zz*UNPUB*Caste at the intersection of Health/Medicine: Impact of Racism on Physical and Mental Health

Black & Blue is the first systematic description of how American doctors think about racial differences and how this kind of thinking affects the treatment of their black patients. The standard studies of medical racism examine past medical abuses of black people and do not address the racially motivated thinking and behaviors of physicians practicing medicine today. Doctors have always absorbed the racial stereotypes and folkloric beliefs about racial differences that permeate the general population. Within the world of medicine this racial folklore has infiltrated all of the medical sub-disciplines, from cardiology to gynecology to psychiatry. Doctors have thus imposed white or black racial identities upon every organ system of the human body, along with racial interpretations of black children, the black elderly, the black athlete, black musicality, black pain thresholds, and other aspects of black minds and bodies.

This book examines the deep roots of racism in the mental health system. Suman Fernando weaves the histories of racial discourse and clinical practice into a narrative of power, knowledge, and black suffering in an ostensibly progressive and scientifically grounded system. Drawing on a lifetime of experience as a practicing psychiatrist, he examines how the system has shifted in response to new forms of racism which have emerged since the 1960s, highlighting the widespread pathologization of black people, the impact of Islamophobia on clinical practice after 9/11, and various struggles to reform.

This is the first book to define and explore Black fatigue, the intergenerational impact of systemic racism on the physical and psychological health of Black people--and explain why and how society needs to collectively do more to combat its pernicious effects. Black people, young and old, are fatigued, says award-winning diversity and inclusion leader Mary-Frances Winters. It is physically, mentally, and emotionally draining to continue to experience inequities and even atrocities, day after day, when justice is a God-given and legislated right. And it is exhausting to have to constantly explain this to white people, even--and especially--well-meaning white people, who fall prey to white fragility and too often are unwittingly complicit in upholding the very systems they say they want dismantled. This book, designed to illuminate the myriad dire consequences of "living while Black," came at the urging of Winters's Black friends and colleagues. Winters describes how in every aspect of life--from economics to education, work, criminal justice, and, very importantly, health outcomes--for the most part, the trajectory for Black people is not improving. It is paradoxical that, with all the attention focused over the last fifty years on social justice and diversity and inclusion, little progress has been made in actualizing the vision of an equitable society. Black people are quite literally sick and tired of being sick and tired. Winters writes that "my hope for this book is that it will provide a comprehensive summary of the consequences of Black fatigue, and awaken activism in those who care about equity and justice--those who care that intergenerational fatigue is tearing at the very core of a whole race of people who are simply asking for what they deserve."