Health Justice And Black Liberation: Shay-Akil McLean

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Black health is directly connected to the displacement and dispossession of our ancestors and the conditions of our neighborhoods.

“State violence differentially distributes morbidity and mortality to those that are deemed enemies of the state.”

In this feature, we ask organizers and academics to reflect on the connections between health justice and Black liberation. This week’s contributor is Shay-Akil McLean . McLean is a Ph.D candidate at the University of Illinois at Urbana-Champaign School of Integrative Biology’s Program for Ecology, Evolution, & Conservationation. 

Gwendolyn Wallace and Roberto Sirvent: Can you please tell readers of the Black Agenda Report a little about your background and the work you do around health justice?

I am a queer trans masculine person of African descent who was born and raised in Buffalo, New York. I am trained as a biological anthropologist, sociologist, and evolutionary geneticist. My research began with studying relationships between racial residential segregation, food apartheids, and dental health in people of African descent. My interests then shifted to studying the scientific critique of biological race. My dissertation provides a theoretical foundation for how to talk about health inequalities without reproducing racism. The ultimate goal is to develop the groundwork for the production of decolonial biological knowledge.

In what ways can you help readers understand state violence (e.g. prisons, policing, surveillance, borders, militarism, housing policy, etc.) as a public health issue? 

The way that people treat each other has biological consequences, meaning that our relationships to one another, institutions, and resources are directly linked to quality of life, life expectancy, and quality of death. State violence is a public health issue because what it does is differentially distribute morbidity and mortality to those that are deemed enemies of the state. All of forms of state violence entail the denial of basic needs and the self-determination of the people in one dimension and/or additional others.

How might Black health depend on changing our relationships to the Earth and the environment? In what ways does environmental justice intersect with Black liberation?

Racialized peoples bear the brunt of chronic illness due to relationships to institutions, land and resources. According to the American Community Survey three-year estimates from 2013; Black women earn 64 cents on the white male dollar. If this wage gap were eliminated, a Black woman working full time for a year would have an additional 153 weeks/2.9 years worth of groceries for her family, which is also the equivalent to 21 months worth of rent. People who are racialized as Black most likely live in racially segregated neighborhoods across the American settler state. Research has shown that there are four times more supermarkets located in white neighborhoods compared to Black neighborhoods. In the words of Thomas Sankara, “he who feeds you, controls you.” The health of people racialized as Black is directly connected to the displacement and dispossession of our ancestors and the conditions of the neighborhoods that we live in. If you choke resources out of an area and systematically under pay workers; what do you think is going to occur besides slow deaths en masse?

“There are four times more supermarkets located in white neighborhoods compared to Black neighborhoods.”

The ways that humans treat one another aren’t separate from how humans relate to the ecological environment and ecology. What you do to people, you do to the land, and all other forms of life. We must keep in mind what Robert A. Parker stated, “Body and environment are always already an interaction.” (Gendlin 2018:xv). The notion that there is an impermeable separation of the self from everything else is a particular individualistic Euro-colonial perspective of the world. The state of the environment is a direct consequence of the colonial manipulation of our relationships to the earth and other living things. The environment represents the conditions that an organism interacts with, through time and space. We live in societies that prioritize profit over people, markets over the environment, and power over all else. It’s the perfect recipe for disaster when you are amongst the demographic whose labor is extracted from to generate profit.

Toni Cade Bambara’s The Salt Eaters begins with one character asking another, “Are you sure sweetheart, that you want to be well?…Just so’s you’re sure, sweetheart, and ready to be healed, cause wholeness is no trifling matter.” What does working toward individual and collective healing look like to you? What would it mean to be whole?

That Toni Cade Bambara quote from The Salt Eaters reminds me of a Toni Morrison quote from Beloved,  where Morrison says, “Freeing yourself was one thing, claiming ownership of that freed self was another.”

I mentioned the Morrison quote because it carries a similar sentiment as Bambara’s quote, which is, the matter of healing is quite serious, beautiful, painful, and tumultuous. This healing process is not ideal, it is not always fun, and it is demanding work. Taking responsibility for yourself, or rather, having a sense of self-belonging and autonomy, is THE work that has to be done to transform the terms on which we relate to one another and resources.

Central to this struggle for freedom is self-reflection and a turning inward when wounded (whether material or immaterial) that holds the possibility of change, most importantly growth, by deciding who we are and how we will treat ourselves and everyone else, or rather relate to ourselves and others. This is what it means to take responsibility for your freedom, by also taking up the parallel responsibility of honoring the freedom of everyone who is not you. Our own personal/individual freedoms are all simultaneously tied to the freedoms of those who are not us. Thus, rejecting oppression means rejecting it for yourself and others. Freedom is achieved by resisting the false freedom that is offered through over-powering others.

