On Oct. 9, 2020, Khiara Bridges, Professor of Law at UC Berkeley School of Law, gave a profound talk on critical race theory and current issues at an event …
Hello everyone I'm Michael Omi professor of 
Ethnic Studies here at UC Berkeley, welcome  
to today's timely and important talk on Critical Race 
Theory sponsored by the Osher Lifelong Learning  
Institute at Cal. This is the second presentation 
in OLLI's series America's Unfinished Work. The series  
brings leading voices from the campus and in 
the community to engage in an examination and  
hopefully eradication of systemic racism in 
order to create a more humane, just, and equal  
society. Now I would argue that most Americans 
didn't even know what critical race theory was  
but President Trump seems to consider it more 
of a threat than the COVID-19 pandemic. Consider  
his remarks three weeks ago at the White 
House conference on American history. I quote  
"Students in our universities are inundated with 
critical race theory this is a Marxist doctrine  
holding that America is a wicked and racist nation.
Critical race theory is being forced into our  
children's schools it's being imposed into our 
workplace trainings and it's being deployed to  
rip apart friends, neighbors, and families." End quote.
Pretty powerful stuff and today professor Khiara Bridges
is going to help us sort out what 
critical race theory actually is and what it isn't. Khiara Bridges is a professor of 
law at the UC Berkeley School of Law,
and she has written extensively including three 
books on issues of race, class, reproductive rights,
and the intersection of the three. She 
graduated as a valedictorian at Spelman College,
she received her JD from the Columbia Law School 
and a PhD with distinction in Anthropology
from Columbia University. Professor Bridges also 
speaks fluent Spanish and basic Arabic, and she  
is a classically trained ballet dancer.
As OLLI director Susan Hoffman said to me,
Professor Bridges is just your basic underachiever.
She'll be presenting and then after that you can
add questions in the chat and she will
will take up those questions at the end of  
her talk. So without further ado, I'm extremely 
pleased to introduce Professor Khiara Bridges.
Thank you so much for that wonderful 
introduction Professor Omi. I am so honored to  
be here with the community today, I 
am so honored to have the opportunity to  
explain or talk about critical race theory 
as well as to apply it to some current events. 
So I'm going to share my
screen and we can get started.
OK, so my remarks today will examine two contexts in which institutional
or structural racism has shortened the lives of people of color
specifically black people, and those two contexts are policing and health policy.
Specifically I will explain what critical 
race theory as an analytical framework  
brings to understanding police brutality 
as well as racial disparities in health  
so the plan for the next hour, we will explore how 
systemic racism kills in the context of policing
we'll explore how systemic racism 
kills in the context of health policy
and then we will have time to engage in a question 
and answer portion and so to that end the
the chat function will be the avenue 
for you to place your questions to me  
and so if you drop your questions in the chat 
during the Q&A at the end of my presentation  
I will turn to answering them. So let's start with 
policing and more precisely I want to start with  
the question of how critical race theory or CRT
for short might encourage us to think about George
Floyd's death earlier this summer. Now there is 
no time for me to give a complete history of CRT.
It is not possible to describe the framework 
concisely or pithily, though Trump tried to  
do so, I will just say that CRT emerged in 
the legal academy in the 1970s and 1980s in  
response to what critical scholars consider to 
be the limitations in traditional civil rights  
discourse, the limitations of the traditional 
way we had come to think about race and racism.  
One of the many ways that critical race 
theorists thought that traditional civil rights  
discourse was limited was with regard to its 
definition of racism. So traditional civil rights  
discourse tends to define racism as discrete,
easily identifiable, invariably intentional,
always irrational acts that are perpetrated 
by bad actors. Essentially traditional civil  
rights discourse defines racism as individually 
held bias or prejudice. CRT proposes that this  
definition of racism is woefully inadequate. While 
defining racism as discrete, easily identifiable,
invariably intentional, always irrational acts 
that are perpetrated by bad actors … while  
that definition might describe a type of racism 
that was ubiquitous in the pre-civil rights era  
and while this definition of racism might describe 
a type of racism that tenaciously persists today,
CRT argues that this definition does not 
describe the mechanisms that do most of the work
of maintaining white people as the dominant 
racial group in this country at present.  
CRT contends that far from being discrete 
or cut off, racism and racial dominance  
are oftentimes the result of the interactions 
of many institutions across multiple domains.
CRT claims that far from being easily identifiable,
racism and the recognition of an act or omission
as a species of racism that frequently requires a 
theoretical framework to help us figure out which  
societal choices inflict racial subordination and 
consequently ought to be designated as racism.
CRT proposes that racism is not invariably
intentional in the post-civil rights era,
racism is oftentimes the unintended
if foreseeable consequence of
choices that we make.
CRT also denies that racism
is unwaveringly irrational. It posits that more often 
than not racism makes all the sense in the world.  
Finally, CRT argues that while racism may be 
perpetrated by bad actors, it more frequently  
is the result of institutional 
structural processes in the post-civil rights era.  
CRT offers that defining racism in the way that 
traditional civil rights discourse proposes is  
problematic and dangerous. When racism is only 
understood as bias or prejudice practiced by a  
bad actor, it puts outside of the field of vision 
all of the institutions, structures, and systems  
that function to subordinate people of color.
