By Jermaine Ash-Shahid Ali, MD and coauthored by Nubia Ali
Racial inequality impacts every aspect of life in this country for youth of color. The COVID- 19 pandemic has exacerbated the inequalities and injustices youth of color endure. As a black physician, I have asked myself, “What can I do to help?” It is fundamental to understand their perspective; simply ask what they are experiencing during this crisis.
I asked my daughter, who is a junior at a public high school in the city, to pose this question to the social justice group she leads, “How have you been impacted by social injustice and the pandemic”? The responses she received are as follows: people feeling it is their right to wear a mask or not; people not being able to access the internet for school; families and friendships disrupted due to social distancing; and unequal access to healthcare, including the vaccine.
African American youth are indoctrinated into the American way of life, which perpetuates systemic racial bias. From a young age, youth of color are attuned to how little black life seems to matter in this country. The world witnessed the black outcry for racial justice and how it was met with police and politicians who took a violent stand against the protestors. Systemic racial bias makes black people feel disenfranchised, feel as though they do not matter, and no one cares. This outlook can magnify feelings of isolation and despair that were already present.
According to census.gov, the black poverty rate decreased in 2019 to 18.8 percent. Despite the improvement, there are still black youth who are unable to access needed healthcare. With access to affordable healthcare limited, it is harder to get needed medical attention. There can be a sense of receiving inadequate, nonempathic care when care is obtained. Medical complaints are seemingly trivialized by the provider such that the patient just wants to end the encounter quickly to stop feeling minimized. Black youth are suspicious of the medical establishment not treating them with the care they need. This feeling can fuel ongoing mistrust of the medical recommendations.
Mask wearing was debated due to the tone set forth through much of 2020 from politicians who downplayed the virus’s significance. This harmful misinformation has a much more devastating impact on vulnerable people, including youth of color. Hence some youth of color are fine to wear masks, and others do not feel they have to wear a mask as the virus is not real or because it is their right not to wear one. Yet, they are among the population with the highest incidence of COVID 19.
Many children are feeling the impact of not being able to be in school in person. Social distancing has further exacerbated the isolation that youth of color experience. For those children living in poverty, obtaining internet service and a device with which to perform virtual school is a daunting task. Parents have been laid off. Some people have had to combine households with others to survive. Social distancing has inadvertently left American society more isolated from each other.
Youth of color, who already felt isolated in a country that does not show them acceptance, are negatively impacted. These feelings lead to depression, anxiety, along with substance use. Suicidal ideation has increased during the pandemic and because of being exasperated from the day-to-day struggle of being black in America.
For health professionals caring for youth of color, specifically, ask how they feel being black in America has impacted their experiences concerning social justice and the pandemic. Courses in cultural diversity and sensitivity can help gain insight into how to listen empathically to youth of color. Encourage the conversation around vaccination concerns. Be prepared for the vehement expression of feelings. Do not take it personally. Their frustration is not aimed at you. Help families to find case management for the resources that are available to the hardest impacted families. Having an empathic conversation about how a person is doing during this crisis may show that someone cares about them and that their life does matter. All lives cannot matter until Black Lives Matter as well.
-Jermaine Ash-Shahid Ali, MD, is a Child and Adolescent Psychiatrist at Seven Counties Services.