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Dr Sandra Husbands on Interpersonal vs Institutional Racism

Dr Sandra Husbands has been the Director of Public Health at the London Borough of Hackney and the City of London Corporation since October 2019. She is also ADPH London Co Lead on Health Inequalities and Co Chair of the Public Health Tackling Racism and Inequalities network and workstream. 

The PH-TRI Programme is dedicated to eradicating racism and health inequality in the public health arena. But that word ‘racism’ is very problematic. It is like a ‘bogey man’ – people are afraid of it, and no one wants to be associated with it. But most of the time the racism people are talking about is interpersonal. It is unpleasant for those who experience it, but no longer socially acceptable or widely practiced in polite society. The more pernicious form of racism is institutional. In this blog I will try and unpick the two.

Personal experience

Some years ago after an operation, my wound failed to heal properly for several months. The surgeons were running out of ideas as to why and eventually decided that I must be an IV drug user. They even went so far as to write it in my notes, even though the only needle marks on me had been made by their team. It turns out they’d left something in the wound, but their default thinking was to use a negative stereotype to explain something they couldn’t easily explain otherwise. This is not because they were racists.

It’s an example of the intersection between interpersonal and institutional racism. Medical training leads us to think in stereotypes – it’s part of the shorthand pattern recognition that allows doctors to make diagnoses. Sometimes, however, the stereotypes are not helpful and can even be harmful, as in this case.

Racism is about a power imbalance that then plays itself out in terms of creating structures, and cultural norms and stereotypes that then feed into some of the interpersonal interactions that people experience.

Racism as a power structure can only be about white people – as a group, not as individuals – having that sort of discriminatory power in the disadvantaging of certain people and creating systems that advantage them over other people. And that’s really quite divorced from what you think about individual people, or those personal interactions.

So if it is about power, what about Black people in positions in power? Can they also be racist?

In the UK school system we have a national curriculum and the majority of people within the power structures in the local and national education system are white. A Black head teacher seems to have quite a lot of control over the domain of their school, but what they don’t have any control over is the content of the curriculum, or over decisions that the local education department makes or the Department of Education at national level. Now, they might come into the school with a very different attitude from the average white head teacher, but they also went through the same teacher training process, which is also part of the problem.

They work in a structure, within a culture, which has been designed and set up and then refined and elaborated on over centuries, that tells us some things are important, some things have more value than others and some people have more value than others. The bit about some people having more value is never explicitly stated, but it’s absolutely implied in a lot of things, including a fixation with European power for instance. There’s a way of thinking about the world from a very Eurocentric perspective that gets reinforced by the way we get taught, the books that are available to read, the way that things are presented in the media. And then that all feeds into common discourse and it infects people, whether you want it to or not. It actually shapes the way all of us think.

So when that Black head teacher comes into the school, saying, “‘I’m going to give all the Black boys a really fair shout, because they don’t get a fair shout in other schools.” she will still have an eye on her Ofsted rating and exam results and behaviour in school and a whole load of things that are not, in and of themselves, racist or discriminatory, but have been set up in a way that Is about normalizing one set of values and behaviours and abnormalizing others.

White privilege

One of those things that really gets people exercised is the idea of White Privilege. Because lots of poor or disadvantaged poor white people will say, “I don’t have any privilege”, which is true, socioeconomically or relative to those in power. But if they didn’t have some degree of privilege, then they would be experiencing the world in a very different way.

Is a poor white person any less likely to pinch something from a shop than a poor black person? Not really. But even the middle class black person who makes more money than anybody who works there and who can afford to buy whatever they want from the shop will get followed around by the security guard, before a white person.

And, here is the collision between interpersonal and institutional racism.

They’ve been programmed, in the world of security that they work in, that some people are more likely to be a problem than others and, therefore, some people need to be policed more than others. It’s the same with the police – they’ve been programmed. The Met Police is increasingly diverse, but the behaviors don’t change because they’re still programmed in a way that says some people are more likely to be criminals than others.

The place where you see institutional racism combine with interpersonal racism most violently is with the police.

The first time my brother got stopped and questioned by the police he was nine years old and he was walking down the street with another little black boy who was a similar age. Two children walking down the road with a football are going to play football, aren’t they?
Police are programmed to see black men in particular as a threat and black people as criminals. And so their first response is often that if there’s some kind of altercation, the black person is at fault.
There are statistics to show that white people are more likely to actually use drugs and be involved in the drug trade than Black people and that they’re more likely to use Class A drugs than Black people are. Yet, Black people are still more likely to be arrested, more likely to be jailed, more likely to be stopped and searched on the pretext that they might have drugs on them or that and that they might be dealing. That’s because the narrative within the police is that it is more likely to be black people involved in drugs. So, that’s an illustration of institutional racism.

Institutional culture

I think some organizations might say, “We are institutionally racist” and they think that admitting it sort of absolves them of it. Rather, than saying, actually, what do we do about it? How do we become anti-racist? By contrast , the Met has persistently said over many years, we’re not institutionally racist and have really rejected the findings of the MacPherson report. And, certainly under the previous commissioner, they talked about, “We’ve got a few bad apples”, as opposed to “There’s actually a culture here”.
Institutional racism doesn’t mean that you’ve got an institution full of racists. It means you’ve got an institution that has structures and policies and processes that create a culture that enables that kind of racist outworking of their policies to affect individuals in a way that is discriminatory.

How can it be that we still have institutional racism when you have people of colour in senior positions within those institutions?

Security or the police are kind of extreme examples, because that plays out in a very charged situation where people might be accused of having done something wrong and of being a suspect. Whereas, within a big institution like a council or an NHS organization, there’s much less of that in an overt way. What you get instead is a narrative that says that there are certain ways of thinking and certain ways of behaving that are preferred and there are ways of thinking and behaving that aren’t. And these have not necessarily got anything to do with professionalism or your ability to do your job.

As an example of that, there have been leadership development programmes that are supposed to be about helping people of colour break through the glass ceiling and be able to progress. Some of the content of those programmes was about trying to get people to behave more like their white counterparts. Now, if those are the behaviours that are going to open the door for you, as a shorthand, that’s fine. But over the long term, what does that do in terms of the wider workforce?

That will open doors for a few people who achieve a certain level, get on to that programme, find a way to be able to present themselves acceptably to the predominantly white power structure within their organization, are able to progress, maybe become a chief exec. But then they perpetuate that, because they have learned that these are appropriate leadership qualities, these are appropriate, professional behaviours, etc. and, therefore, that’s what I want to see. So, they’re going to recruit more people who present themselves like that. The majority of people who do are going to be other white people and, equally, they’ll be other white middle class people, who went to certain universities, as opposed to Joey from the Council estate, who went to a comprehensive and then did the OU online at night, while he was working as a security guard.

Why are we not trying to encourage and recruit more people like Joey? Because we have recruitment and selection processes that privilege certain things. Even when you do blind recruitment, so you don’t know who this person is or what their personal details are, if you’re looking for specific types of experience and specific types of education, for people to respond to questions in a particular way, you’re still imbuing your bias into the selection process. And if you’ve come through because of that selection process, you’re likely to think it was a good selection process. So, why would you change it?

Just allowing some people to come through, is not going to change the structure. What you actually need to do is say we need to change the structure. We need to change the processes. We need to really change the way of thinking as an organization and that’s what’s going to change the makeup of the workforce in all of its complex diversity, not just in terms of ethnic diversity.

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