With that background, consider the questions
that the traditional liberal definition of racism 
leads us to ask when we learn that george floyd  
was killed after police officer Derek Chauvin 
kneeled on his neck for close to nine minutes  
the definition directs our focus to the police 
officer who killed him, Derek Chauvin, and it guides  
us to an interrogation of Chauvin and his views on 
race, so we ask has Chauvin ever use the n-word we
ask does Chauvin have any black friends we ask does
Chauvin listen to hip-hop essentially the liberal  
definition of racism leads us to ask whether 
Chauvin is a bigot and if we determine that Chauvin
is a bigot then we can be comfortable concluding 
that Floyd's death is a manifestation of racism  
and if we determine that Chauvin is not in fact a 
bigot then Floyd's death cannot be understood as a
manifestation of racism notably there is evidence 
that chauvin may not be a bigot he was married to  
an Asian woman after all so can a white person 
be a bigot if he's married to an Asian woman can  
one dislike black people while loving at least 
one Asian person can dislike of black people  
and love of an asian person be simultaneous please
note that these are profoundly uninteresting  
questions to ask. Now when racism is defined in
the way that CRT proposes we are encouraged to
ask different questions about Floyd's death 
when we learned that the police encounter  
that ended in Floyd's death began because Floyd 
might have been attempting to use a counterfeit  
$20 bill at a convenience store we might remind 
ourselves of definition of a white-collar crime  
white-collar crimes are generally understood as 
non-violent acts that result in financial harm and  
that are committed for financial gain so the crime
that Floyd was allegedly attempting to commit was
a white-collar crime note as well that Eric Garner 
was allegedly committing a white-collar crime  
minutes before his death. As a reminder in 2014
Eric Garner was killed after a police officer
Daniel Pantaleo put him in an illegal chokehold,
Pantaleo initiated the encounter that ended in
Garner's death because Garner was illegally 
selling individual cigarettes from a pack.
New York state like many other states taxes the 
sale of cigarettes and other tobacco products  
New York state collects taxes from the sale of 
tobacco products by requiring persons who sell  
these products to register with the New York state 
tax commission and to prepay taxes on the sale of  
the products through purchasing tax stamps so when
Garner sold the cigarettes without a license from
the New York state tax commission and without the
requisite tax stamps New York state was not able
to collect taxes on his sale of the cigarettes so 
essentially Pantaleo attempted to arrest Garner  
because garner was allegedly engaging in tax 
evasion a white-collar crime so again both george  
floyd and eric garner were allegedly engaging in 
white-collar crimes before their deaths and again  
white-collar crimes are generally understood 
as non-violent acts that result in financial  
financial harm and are committed for financial 
gain crt encouraged us to ask questions about how  
race informs our definitions of crime now i've 
been thinking a lot about recessions lately you  
might be too in 2007 the country was thrown into 
the greatest economic downturn that the nation  
had experienced since the great depression of 1929 
just a very brief history of the great recession  
banks had relaxed their lending practices giving 
bigger mortgages to borrow borrowers who had not  
provided and could not provide proof of their 
ability to make payments on their mortgages  
financial institutions packaged these mortgages 
into securities and when homeowners eventually  
defaulted on their loans the value of 
these mortgage-backed securities plummeted  
banks who owned these securities were unable to 
raise capital and they teetered on the verge of  
collapse until the government bailed them out now 
the great recession was made possible by predatory  
lending and greed what i want to highlight here 
is that the financial practices that led to the  
great recession were non-violent they resulted in 
financial harm and they certainly were engaged in  
in order to reap financial gain but they were 
not crimes crt invites us to ask how does race  
and class influence decisions to criminalize 
some non-violent harmful practices that are  
committed for financial gain crt invites us to 
ask how does race and class influence decisions  
not to criminalize other non-violent harmful 
practices that are committed for financial gain  
why do we decide to simply leave some of these 
harmful practices to agencies to regulate or not  
further if floyd was in fact trying to pay for 
something with the counterfeit 20 bill why did  
he do that why had garner felt compelled to sell 
single cigarettes from a pack on the sidewalks  
of staten island new york what does it reveal 
about the economic opportunities available or not  
available to floyd that he thought that attempting 
to pay for some goods with a counterfeit bill  
was worth the risk what does it reveal about the 
economic opportunities available or not available  
to garner that an able-bodied adult man of sound 
mind concerning individual cigarettes from a pack  
something that was worth his time and 
energy also what empowered chauvin or  
any police officer for that matter to engage 
with floyd an individual who was suspected  
to be engaging in a non-violent crime what 
empowered pantaleo or any police officer  
for that matter to engage with garner who also 
was suspected to be engaging in a non-violent  
victimless crime specifically why has our 
constitution been interpreted to give the police  
the latitude to initiate contact with individuals 
suspected of engaging in non-violent crime  
moreover when we learn that 46 year old george 
floyd suffered from coronary artery disease and  
hypertensive heart disease health conditions 
that might have made the knee that shelby  
placed on his neck for close to nine 
minutes much more likely to be deadly  
we can ask questions about why floyd had come to 
inhabit such a state of unhealth similarly when  
we learn that 43 year old eric garner suffered 
from a host of health issues including asthma  
that made the illegal chokehold in which 
pantaleo put him much more likely to be  
deadly we can ask questions about why garner 
had come to inhabit such a state of unhealth  
why did floyd as well as so many black people 
in this country suffer from heart disease  
why did garner as well as so many other 
indigent folks in this country suffer from  
obesity why did garner as well as so many 
other poor people of color suffer from asthma  
why did floyd and garner as well as so many 
other black people suffer from hypertension  
the answers to this batch of questions do not 
involve malicious actors but rather deadly systems  
and structures and just a nod to the novel 
coronavirus at this point in the us's encounter  
