As many individuals across the United States and in New Haven are engaged in conversations and activism around systemic racism, sparked in part by the disparate impact of COVID-19 on communities of color and recent horrific incidents of police brutality against black men and women, around 170 members of the Yale community and others convened on Zoom on July 22 for a conversation titled “Anti-Blackness, Abolition, and Criminal Justice: A Conversation with Dr. Emily Wang and Professor Tracey Meares."
Anna Reisman, MD, director, Program for Humanities in Medicine, and professor of medicine at Yale, and Helena Hansen, MD, PhD, director of Social Medicine in Action, and associate professor, Department of Psychiatry, NYU Langone Health, organized and moderated the program, in which Sydney Rose Green, a fifth-year MD-PhD student at Yale School of Medicine (YSM) and the Program in History of Science and Medicine, also participated as discussant.
Tracey Meares, JD, Walton Hale Hamilton Professor and a founding director of the Justice Collaboratory at Yale Law School, began the conversation, explaining that people need to know the history of the abolition of slavery and Reconstruction to understand the current advocacy for “abolishing” and “defunding” the police. Meares is a nationally-recognized expert on policing in urban communities.
Meares stated that the term abolition is inescapably tied to the context of slavery, and that while the 13th Amendment eradicated the legal category of slavery, it did not do the rest of the necessary work to establish citizenship for the formerly enslaved. The 14th Amendment ensured birthright citizenship for emancipated enslaved people and the 15th Amendment was directed at ensuring their right to vote. Reconstruction made some progress on the systemic changes necessary for citizenship, but it lasted only 11 years before a backlash of white supremacist terror ended it.
The calls today for abolishing and defunding the police, Meares believes, are calls to fulfill the promise of Reconstruction that never took place and provide the set of public goods of citizenship that Reconstruction was to have provided. In our era some of those goods include quality health care, housing, and education. Meares described safety as one of those public goods, but said that when people who live in neighborhoods that are disadvantaged from decades of underinvestment and neglect are asked to define safety, they will often focus on issues such as housing, food security, and access to health care—not how quickly armed law enforcement officers arrive when someone calls 911.
She then compared the concepts of abolishing and defunding the police to a compass, noting Ted Alcorn’s metaphor. These terms point us in the direction we may want to go, but they are not a road map for how we get from here to there. As Meares described later in the conversation, even if policing was dramatically changed overnight, communities in need would still be fragile, with, for example, poor health care, housing, and schools, and these underlying conditions will take time—and a significant amount of money—to change. Meares added, what makes change particularly difficult is that money currently invested elsewhere will have to be reprioritized, meaning there would have to be a sacrifice of privilege.
YSM Associate Professor Emily Wang, MD, MAS, agreed with Meares that there is difficult work ahead and that progress is not going to be fast. Wang is the director of the Health Justice Lab, which focuses on improving the health of individuals and communities who have been affected by mass incarceration. She also is the director of the new SEICHE Center for Health and Justice, which will focus on identifying and applying strategies to improve the health of individuals and communities impacted by incarceration in Connecticut, nationally, and globally.
Wang noted that while it is positive that COVID-19 has led to more decarceration, early release is often dangerous because of the poor support systems available to formerly incarcerated individuals outside of prison. Made worse by COVID-19, these include, for example, lack of food, jobs, housing, and health care.
Wang said that as health providers, we must ask ourselves how we provide the vital support needed for people leaving prisons. Referring to the history Meares had highlighted, Wang noted that when a health care system for newly-freed individuals began to be created during Reconstruction, the doctor-patient ratio was poor, with 100 doctors caring for four million people. Many of the newly free individuals did not have vital supports in place, similar to released prisoners today. Wang said that health care providers also need to interrogate themselves and the health system to see where they are complicit with anti-blackness, noting that COVID-19 has unmasked longstanding health disparities.
In her remarks, Green thanked Meares for providing important historical context and Wang for showing photos of people in the prison system, humanizing what often is an abstract topic.
Green shared how she first came into consciousness of the role of health care providers in perpetuating systemic racism. In 2013, she was living in Florida when Marissa Alexander, a black woman with three children, was facing 20 years in prison in Florida for firing warning shots to protect herself in her own home from her violent husband. Green did not understand why health care providers, such as pediatricians, did not stand up and say a prison sentence would harm Alexander’s kids and Alexander herself. Green viewed the health system as implicated in what happened to Alexander.
Regarding the road map for change, Wang pointed to Yale University, Yale New Haven Hospital, and YSM as the biggest three employers in New Haven, and noted that nationwide, about one of seven new jobs is in health care. She said that if our local institutions step up and hire from minority communities, that would have a significant economic impact, and would importantly change the look of who works in our health system.
Wang also focused on the importance of changing the hearts and minds of ordinary people and said this happens most often when people meet individuals who are different from them, for example, who have been incarcerated. She said unfortunately this does not happen often, because we lead segregated lives.
Meares agreed that bringing about systemic change requires that ordinary people understand that the system we live in is unjust, adding that this is the work we must be doing.
Green’s advice to medical students and trainees for bringing about change: “Don’t wait. As a collective, our voices can be just as powerful.”
One of the final questions of the evening was whether providing medical care to people in prison legitimizes incarceration. Wang admitted this is a complicated issue for which she does not have an answer. From a professional perspective, she and her colleagues center their values and practices on the wishes of their incarcerated patients. Personally, she knows that without good health care, incarcerated patients will suffer.
Meares responded by saying she has never been an idealist, but rather is a pragmatist, adding “there is no purity to this if you are on the ground doing the work.”