Q&A on Context Matters: Kicking off Black History Month with Keisha Bentley-Edwards

By Liz Switzer

Developmental psychologist Keisha Leanne Bentley-Edwards, PhD, MA, is an associate professor in the division of General Internal Medicine, the Associate Director of Research and the Director of the Health Equity Working Group for Duke’s Samuel DuBois Cook Center on Social Equity, a scholarly collaborative that studies the causes and consequences of inequality and develops remedies for these disparities and their adverse effects. Using a cultural lens to understand social, emotional and academic outcomes, her work examines how gender, culture and racism  influence how the world responds to Black Americans and how this influences health and social disparities.

What does Black History Month mean to you?

Black History Month has always been a great time for reflection. It's come a long way. There have been times when there has been more meaning attached to it. For instance, when I was a kid, a lot of the Black History Month activities revolved around safe black history. Things like inventions, or a very modified, narrow perspective of Dr. Martin Luther King, Jr., Rosa Parks, and even Harriet Tubman, but not too deep into actual history, content or even understanding the context of why these inventions were significant. It was more like you should be proud that there are black inventors, but not really talking about why they invented the things that they did, what the challenges were to get those patents, and why they weren't rich. What I appreciate about the way Black history is taught now in schools is that you get a bit more of the context.

The thing I enjoy about Black History month is that you can have a balance of things that you can be. This is a great accomplishment. But also understanding why it was such a great accomplishment, or even if it was a challenge, or it was something that was terrible. We can think about what we can do so that those terrible things don't happen again. I love the knowledge, the reflection, and the fact that every year I learned something new.

Why should healthcare practitioners and researchers care about Black History Month?

The important part about Black History month is that it gives you all, in one concentrated time an opportunity to learn about Black history, whether it's learning about physicians and health innovations, or understanding the arts, literature, dance. This concentrated storytelling gives a fuller picture than if you were doing a self-study, maybe reading one book a year, or watching one documentary.

Take Langston Hughes and others and the work that was being done during the Harlem Renaissance in the 1920s and 30s, for example: Well, there were also these lynchings and mob violence going on at the same time, often these artists’ work was in response to these events. In context, the poetry, art, and music of the Harlem Renaissance becomes much more intense.

Instead of reading about these activities in isolation, you get a fuller picture with all those bits and pieces of what was happening, not just across America but internationally. That’s the reason health researchers should want to know about Black History Month. When we look at health disparities, you get an idea of why some of these disparities have endured. A look at history can give you an understanding of the context of why we have disparate outcomes when it comes to infant mortality, treatment-responsive cancers, and heart disease. The myths about Black bodies allowed racialized treatments like race corrections, exclusionary training practices, and segregated health systems to occur. You look at how some of these policies may have had both intentional and unintentional consequences so that you can have a fresh perspective on how you would go about tackling these disparities and eliminating them.

Black History Month isn't just for black people, it’s for everyone because we all have something to learn. Oftentimes black history isn't isolated to the players and specific black history events, so it gives you a fuller picture of what was going on.

You were chosen as a speaker for the Dean's Distinguished Research Series that is coming up. What is your topic going to be and why did you choose it?

I haven't fully chosen my topic yet but the underlying theme in my work is that context matters. I often talk about the role of racialized myths when it comes to racial biology and the context of understanding these ideas that black people feel pain differently, have thicker skin or exaggerate their pain. These myths allowed medical experimentation to occur in the 1800s and 1900s. You still see them in recent textbooks and in everyday practices. So, understanding the context of how we got here, and how we got these beliefs, gets back into the Black History Month of understanding the history that we may not be proud of. Instead of focusing on shame, we can take pride in gaining new knowledge so that you, and really, we all can do better.

What are some of the biggest strides that have been made recently in health, equity, and research?

A decrease in a lot of the things that have killed black people. If we were to think about infant mortality over the last 30 years, we can see that those numbers have decreased. If we were to look at the percentage of people who die from heart attacks, we see that those numbers have decreased. The problem is that the disparities between black people and white people have remained pretty solid. What happens is you end up with the things that we do to improve everyone's health so the disparities remain stable. But we need the challenges. We need to find the missing pieces so that we can give an extra push towards racial equity and health outcomes.

I think one thing that people are starting to understand more now is the difference between precision medicine and race medicine. Precision medicine is using genetics to determine better treatment options, but race medicine will do it solely based on our social construct of race. I think as an overall society and field we're moving away from just basing treatment solely on race, because how people identify race is arbitrary or even evolving. This transition from recognizing that race medicine is not precision medicine is a good direction to go in. And, as we talk about social determinants of health, understanding that these social determinants will affect us differently based on our social construct of race.

What are the biggest challenges that lie ahead?

I think the biggest challenge is knowing what to go after next. In the last few years, racism has been acknowledged as part of the public health crisis that is going on in this country. Specifically, looking at structural racism. I think one of the challenges is that people can get overwhelmed with thinking about structures and policy. They end up not really thinking about what they have influence over as far as policies in their work environment that may have a disparate impact based on race. The challenge is to stop being overwhelmed with racial inequities and going ahead and making change, even if it's uncomfortable, even if we get pushed back. The challenge is being brave enough to do something and with a sense of urgency. This fits with the 2023 Black History Month Theme, Black Resistance.

What advice from a racial equity perspective would you give researchers?

I'd say the biggest piece of advice I would offer for someone who's new on the racial equity journey is to not do it alone. For people who are a little further along on this journey, don’t be afraid of making mistakes. Be intentional in your actions, but also be ready for accountability if you get it wrong. But don't give up. A lot of times people are so afraid of the accountability that's involved with making mistake that they just do not do anything at all

Dr. Bentley-Edwards recommends the list below as follow-up reading that may be of interest. With the exception of the Langston Hughes book, all sources are available online for free either through the weblink or via Duke’s library.

  • Bentley-Edwards KL. We Need to Change How We Teach Black History. TIME, 2016.
  • Eschner K. This Prolific Inventor Helped Give Us The Phrase “The Real McCoy”. Smithsonian. Washington, DC 2017.
  • Hughes L. The weary blues. New York: Alfred A. Knopf, 2015; 1926.
  • Zora Neale Hurston: Claiming a Space. American Experience. MacLowery R, Strain TH. January 17, 2023.
  • Parshina-Kottas Y, Singhvi A, Burch AD, et al. What the Tulsa Race Massacre Destroyed. The New York Times. May 24, 2021. (Also accessible through Duke Libraries)
  • Roberts D. Fatal invention: How science, politics, and big business re-create race in the twenty-first century. New Press/ORIM; 2011. (available online through Duke libraries)
  • Washington HA. Medical apartheid: The dark history of medical experimentation on Black Americans from colonial times to the present. Doubleday Books; 2006. (available online through Duke libraries)