with covet 19 most are aware that the disease 
has disproportionately killed black people  
i believe that the mature mortality rates 
from cover 19 are twice as high for black  
people than they are for white people and this 
is true because of racial disparities and health  
because of structural racism black people suffer 
from higher rates of the underlying conditions  
the asthma the hypertension the heart and lung 
disease the diabetes that are risk factors for  
developing a particularly severe case of copa19 
in other words well before their encounters  
with the police officers who would eventually 
kill them eric garner and george floyd's bodies  
had already been damaged by the structural 
racism that has made covet 19 particularly  
devastating among communities of color and i will 
return to racial disparities in health in a bit  
so defining racism in the way that the traditional 
liberal tradition proposes this allows us from  
looking at these broader issues instead it keeps 
our attention squarely focused on the individual  
police officer who kneels on floyd's neck for 
close to nine minutes it keeps our attention  
squarely focused on the individual police 
officer who placed garner in an illegal chokehold  
in this way we see how the liberal definition 
of racism suggests that in order to fix  
any race problem the nation continues to have 
no great societal reformation is necessary  
now few most would argue that there are likely 
not incredibly large numbers of bigots roaming  
the streets and the post-civil rights era now of 
course bigots exist and they might even occupy  
positions of power however i believe most people 
across the political spectrum would probably all  
agree that bigots are still in the minority in 
our country now if racism is only individually  
held bias or prejudice prejudice and if biased 
or prejudiced individuals are in the minority  
then racism is an aberration and if racism 
is an aberration then racial justice will  
be achieved when these aberrant individuals are 
identified and denied the ability to harm others  
the work of anti-racism then is simply to remove 
these blemishes from an otherwise perfectly good  
body politic but if racism is divided more broadly 
in the way that crt proposes then there is nothing  
simple pat or easy about the work of anti-racism 
let's return to george floyd the liberal  
definition of racism suggests that the work of 
anti-racism is to remove children from the police  
out force if he is indeed a bigot it also suggests 
that we need to implement procedures that will  
prevent other bigots from becoming police officers 
and if we do those two things ta-da problem solve  
but if racism is defined in the way that crt 
proposes the more wide range changes are necessary  
these changes involve 
addressing society's decisions  
to criminalize non-violent 
activities in which the poor  
because of their indigenous primarily engaged 
like selling individual cigarettes from a pack  
these changes include creating legal opportunities 
for individuals to support themselves and their  
families financially these changes include 
creating a durable generous and non-punitive  
social safety net for those who find it difficult 
or impossible to be financially self-supporting  
these changes involve reconsidering the court's 
interpretation of the fourth amendment's  
prohibition against unreasonable searches and 
seizures and interpretation that has empowered  
police officers to approach and arrest individuals 
engaging in non-violent victimless crimes  
these changes include addressing the sighting of 
environmental hazards in poor communities of color  
which contributes to the high rates of health 
problems among the residents of these communities  
these changes include making healthy foods 
available and affordable in poor neighborhoods and  
these changes include tackling the myriad reasons 
that people of color in this country are sicker  
and die earlier than their white counterparts 
including our two-tiered health care system  
and the deadly toll that racism-related stress 
takes on the bodies of people of color and so this  
example reveals that crt's definition of racism 
means that anti-racism requires an extensive and  
some would say radical reordering of society and 
my little brain suggests that that is the reason  
that trump has decided to attack crt because 
we suggest that in order to fix the country's  
enduring race problem something that trump denies 
we have to make great changes in the status quo  
okay now a couple of minutes ago i said that 
because of structural racism black people suffer  
from higher rates of the underlying conditions 
the asthma the hypertension the heart and lung  
disease the diabetes that are risk factors for 
developing a particularly severe case of covet 19  
and so i want to unpack that claim and in 
unpacking that claim i want to examine the  
second context in which systemic racism kills 
in the second context being health policy now  
researchers have long documented that black people 
have higher rates of every major common illness  
and i shall also mention that there are racial 
disparities in maternal and infant mortality black  
babies are twice as likely than white babies to 
die before their first birthdays and black women  
are three to four times as likely as white women 
to die during pregnancy childbirth and shortly  
thereafter what explains this so i first want 
to discuss three popular explanations of racial  
disparities in health that do not take systemic 
racism three explanations of racial disparities in  
health that critical race theorists have critiqued 
and then i want to look at explanations of racial  
disparities in health that do take systemic racism 
seriously so let's start with this first one gene
so critical scholars resoundingly reject the idea 
that genetic differences between the races explain  
racial disparities and health nevertheless 
there is always a study popping up somewhere  
that offers to explain racial disparities in 
health in genetic terms so this is an excerpt  
from an article from my former institution boston 
university in 2012 a group of researchers there  
sought to identify what they called the role of 
genetics in black women's experiences with cancer  
and as you see this is the headline 
from a new story covering their research  
genetics can trump income access to care and 
here's a little excerpt from the study what i want  
to draw your attention to is this final little 
piece that says at all ages mortality from breast  
cancer is higher for black women and it's clear 
now that it's not due to differences in access  
care or treatments and so these researchers are 
committed to the idea that genetic variation  
between racial groups explains these elevated 
breast cancer mortality rates among black women  
the problem is that people who claim that 
genetic differences between races explain  
health differences between races have never been 
able to identify a genetic variation that is  