What role can love, care, and mutual aid play in our collective struggle against capitalist medicine and state violence? 

In my understanding, practicing ethics of care and mutual aid is the closest we can get to practicing “communalism in the now” or as Kwame Nkrumah put it, “Socialism, therefore, can be and is the defense of the principles of communalism in a modern setting.”

This means that we should practice principles of communalism in our everyday lives. So, at the simplest level, we take care of eachother. As philosopher Anthony Weston puts it in A 21st Century Ethical Toolbox,  taking care of each-other means that we think and act ethically,  which “is to take care of the basic needs and legitimate expectations of others as well as our own” (2013:5).

How do you take care of something? Weston describes taking care as sustaining and nurturing others whether in that be in the material or immaterial sense. What are the “basic needs” that must be met? Basic needs includes things like food, water, shelter, clothing, healthcare, education, community (which includes opportunities to participate).

“We should practice principles of communalism in our everyday lives.”

The reality is, our people cannot and never have been able to rely on the settler state. Central to our thriving as a community is the establishment of our own community institutions that provide basic needs and other resources to the masses. This includes organizing colonized peoples to physically defend their communities from settler state violence.

Part of the work that I am attempting to think and do is about how to equip the masses with the information needed to protect themselves when they have to navigate oppressive state and medical institutions. In order for such institutions to be organized by and for the masses, we must take care of eachother.

How does your work go beyond appeals for reform, access, inclusion, and equality? In other words, how does health justice connect directly with goals of abolition, revolution, and Black liberation?

My work is about making communalistic alternatives highly probable instead of just possible. With that being said, I have very little interest in reform, inclusion, and equality. Reform is a change in expression but not principle or outcome. Reform is necessary when, and only when, the system being reformed is grounded in communalist principles. There are few institutions that meet that requirement. In most cases, the systems that we are familiar with in the modern world should be abolished (done away with, annul) because those institutions do not produce outcomes that benefit the masses.

Inclusion is often believed to be an important component of liberal neocolonialism. But, what exactly are we talking about being “included” in? And if you think about it, colonized peoples are already “included”, just against our will and in ways that do not benefit us. It’s the power to transform the terms upon which inclusion is established. Equality is generally understood as giving everyone the same or equal amount of power. There are two facts of life: (1) change, and (2) variation. We don’t all need the same things to be sustained, to heal, to rest, recover, etc.. Equity is a better suited principle in my opinion, because it allows room for variations in experiences and circumstances. Access to resources and opportunities is something our people need, but we must consider whether or not that access is controlled by the masses or the settler state. As a result, I spend a good amount of my time doing work that helps facilitate the establishment of our own communal organizations and networks so that the masses do not have to appeal to the interests of the state.

“In most cases, the systems that we are familiar with in the modern world should be abolished.”

I understand the fight for Black liberation (which entails the abolition of colonialism through revolution) by thinking about health justice by asking about two things: (1) quality of life (QoL), and (2) quality of death (QoD). How people treat each other has biological consequences, meaning that our relationships to one another, institutions, and resources are directly linked to QoL, life expectancy, and QoD. This understanding leads us to consider, “What is needed to sustain a good quality of life?” Agency, food, water, shelter, clothing, education, healthcare, and etc. If the people are taken care of (have their basic needs met), that means that society is working to create the necessary conditions for their physical wellbeing to be sustained, contributing to the increase possibility of a longer life expectancy. I also think that QoD is important for our people to consider, because our freedom is also linked to not just the right to life, and how we live it, but also how we die.

Gwendolyn Wallace (she/her) is a senior at Yale University pursuing a BA in the History of Science and Medicine, concentrating in Gender, Reproduction, and the Body. Her research interests include histories of community health activism, reproductive justice, and the intersections between race-making, science, and medicine. Gwendolyn enjoys working with young children, gardening, and searching for used bookstores to explore.

Roberto Sirvent is Professor of Political and Social Ethics at Hope International University in Fullerton, CA, and an Affiliate Scholar at Yale University’s Interdisciplinary Center for Bioethics , where he directs the Race, Bioethics, and Public Health Project . He is co-author, with fellow BAR contributor Danny Haiphong, of the book,  American Exceptionalism and American Innocence: A People’s History of Fake News—From the Revolutionary War to the War on Terror .