GRAD 219 Course – The Black Experience in American Medicine – Week 3

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This is a guest post by Jackie Roger, Ph.D. Candidate, UCSF Program in Bioinformatics (BI)

During our class on 5/21, we learned about the term “biopolitics”. After our discussion in class, I wanted to learn more about it and ended up doing some additional reading. Biopolitics, conceptualized by Michel Foucault, is the intersection of life and politics. In practice, it is the governance and control of human life. Many of the topics that we have covered in class can be contextualized within biopolitics.

On 5/17 we talked about forced sterilizations in California prisons. This was a mechanism for controlling who could and could not procreate, and was deeply rooted in white supremacist ideologies. On 5/24 we discussed the hysteria in the 1980s about the “crack baby epidemic” that never ended up happening and had no reasonable scientific basis. There was widespread panic about the possibility of babies born with physical and cognitive disabilities, but little concern about the lack of resources and support for women with substance use disorders. In both of these examples, the focus was on the child-bearing potential of women, and not on the personhood of women. Both forced sterilizations and public hysteria were used to police who should be having children.

On 5/19 we reviewed the Tuskegee syphilis study, and on 5/26 we drew parallels between the racial disparities of the HIV/AIDS epidemic in the 1980s and the ongoing COVID pandemic. In all three of these examples, the medical system prioritized white lives over black lives. There was significant investment in caring for white patients, while black patients were often neglected or mistreated.

GRAD 219 Course – The Black Experience in American Medicine – Week 1

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This is a guest post by Jackie Roger, Ph.D. Candidate, UCSF Program in Bioinformatics (BI)

Towards the end of this past week, several of the readings and videos discussed the intersection of racism and OB-GYN. We learned about the medical experimentation on black women’s bodies (Linda Villarosa’s article in NYT), the mutilation and subsequent museum display of Sara Baartman’s genitalia (Dr. Deirdre Cooper Owens’s talk on Youtube), and the black maternal health crisis (Dr. Susan R. Bailey article on the AMA site). These examples illustrate how the historical legacies of anti-black racism are embedded in present-day OB-GYN research and medicine. One component of this is disparities in the maternal mortality rate, which was the focus of Dr. Bailey’s piece.

She described two initiatives to reduce this disparity: the MOMMA Act to extend coverage for post-partum care and the Release the Pressure campaign to promote heart health and healthy blood pressure. The MOMMA Act seems like a good start, and could reduce both overall maternal mortalities and the racial disparities in maternal mortalities. The Release the Pressure campaign calls upon black people to take steps in their own lives to improve their heart health (since heart disease is one of the leading causes of pregnancy-related death). There are so many aspects of systemic anti-black racism within the medical system and beyond that directly contribute to increased risk of heart disease. A campaign that asks them to offset these things by “taking a few more steps a day” etc seems insulting. I think that truly addressing disparities in OB-GYN will require structural changes in the healthcare system.