specific to a racial group the failure to identify 
race-specific genetic variations is due to the  
fact that such race-specific genetic variations 
do not exist researchers who propose that genetic  
differences are causing racial disparities in 
health usually reach this conclusion after they  
have control for potent other potential causes of 
the disparity like income socioeconomic status or  
access to health insurance and health services 
and although these researchers may eliminate  
many non-genetic causes of any given racial 
disparity in health outcome they never identify  
the genetic cause of the disparity their faith 
that genetic variation between the races exists  
leads them to presume that such as the genetic 
cause of the disparity exists this is precisely  
what these researchers at bu are attempting to 
do they show that if we control for access care  
treatments black women still die at elevated 
rates from breast cancer and because of their  
faith and genetic race or ideas of genetic race 
they're going to spend tens of millions of dollars  
looking for the genetic culprit that explains 
these elevated rates of breast cancer mortality  
again we collectively ought to oppose the claim 
that genetic variations between the races explain  
racial health disparities most prominently because 
the empirical research cannot support it one of my  
favorite people in the world dorothy roberts 
at u penn explains it is implausible that one  
race of people evolved to have a greater genetic 
predisposition to heart failure hypotension infant  
mortality maternal mortality diabetes asthma we 
might even add covet 19. there is no evolutionary  
theory that it can explain why african ancestry 
would be genetically prone to practically every  
major common illness but we also ought to oppose 
the claim that racial health disparities can be  
explained in terms of genetics because they are a 
dangerous distraction from those mechanisms that  
actually explain why people of color are sicker 
and die earlier than their white counterparts  
when you're like me and you're convinced that 
these disparities are caused by structural factors  
like residential segregation and the unhealthy 
housing stocks found in the neighborhoods that  
people of color call home like the clustering of 
environmental hazards in segregated neighborhoods  
neighborhoods of color like high unemployment 
rates like the unavailability of quality health  
services when you're like me and you believe 
that these factors are killing black people  
that any suggestion that genes are killing black 
people sounds like an excuse it sounds like an  
excuse not to address what really is causing the 
deaths of black people so critical race theories  
rejects the claim that bad genes are causing 
racial disparities in health we also reject the  
claim that culture explains racial disparities in 
health now there is an undeniable it is undeniable  
that one's behavior affects one's health there 
is a greater likelihood that a person who eats  
healthy foods and works out every day will have 
better health outcomes than a person who eats  
fatty high sodium foods or drinks sugary beverages 
and smokes cigarettes and doesn't exercise  
however the undeniable truth that unhealthy 
behaviors lead to unhealthy outcomes is more  
problematic when unhealthy behaviors are imagined 
to constitute a culture that explains racial  
disparities and health differently stated we ought 
to be wary of arguments that people of cultures  
of people of color's culture leads them to 
engage in behaviors that compromise their health  
one hears cultural explanations of racial 
disparities in health ever so often  
for example there is an argument that the tuskegee 
experiment has led to a culture of distress of  
physicians and other health care providers among 
black americans and this culture is thought to  
have damaging health consequences as it leads 
black americans to refuse to seek medical care  
when they ought to do so another example is the 
argument that indigenous culture native culture  
leads the people steeped in it native americans to 
consider to start to consume excessive amounts of  
alcohol which causes hypertension stroke 
liver disease and an assortment of cancers  
another cultural argument is the argument that 
the foods that comprise the cultural repertoire  
of soul food foods that black americans are 
believed to eat because it is part of our culture  
these are the sugary high fat high sodium foods 
that lead to obesity hypertension and diabetes  
the problem is that it is misleading to conclude 
that when people of color engage in unhealthy  
behaviors it is because their culture made them 
do it it is misleading because the reality is that  
oftentimes the lives of people of color have 
been constrained in ways that make unhealthy  
behaviors the only option in other words the 
health behaviors of people of color may not be  
cultural in the usual sense of the term if some 
people of color do not go to the doctor as often  
as they should it is likely because they are 
uninsured or then or there are no health providers  
accessible to them or it might be because they 
had an interaction with the health provider  
that made them lose trust in in in the health 
care system and so we don't need to rely on the  
tuskegee experiment from the 1920s to explain 
black people's distress of health providers if  
some people of color drink alcohol to excess 
it may be because they are coping with poverty  
and racism if some people of color eat foods 
that are high in fat salt and sugar it may be  
due to those foods being the only affordable 
options in their neighborhoods i like to remind  
people that it's called the dollar menu mcdonald's 
has a dollar menu the foods on that menu cost a  
dollar which means you can get a burger fries soda 
and probably something sweet for four dollars see  
how far four dollars gets you at whole foods see 
how far four dollars gets you at the berkeley bowl  
and then there are the droves of studies 
that show that behavioral differences  
cannot explain racial disparities in health one 
scholar summarized the literature succinctly  
when he wrote as observed 10 years ago health 
behaviors can be potent contributors to disease  
risk there is little evidence however that 
alone or in combination health behaviors can  
explain racial and ethnic health disparities 
so identifying genes and culture as the causes  
of racial disparities in health represents a 
commitment not to take systemic racism seriously  
but if i'm completely honest with you guys i will 
admit that genetic and cultural explanations of  
racial disparities in health actually are not 
the most popular theories offered to explain  
why people of color are thicker and die earlier 
than their white counterparts in fact the most  
popular explanation of racial disparities in 
health today is likely the fact of implicit bias  
however there are significant limitations to this 
