Who Has The Power? A Call for Black and Brown Leadership in Public Health

By Antwan Matthews, BS | July 31, 2018
SHARP Scholar, ETR and San Francisco Department of Public Health

I am Antwan Matthews, a native of Meridian, Mississippi, and recently graduated from Tougaloo College in Biology. This summer I have the privilege to serve as a scholar for the Summer HIV AIDS Research Program (SHARP), an NIH-funded initiative of the San Francisco Department of Public Health.    

I have an argument to offer about the ways we think about public health. I believe that black and brown people are supremely qualified to address health disparities in their own communities. However, they do not currently have the social or political support to do this. They need to be empowered to do this work.

My white colleagues who believe in helping communities of color must be ready to step back and start thinking in new ways about how to genuinely offer support.

A Scholar’s Way

As a scholar, it is important for me to continue to develop my expertise and learning methods about research, medicine, and interdisciplinary strategies that advance science. The SHARP program allows scholars to examine the contributions people of color have added to scientific advancement. Through this program, I have the opportunity this summer to work with Dr. Ifeoma Udoh, Senior Research Associate at ETR, on one of ETR’s HIV projects.

HIV/AIDS disparities in communities of color have been the focus of many research investigators who want to advance innovative solutions—interventions, programs and policies. However, throughout the history of research, black and brown bodies have been exploited for the benefit of science. In countless instances, the justice of human dignity was simply disregarded.

Medical mistreatment has created distrust within black and brown communities. For example, the Henrietta Lacks story, recently acknowledged in a New York Times bestseller biography, offers an illustration of unethical research studies on black women that continue to modern times. These have included forced sterilization of black women, gynecologic experiments performed on black slave women in the 1840’s, modern-day lead contamination in black communities, cancer clusters and a mortality gap in black communities, and more. Such studies have intensified the skepticism of people of color concerning new scientific advancements and contributed to a reticence to participate in legitimate research.

Health inequity in communities of color has also contributed tremendously to broader social inequities.

Whose Power?

So I am asking, “Who has the power?” Who is empowered to explore the narrative of black and brown people being able to become self-sufficient in addressing health care inequities in their own communities?

There are many examples of black leadership and liberation in the history of modern public health (see box). It is crucial to highlight these initiatives to be absolutely clear on my argument that black and brown people are beyond qualified to address health disparities in their own communities. However, they do not have the social, economic or political support to sustain effective broad-based public health initiatives. These circumstances are a fundamental driver for me in my own academic and career pursuits.

The Opportunity of Voice

Writing this blog post has allowed me the opportunity of voice. I want to mobilize a movement that shows how vital it is for black and brown populations to develop initiatives, resources and funding. This is the most effective way to address the systemic entities that directly and indirectly contribute to the gross inequities that persist within our communities.

At times, the public health narrative about including people of color in decision-making for our communities turns out to be more harmful than helpful. The ideologies surrounding “having a seat at the table” often imply that, “black and brown people can come to the table as long as they understand they are just offering a complementary voice to their white counterparts!”

This is not true inclusion or representation, but it is all too common. Most of the time, initiatives are started in underserved communities prior to the inclusion of community members. The results of such efforts have a history of failing to produce promising results. Sometimes, they just fail outright.

I have seen funders support organizations that run a few focus groups, host a conference call—and then launch HIV prevention initiatives without authentic and engaged community representation. If the interventions are not designed and developed by community members directly, the programs may ultimately be a waste of financial resources.

I’m Building a Table

We—black and brown people—do not need a “seat at the table.” We need our own table. We need the support and opportunity to create fundamental components for public health initiatives that will be sustaintainable in our communities.

When our white colleagues endure some drastic epidemic, do they ask the black and brown community for our input on how to reach a white population? Generally not. Why, then, when black and brown people advocate for themselves, must they include white counterparts for approval and inclusion?

This view implies that the power flows wherever privilege is most profuse. But that’s always been our history—our black and brown bodies have been exploited, our communities have been drained of resources, and we have had to depend on projects managed by white “rescuers” to provide the bare minimum for us to survive.

This is an injustice, this suggestion that our communities can only prosper if white communities help us. The black and brown community must detach ourselves from that narrative. We do hold some sort of power!

We may not have all the resources, but we do know what our communities need to survive and thrive. And we know we cannot thrive when there are barriers such as inequitable policies, lack of access to care, elevated insurance premiums, disapproval for project funding, lack of representation in medical and professional schools, pay inequity and more.

To my white colleagues I say, “If you believe in helping the black and brown community, understand this: we must be in charge. If decreasing disparities in black and brown communities is really a public health objective, it is vital that we increase accessibility to resources for students of color. It is imperative that black and brown youth receive opportunities to challenge the status quo in our society. That is where the solutions will be discovered.”

Becoming an Expert: My Personal Journey

I am a developing expert. I am on a journey to diversify the field of medicine. I want to bring new contributions to the narrative of self-sustainability. I have utilized my platform to study science and interdisciplinary courses. My goal is nothing less than redefining the philosophy of health.

Throughout my undergraduate years, I worked with pharmaceutical companies, writing companies, film companies, government officials and community-based organizations. I started a health organization at Tougaloo College, studied at Brown University, was awarded diverse internships related to immunology, microbiology, public health and population health.

I’ve served in several scholar programs, including as a Pedro Zamora Scholar, Tougaloo-Brown Scholar, Howard Hughes Medical Institute Scholar, AIDSWatch Scholar and, now, a SHARP Scholar. My abstract for Microbiology was accepted to the Annual Biomedical Research Conference for Minority Students (ABRCMS). I appeared in a documentary and contributed to magazines. I’ve participated in interviews and panel discussions related to my experience with the health care field.

To address these key issues of misrepresentation and disempowerment of black and brown people, I’ve pursued every possible opportunity to strengthen my position to better advocate for people of color.

My Call to Action

Today, I am proposing a call of action for developing scholars and experts of all backgrounds: we must continue to use the platforms of education and opportunity to understand the unfamiliar. We are future researchers, lawyers, physicians, philosophers, anthropologists, CEO’s, journalists, government officials, consultants and more. We have the ability to challenge the institutionalized and systemic entities that perpetuate disparities.

We must all remember that if the objective is to eliminate health disparities, black and brown people—students, scholars, experts, citizens—must have the power to be in control of public health initiatives in our own communities. Even though privilege often dictates power, experience plays a critical role as well. Black and brown communities can create self-sufficient initiatives focused on capacity-building, leadership development and resource consolidation. We can build institutions that address public health issues specific to our needs.

So, when we are asked, “Who Has the Power?” let’s remember we have the power in our communities!

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Antwan Matthews has completed his Bachelor of Science in Biology at Tougaloo College. He is committed to restructuring the health care field to involve more students of color in decisions affecting the health outcomes of their communities. His goal is to obtain an MD and a JD to further his mission to create holistic approaches to address determinants of health in communities of color.