Pulling back the curtain on race and health care

Visionaries is a limited series that looks at characters trying to transform the way we live.

Dr. Rachel Hardeman’s journey to understanding community health care began in Cuba, where she studied medicine and public health at the Latin American School of Medicine from 2002 to 2004. “It’s really there that I learned not just what public health was, but how powerful it could be,” she said. “I saw that there is a different model for caring for people than what we know and what I was exposed to in the United States.”

In February 2021, Dr. Hardeman, who is now a reproductive health equity researcher and associate professor at the University of Minnesota, founded the Center for Anti-Racism Research for Health Equity, which seeks care solutions health to the effects of policies and attitudes that work against people of color. Dr. Hardeman is the first to acknowledge that it can be difficult to balance her academic work and the center. “I feel like I’m building a plane while flying the plane,” she said. “The work can’t stop while I build the center’s infrastructure.”

While the data-based topics and results of his research—survival rates of black infants cared for by black physicians versus white physicians after difficult deliveries, for example—sometimes spark controversy, Dr. Hardeman think they are necessary to understand the black experience. in the USA.

She also partnered with the Roots Community Birth Center in Minneapolis, one of the first black birth centers in the United States. Her work has shown the difference Roots and similar centers can make for mothers and their babies, revealing more positive results than many hospital systems.

Government involvement, Dr. Hardeman said, is also essential. As she tries to get support from Congress, she leads a task force with the Centers for Disease Control and Prevention as well as the American College of Obstetricians and Gynecologists, where “we are tasked with developing a tool to help maternal mortality review committees to identify racism as a contributing factor to maternal deaths,” she said.

Dr. Hardeman hopes to inspire others to think bigger about the policies that cripple women of color, and in turn, to think about solutions that protect mothers and babies: “We need to think about the complexity of how everything it turns out to be just capable of making an impact. (The following interview has been condensed and edited.)

When and how did you decide where you wanted to focus?

At Xavier University of Louisiana, a historically black university in New Orleans. I was actually on the pre-med path. I talked a lot about health disparities, but I didn’t have the language for what I was seeing, within my family and my community and certainly in New Orleans. Xavier is surrounded by really poor, under-resourced neighborhoods and a lot of marginalized people, and so I knew – even as an undergrad I knew – that I was really interested in asking: how do we change that reality?

And your path to that was through academia?

I went to my doctorate. program in order to get the training I needed to go work for a policy institute to use evidence to inform policy. And somewhere along the way, I started looking around who I learned from and who taught me as a graduate student, who said the words I wanted and needed. to hear about racial inequality and health and who wasn’t.

What did you learn from this evaluation?

I realized that as a doctoral student or in the School of Public Health, I had never taken a course from someone who was black. So I thought, “If not me, then who?” What could my place be in academia? What would that look like? Can I occupy space in academia and stay true to who I am?

And it looks like you’ve found quite a few roles that accomplish this. Do you feel obligated to do everything?

I feel like you have to work in multiple places along the spectrum to actually get the job done. It’s all connected, and I’m a big thinker. I like to think big and bold and broad about this work and the ways it can be connected. So everything I do is very intentional. I deeply feel the urgency. Its a question of life or death.

Do you have free time?

[Laughs] I do not know. The work was really interesting and important because we sounded the alarm about the impact of racism on maternal health. Now we’re kind of trying to see how we collect that data and identify what’s happening and those maternal deaths, so that both maternal deaths – mother and child – aren’t in vain. In addition, from a statistical point of view, we need to be able, from a quantitative or research point of view, to name what is happening and also to map how we intervene.

Does your identity as a black woman play into your feeling that you have to do everything in this space?

You know the story of black women taking on the role of caregiver. My daughter and I both have shirts that say “Black Girls Save the World”. I think it’s hard to walk away from this phenomenon, especially when I think of the black role models who came before me who did incredible things: my mother and my two grandmothers, who were simply people amazing people who cared about their families and communities and did what they could to bring about change in the spaces where they found themselves. I come from a family where it was very clear to me from an early age that to whom we give a lot, we ask a lot. I’ve always had this sense of responsibility, in addition to caring deeply about people – my people – and caring deeply about liberation.

With all of this in mind, how do you take care of yourself to avoid burnout?

Over the past two years, I have become more intentional when it comes to self-care. I found an amazing black therapist who helps me a lot. I intentionally take time to go away with my family. Recently my husband and I booked a plane ticket and went somewhere warm for a few days to relax and get some vitamin D, some sunshine. I am also trying to change my way of thinking. I can’t show up if I don’t take care of myself.

I think it was [the sociologist and New York Times contributing opinion writer] Tressie McMillan Cottom who said: “These institutions don’t love you or they won’t love you back. They are always there to generate knowledge and generate capital, and you have to recognize that you are someone who helps make that happen. But you don’t owe them anything. This is advice I have to take personally. We are all replaceable.

What would you say to another black woman who may be starting out in her career and feels like she has to do it all?

I always want to encourage them to clearly explain why they are there and what they want to do. They also need to make sure that’s what motivates them. I always say my purpose in being here is to manifest racial justice so that black women and girls can experience all the greatness and glory they can achieve and have opportunities for health equity. I think you need to know that and be clear about it so that you can be in the space of the spaces I’m in and thrive.