theory and first i'll describe the literature on  
implicit bias and then i'll discuss its weaknesses 
but before i launch into that i just want to note  
that a lot of critical race theorists have 
looked into implicit bias a lot of critical race  
theorists have examined how implicit bias plays 
out in the health context in the policing context  
and employment context and admissions context so 
which is to say a lot of critical race theorists  
have dedicated their lives and their scholarship 
to exploring how implicit bias operates  
and then there are other critical race 
theorists who have critiqued um the literature  
on implicit bias and they have articulated 
the critique that i'm going to share with you  
which is to say critical race theory isn't 
a cult it is not a unified or it's not a a  
theory within which everyone disagrees there 
with it within which everyone agrees there is an  
incredible amount of disagreement and contention 
and conversation and dialogue among critical race  
theory so when someone offers to say critical race 
theory is this xyz um it's likely ignoring the  
heterogeneity um the contestation and the fluidity 
that exists within the theory so with that in mind  
implicit bias in 2005 the institute of medicine or 
the iom which is now a different division but they  
released a report documenting that people of color 
receive lower quality healthcare than white people  
even when you control for all the things that 
might explain differences in care like insurance  
status like income like age like severity of 
the conditions and the iowa reported that racial  
minorities are less likely than white people 
to be given appropriate cardiac care to receive  
kidney dialysis or transplants and to receive 
the best treatments for stroke cancer or aids  
the iom concluded by describing 
what they said was an uncomfortable  
reality some people in the united states are 
more likely to die from cancer heart disease and  
diabetes simply because of their race or ethnicity 
not just because they lack access to health care  
many studies have buttressed the iom's 
findings by documenting that providers  
are less likely to prescribe and deliver effective 
treatments to people of color when compared to  
their white counterparts even after controlling 
for all those important characteristics like class  
most researchers have explained the reality that 
providers give inferior care to their patients of  
color by looking to implicit biases the idea is 
that providers have views about racial minorities  
of which they are not consciously aware and these 
are views that lead them to make unintentional  
and ultimately harmful judgments about the 
care that they give people color the care  
that they give people of color many of you are 
familiar with the implicit association test  
and this is a test that purports to measure test 
takers implicit biases by asking them to link  
images of black and white faces with pleasant and 
unpleasant words under intense time constraints  
now when physicians are given the iat 
they tend to associate white faces and  
pleasant words much more easily than they 
can associate black faces in pleasant words  
in fact research shows that these anti-black 
pro-white implicit biases are as prevalent among  
providers as they are among the general population 
which is to say there is nothing about medical  
school that cleanses individuals of the implicit 
biases that exist in society more generally  
further there is research that purports 
to show that providers implicit biases  
um actually impact the health care that they give 
right it's one thing to have an implicit bias it's  
another thing to actually act on the implicit 
bias and this research shows that providers are  
acting on their implicit bias for 
example one study showed that physicians  
whose implicit association tests revealed them 
to harbor pro-white implicit biases were more  
likely to prescribe pain medications to white 
patients than to black patients another study  
administered the iat to physicians and then asked 
them whether they would prescribe thrombolysis  
which is an aggressive yet effective treatment for 
coronary artery disease keep in mind that was the  
disease that george floyd had when he died so this 
school this uh this uh study asked physicians to  
whether they were prescribed this treatment for 
coronary artery disease to patients presenting  
with a range of symptoms for the disease 
and this experiment revealed that physicians  
whom the iat test revealed to harbor anti-black 
implicit biases were less likely to prescribe  
thrombolysis to black patients and more likely to 
prescribe that same treatment to white patients  
so if these studies are up to 
something then implicit biases  
might be contributing to racial disparities 
in health when observers including the media  
as well as medical schools talk about racial 
disparities in health this is the focus that  
they tend to have the focus is on implicit bias 
sort of at the beginning of the coronavirus
tragedy in the u.s i was asked to speak on new 
york public radio about racial disparities and  
maternal and immortality from covet 19 and that 
is precisely what they wanted to talk about they  
wanted me to talk about implicit biases and 
how implicit biases might be contributing to  
disparities in covet 19 mortality rates between 
black people and white people and then for their  
part medical schools when they address racial 
disparities in health they tend to focus on  
implicit biases some medical schools even go so 
far as to give their students an iat so that the  
students know that they have implicit biases and 
the extent of them and then these programs tell  
students and residents you know to be mindful 
about how their documented implicit biases  
may influence the health care that they give 
and to be honest that is incredibly laudable  
but the issue is that racial disparities 
in health cannot be explained entirely in  
terms of implicit bias that is the fact 
that providers have implicit bias is an  
incomplete explanation of racial disparities in 
health implicit bias has to be put in conversation  
with systemic racism it has to be put in 
conversation with institutional and structural  
racism and so in the balance of my remarks which 
is about 10 more minutes i will discuss the  
analytical limitations of the field of implicit 
bias and then i will ask the question what do we  
see when we put implicit bias in conversation 
with institutional and structural racism first  
the feel of implicit bias is limited on its own 
terms the field is focused on the individual  
and the prejudices and aversions that he or she 
may or may not possess and then note how this  
focuses a piece with the definition of racism 
positive by traditional civil rights discourse  
right racism as discreet easily identifiable 
invariably intentional always irrational acts  
that are perpetrated by bad actors essentially 
traditional civil rights discourse posits that  
