Pulling Back the Curtain on Race and Health Care

Visionaries is a limited series that looks at figures who are 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. “That’s really where I learned not just what public health was, but how powerful it could be , “She said. “I found that there is a different model for caring for people than we know and what I’ve been 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 looks at health care solutions to the effects of policies and attitudes that work against people of color. Dr. Hardeman is the first to acknowledge that balancing his academic work and the center can be a challenge. “I feel like I’m building a plane while also flying,” she said. “The work can’t stop while I build the infrastructure for the center.”

While researching the subjects and data-driven results – survival rates of Black infants who are scared by black doctors versus white doctors after difficult deliveries, for example – sometimes garner controversy, Dr. Hardeman believes they are essential for understanding the Black experience in the United States.

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

Government involvement, Dr. Hardeman said, is also key. While she’s trying to get congressional support, she’s leading a work group with the Centers for Disease Control and Prevention as well as the American College of Obstetricians and Gynecologists, where “we’re tasked with developing a tool to help maternal mortality review committees identify. Racism is a contributing factor in maternal deaths, “she said.

Dr. Hardeman hopes to inspire others to think bigger about policies that hamstring women of color, and in turn, to think of solutions that protect mothers and babies: “We have to think about the complexities of how all this shows up to be able to be right. have the impact. ” (The following interview has been condensed and edited.)

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

At Xavier University of Louisiana, a historically black college 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, right within my family and my community and certainly in New Orleans. Xavier is surrounded by some really poor and underresourced neighborhoods and a lot of marginalized folks, and so I knew – even in undergrad I knew – that I was really interested in asking: How do we change this reality?

And your path to that was through academia?

I went into my Ph.D. The program, with the intention of getting the training needed to go to a policy institute, uses evidence to inform. And somewhere along the way, I started looking around at who I learned from and who taught me as a doctoral student, who was saying the words that I wanted and needed to hear about racial inequities and health and who wasn’t.

What did you learn from that assessment?

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

And it seems that you’ve found quite a few roles that accomplish that. Do you feel as if you have to do it all?

I feel like you have to work at multiple places along the spectrum to actually get the work done. It ‘s all related, and I’ m a big thinker. I like to think big and bold and broadly about this work and the ways that it can be connected. So everything I do is very intentional. I deeply feel the urgency. It’s a matter of life and death.

Do you have any free time?

[Laughs] I don’t. Work has been really interesting and important because we’ve heard the alarm on the racism of impact on external health outcomes. Now we’re trying to sort of see how we collect this data and identify what is happening and these maternal deaths, so both the maternal deaths – mother and child – are not in vain. Also, statistically, we need to be able to either from a quantitative or a research perspective, what’s happening, and also map out how we intervene.

Does your identity as a Black woman play into your feeling as if you need to do everything in this space?

You’re familiar with the narrative of Black women taking on the caregiver role. My daughter and I both have shirts that say “Black girls save the world.” I think that phenomenon is hard to move away from, especially when I think about the black role models that came before who did incredible things: my mom and both my grandmothers, who were just incredible people who cared for their families and their communities and What they did could affect the spaces that they were in. I come from a family where it was very clear to me from a young age that to whom much is given, much is needed. I’ve always had this sense of responsibility, in addition to just caring deeply about people – my people – and caring deeply about liberation.

With all of that in mind, how do you care for yourself to prevent burnout?

In the past couple of years, I’ve become more intentional about self-care. I found an amazing black female therapist who helps me a great deal. I intentionally take time off to go with my family. Recently, my husband and I booked airfare and we went somewhere warm for a few days to relax and get some vitamin D, some sunshine. I ‘m also trying to shift my thinking. I can’t show up if I’m not taking care of myself.

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

What would you say to another Black woman who’s probably starting out in her career and feels like she needs to do it all?

I always want to encourage them to be clear about why they are there and what they want to do. They also have to make sure that ‘s what driving them. I always say my purpose here is to manifest racial justice so that black women and girls can live their full greatness and glory that they can achieve and have opportunities for health equity. I think you have to know that and be clear about that to be able to space in the spaces that I am in and thrive.

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