the K to 12 system about how Asian-Americans fit within this larger conversation of race and racism within our society.
A lot of it comes down to us being invisible because we’re not seen in the curriculum. We don’t understand the history. And we’re never told about the history of Asian-Americans in this country.
I wish that we could educate like everybody about Asian-American history, about Black history, about LatinA history, about Indigenous history, so I think the beginning of it is just for us to start having those conversations and start educating everyone about this.
ASWITA TAN-McGRORY: I just want to add to that. We need to change some of the terminology. And I'm just as guilty of using it myself, and sort of following whatever is currently like on trend, right. So the whole BIPOC piece, right, it’s like Black, Indigenous, and then people of color. There's been some resistance to that, because it sort of lumps everybody together.
And when people just say black and brown, I wonder, so am I included in that, right? So I think we need to change that. But I think what we really need to do, we need to ask ourselves the question of, like, what system gets to stay in place? And who benefits from that system? It ain’t me.But I think we aren’t asking the right questions, which is like, who is benefiting from the system? And what system gets to stay in place? And if you ask that question, then you realize that yes, we are people of color. And we experience racism, right. That’s really the forest from the trees. You need to step back and see the big picture.KELSEY DAMRAD: Thank you so much. So we've talked a lot about how this has been sort of a moment in history where the conversation has been ignited, and it feels more or less stronger than maybe in the past. Does this feel to you like a moment of change, where racism against Asian-Americans will be legitimized, and in a sustainable way moving forward.
JULIANA CHEN: It certainly feels momentous, in that change is happening. But I think what we all also know, is that change is complicated, and change is slow. So I think only time will tell if this ends up being the big change that we’re all wanting it to be.
ASWITA TAN-McGRORY: I'm forever hopeful. But I do think it takes a long time. The hard work always starts with yourself. So I think if nothing else, this has caused us to sort of stop and self-reflect, and really understand like our own lens of what we might have, our own biases towards this, and really try to understand why is there internalized racism? Why did I believe in this stereotype? And how am I contributing to that?
And so I would say, that feels maybe not as big as momentous. But it’s really core to making a change overall, we’ve got to make the change first in ourselves, and then we can make systems change. So incremental baby steps, we will get there.
KELSEY DAMRAD: Wonderful. Thank you all so, so much for your time today. I can't tell you how much I appreciate it, and have appreciated hearing your stories, and personal perspectives. It’s been such a pleasure to speak with you all.
ASWITA TAN-McGRORY: Thank you.
KIMBERLY TRUONG: Thank you so much.
JULIANA CHEN: Thank you for having us, Kelsey.
END
Charged is a podcast devoted to uncovering the stories of the women at Mass General who break boundaries and provide exceptional care.
In the US, people of color have long experienced inequalities in health care. In this special Charged episode we discuss these inequalities and racism in health care.
This summer we’ll be sharing some of our favorite episodes from the first season of Charged in our Summer Roadtrip Playlist.
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Episode #7 of the Charged podcast