racism is what happens when racist individuals 
think racist thoughts and then do racist things  
implicit bias essentially says the same thing 
right officially says that we're talking about  
discrete identifiable it's not intentional it's 
unintentional but they are irrational acts that  
are perpetrated by bad actors so critical race 
theorists and progressive theories of race have  
fought tooth and nail to challenge this narrow 
formulation of racism again we posit that in  
the post-civil rights era racism is what it's 
better to find as what happens when institutions  
and structures operate in a race neutral 
manner that nevertheless perpetuates historical  
disadvantage and produces new forms of racial 
disenfranchisement nevertheless implicit bias  
remains squarely in this individual-centered 
paradigm and this individual-centered paradigm  
causes us to think of racism as a private concern 
which might mitigate any responsibility that the  
state and society more generally might have for 
the eradication of racism and racial inequality  
so we might be skeptical of implicit 
bias research because it might  
commit the error that non-critical 
thinkers of race make it might be  
focused on individualist racism and it might 
be ignoring institutional and structural racism  
further there is an argument to be made that 
the problem is not that individuals have  
implicit biases instead the problem 
is that we have constructed a society  
wherein people of color are at the bottom of most 
measures of social well-being people of color  
more frequently bear the burdens of poverty than 
white people people of color are incarcerated more  
than white people people of color are confined in 
immigrant detention centers more than white people  
people of color rely on the social safety net more 
than white people people of color are unemployed  
more frequently than white people people of color 
die violent deaths more frequently than white  
people and it is doubtful that implicit biases 
alone can explain these disturbing inequalities  
more likely the reverse is true these inequalities 
explain implicit biases and for that reason  
critical race theorists have argued that the best 
approach to dealing with implicit bias is through  
a sustained process of social change that 
results in the elimination of the socially  
disfavored status of the subordinated group if 
people of color were not invariably located at  
the bottom of social hierarchies providers likely 
would not have negative implicit biases about them  
but perhaps more importantly the field of 
implicit bias needs to be put in conversation  
with structural racism and what would we see 
if we paid attention to structural racism well  
we would see that individuals with implicit biases 
as well as individuals without implicit biases  
they are all practicing medicine within a 
two-tiered health care system and this is  
a system that allows for the privately insured who 
are disproportionately white to access health care  
that is simply better than the publicly 
in short not to mention the uninsured  
and to make this point as tangibly as 
possible i will tell you a bit about my first  
book reproducing race is an ethnography of 
the obstetrics clinic of a public hospital  
in manhattan i call the hospital alpha just to 
give it some anonymity an alpha hospital is a good  
hospital it is world renowned for its research 
and innovations however these achievements do not  
exempt it from its status as a public hospital 
alpha must still depend on government dollars  
which are always in short supply and the result 
is that alpha is plagued by problems that visit  
many public institutions it is underfunded and 
understaffed moreover the equipment that the staff  
and the physicians use may be in short supply or 
may have been superseded by newer better versions  
versions that are outside of the hospital's fiscal 
reach due to budget constraints and this is a long  
quote from a chief resident and the chief resident 
was just explaining to me the difference between  
alpha and omega omega is the private hospital 
that literally sits right next door to alpha  
now omega doesn't take medicaid um so all of 
omega's patients are privately insured and which  
what that means is that omega gets more money per 
patient because private insurance is reimbursed at  
rates that are twice to three times the rates at 
which medicaid reimbursed so alpha just has more  
money also note that because alpha doesn't have 
doesn't take uh public insurance and take medicaid  
you have this strict dichotomy of populations 
the poor patients go to alpha and the more  
affluent patients go to omega and what this close 
is explaining is that when you're in omega you're  
likely to be able to have better scans because 
the equipment in omega is better than alpha  
your ability to have a scan an mri a cat scan what 
have you it's just the amount of time that you  
have to wait is going to be shorter because omega 
has more of the equipment than alpha hospital  
um and then there's a part of this quote which 
says that you know we might just we might do a  
scan and alpha on this old equipment and we'll 
call it a poor study we won't know what to do  
with you know we can't make any conclusions based 
on the skin because of the quality of the machine  
meanwhile at omega you'll never have a poor study 
which means that if you're an omega your health  
care that you're receiving it's just going to 
be superior which is to say individuals with  
implicit biases as well as individuals without 
implicit biases are practicing medicine within  
the inequalities enabled by the country's 
two-tiered health care system so i repeat  
implicit bias as a theory of racial disparities in 
health is radically incomplete and finally let us  
not forget the social determinants of health for 
the uninitiated the social determinants of health  
are the conditions under which people live 
that affect their health critical scholars  
are committed to the idea that these structural 
factors the availability of health care quality  
schools non-hazardous jobs safe and secure housing 
non-violent unpolluted cities and communities etc  
these structural factors go a long way towards 
explaining the poor health that people of color  
have there are studies too numerous to count that 
document that the environments in which my racial  
minorities live work play and age are all likely 
to compromise their health and it is important to  
underscore that there is nothing inevitable about 
the fact that people of color inhabit the most  
polluted environments there is nothing inevitable 
about the fact that people of color inhabit these  
environments while also lacking the means like 
health insurance to protect their health the  
world health organization's position on this 
issue is compelling the unequal distribution of  
health damaging experiences is not in any sense 
a natural phenomenon but as a result of a toxic  
combination of poor social policies and programs 
unfair economic arrangements and bad politics  
so sure implicit biases harbored by medical 
providers may be impacting the health care  
that they give patients color but the society in 
which patients of color are living that is what's  
doing most of the heavy lifting when it comes to 
shortening and reducing the quality of their lives  
so i will in there um i will conclude just 
by saying that i'm so glad that so many have  
protested george floyd's death i'm so glad that 
so many have protested brianna taylor's death  
and i'm so glad that so many continue to protest 
these deaths but i hope that we keep in mind that  
what protesters are protesting it's bigger than 
derek chauvin it's bigger than the minneapolis  
police department it's bigger than the louisville 
police department is bigger than policing it is  
bigger than the criminal legal system as a 
whole i take their protests to be protests  
of a racial order of things that have found that 
it's found a number of different ways to shorten  
and in black people's lives and with that i am 
done and i look forward to the conversation i  
professor kiara bridges thank you very very much 
um we are in your debt for such a comprehensive um  
and sort of deep analysis um and thank you for 
for really explaining the critical race theory  
um the questions that emerged the first five 
questions were not questions they were just  
um a shower of appreciation um and i 
and obviously contained within that was  
the question how else uh can people share your 
presentation and so i just want to take a moment  
to tell people that um our classroom team rob 
and and max will be posting this on youtube um  
probably sometime on monday and so that will 
be available through the um the ali website and  
please do share it do talk about it um 
i'm gonna i'm gonna ask the first question  
um and part of it is when we see how woefully 
inadequate the civil rights definition is is there  
any hope or belief that the international human 
rights declaration that the un has put together  
would it be better um you know for us to begin 
to use that um as a kind of rubric and guide  
um and so are you familiar with the international 
human rights declaration i i am but it might be  
helpful for you to share um share the definition 
with the audience so that they are familiar as  
well um you know what i think i will do is there 
is i know there's someone in our crowd right now  
who's worked a lot on the international 
human rights rita marin is is with us today  
um and has taught courses on international 
human rights which i think covers the whole span  
of the things that we were just bringing you 
were bringing up around housing and health care  
you know sort of life liberty and the pursuit 
of happiness right education um all of that  
um and i don't know you know i think since it's 
something that we're trying to cultivate within  
international law might it not also guide us on 
on some things as well yeah so um so i will um  
just offer that you know the inter international 
human rights framework is much more comprehensive  
than any framework that the uh us has ever 
embraced um for example um there are rights  
to be freedom uh to be free from discrimination 
on the basis of culture race sex um the rights to  
uh clean air water um the right to be free from uh 
discrimination on the basis of religion etc cetera  
and so the international human rights framework 
tends to be much more expansive and comprehensive  
than the framework that we embrace in 
our anti-discrimination law in the u.s  
one thing that i want to highlight is the 
distinction between negative rights and positive  
rights and so in the u.s we tend to embrace or 
rather our constitution has been interpreted  
to protect only negative rights 
which is the right to be free  
from government intervention so the government 
cannot go in your home and take food out of your  
out of your refrigerator and the 
government cannot go in your home  
um and and take your prescription medications 
out of your um of your bathroom cabinet  
positive rights are different and positive rights 
are are much more recognized in international  
human rights uh treaties and instruments positive 
rights are rights to government assistance and so  
a positive right to food would mean a negative 
right to food means that the government can come  
in and take the food out of your refrigerator but 
a positive right to food means that the government  
has to make sure that you have food to eat 
um and a negative right to uh freedom from  
having the government take your prescription 
medication means that the government can come  
in and take your prescription medications but a 
positive right to health means that the government  
has to provide you with the tools that you need 
in order to be healthy international human rights  
treaties and instruments protect positive rights 
the u.s constitution as i mentioned already  
has has uh has been interpreted to protect only 
negative rights which leads us to a present state  
of of our laws which is that you have no recourse 
when you don't have the basic necessities that one  
needs you have no recourse there are no rights you 
can't sue because you lack food clothing shelter  
health care and so yes international human rights 
would be a wonderful regime for interpreting  
on the rights that we that we recognize in 
our constitution as well as the rights that  
we you know that have been provided in statutes 
like the civil rights act of 1964 for example  
the problem is that the supreme court has been 
very clear um starting around about the 1970s  
that the constitution does not protect positive 
rights but also that we ought not to look to  
international human rights treaties to interpret 
our constitution the late justice scalia um wrote  
vigorous defense whenever a majority of the 
supreme court even looked over to international  
human rights treaties um to you know to interpret 
what our constitution protects um he dissented  
vigorously on a number of occasions whenever any 
sort of overtures were made towards looking at  
international human rights treaties so which is 
to say there is a idea of american exceptionalism  
that america is so unique um that our constitution 
is so distinct from any other legal instrument  
um that we ought to be insular and myopic when it 
comes to interpreting what that document provides  
so we would we would be in much better but much 
better uh hands or would be in a better situation  
if we actually look to other outside bodies yeah 
thank you thank you for that response um a couple  
of questions uh to get in is does the um obamacare 
or aca does that have has that had any impact on  
um inequities so the the so oh the affordable care 
act is going to um address some racial disparities  
in health and as much as some of the uh cause of 
racial disparities and health is inaccessible you  
know the inaccessibility of health care so to 
the extent that individuals can access health  
care through the affordable care act um then they 
will be able to protect their health and racial  
disparities and health will be uh eliminated 
to some or to limit it in some extent to some  
extent the issue is that uh states were given the 
option to expand to medicaid uh medicaid or not  
um through uh in a an nfib versus sebelius 
the supreme court case that initially upheld  
the constitutionality of afford of the affordable 
care act and so it was we called it the red state  
option so states were given the option to expand 
medicaid or not it just so happened that the  
states that chose not to expand medicaid where the 
medicaid were the states um that had large numbers  
of black people so um and as much as you know 
black people disproportionately lack health care  
if they're stuck in these states that chose not to 
to expand medicaid through the affordable care act  
then the affordable care act would not have worked 
to ameliorate at least that obstacle towards  
achieving the health that their white counterparts 
have thank you okay um an earlier question that  
came in that i kind of want to qualify as maybe 
an evolutionary biology question um and i will i  
let me just preface it that uh one of the 
things that i think people have been noting  
is the uh the low death rate um around covid19 in 
africa you know and how many people are infected  
and then what the what the fatality or 
mortality rate is there so i have that in  
mind as i pose this question to you which is 
by one of the members who said if if in fact  
racism has become so ingrained in our psyches 
and perhaps influencing our dna is there not  
some basis around the fact that there is um now 
a genetic um set of issues that are emerging  
that's you know so that's act that question um 
calls up and invites me to explain epigenetics  
um so epigenetics is a field of research um 
that looks into how environments can impact the  
expression of genes so again we're not talking 
about how environments cause genetic mutations  
but rather how environments cause different 
aspects of the genes to be expressed  
so this is the difference between genotype and 
phenotype phenotype is the expression of genes  
the reality is that environments can influence 
the the expression of genes and moreover those  
different genetic expressions can be passed 
down from generation to generation and so the  
way that i like to describe it is that my 
grandmother grew up in the jim crow south  
she was a maid in the jim crow south 
the jim crow south impacted um being  
a black person and jim crow south as a maid 
impacted the expression of her genes which  
likely contributed to the fact that she died 
of a heart attack at a relatively young age  
when she had her child which is my mother 
and my mother had me i have inherited my  
grandmother's expression of her genes which is 
to say i've inherited this disadvantage so it's  
kind of like part of me although i have a great 
job at university of berkeley and a law school  
and i have great health care i have inherited 
that disadvantage in the way that my genes  
have expressed the hope of course is that two 
generations out my child and my child's child they  
can now live the environment that i have lived 
which is one that is of relative privilege so the  
question that was posed is getting at the field of 
epigenetics um and i think the field of epidemic  
actually i do know that the field of epi genetics 
is incredibly interesting to researchers because  
it can explain some of the the some portion of 
racial disparities in health but i think it's  
important to recognize that as environments change 
genetic expressions environments can unchange  
uh genetic expressions um and so epigenetics 
should not be a call for abdicating responsibility  
like uh it's in the genes what can we 
do let's move on to other things like  
i don't know other things but rather epigenetics 
is a call for us to create environments  
um that impact genetic expression in healthful 
ways so that future generations can be healthy  
uh thank you for that response and it sort of 
i guess it asks um for all of us to have much  
more dialogue dialectical thinking absolutely 
yeah you know one thing i would just add to to  
that answer is that you know i i rely on dorothy 
roberts um research and much of my scholarship  
because she's brilliant but she has um she offers 
that race is not a biological concept with um  
political consequences rather it's a political 
concept with biological consequences so there's no  
denying right my my father has hypertension right 
um there's no denying that being black in this  
country means that you have a greater likelihood 
of just dying earlier and being sicker but it's  
not because it's in the genes but rather because 
this is a political construct that is killing us  
literally it's impacting our biological processes 
and maybe even our genetic expression of our genes  
is there um it as a sort of question to close 
with is there in this so-called political moment  
that we have um with so many 
more people mobilized and aware  
around racial injustice is there some are there 
particular areas that you're feeling more hopeful  
i'm feeling hopeful um that so you 
know critical race theory has been  
talking about these issues since you know the 
1970s um and what i'm hopeful about is that  
our the conversations that we have been 
having the insights that we have generated  
are no longer confined to the legal academy 
they're no longer confined to you know books that  
are in somebody's library and nobody pulls down 
it's no longer confined to law reviews rather  
these ideas the concept of structural racism 
um these ideas have have traveled beyond  
you know the ivory tower and so i am i 
am hopeful that this is an opportunity  
to um for people to be interested for people 
to learn more about um racial inequality  
um and for people's ideas around racism and rape 
in racial inequality and racial subordination to  
become more nuanced but i have to say that it has 
to be more than a moment it has to be a sustained  
event um and so i hope that you know when 
2020 comes to an end it can't come to an end  
quick enough but when 2020 comes to an end 
and we begin 2021 um that we stay interested  
in these issues because they're not gonna go 
anywhere um simply because we turn our back to  
them won't mean that you know that policing won't 
be dangerous and that the you know the next novel  
coronavirus won't kill people of color um at 
greater rates um these issues aren't going away  
so we ought to remain uh focused and interested 
in them professor bridges thank you very very much  
um thank you for contributing to this 
hopefulness and to this constant education and um  
going going beyond uh where we 
are right now as quickly as we can  
thank you so much for allowing me to share my 
work with your your community it's been a pleasure
have a good weekend everybody take care

Leave A Comment

Your email address will not be published