Studying Health Inequities: A Conversation with Associate Professor Rahwa Haile

portrait of Rahwa Haile

Associate Professor of Public Health Rahwa Haile’s work has always been influenced by a broad academic background and a strong interest in history.  Haile earned her undergraduate degree at Columbia University, completing a History major along with substantial coursework in Gender Studies.  According to Haile, “My undergraduate experience was special and transformative.  I learned how to be a writer and a critical thinker.”  After graduating from Columbia, Haile enrolled in a graduate program in American Culture at the University of Michigan.  After completing a Master’s in American Culture, she began to pursue a doctorate in Public Health.  As Haile explains, “I was still studying many of the same issues when I shifted to Public Health.  I was studying the social production of inequality and how resistance develops.  Rather than working with literary texts, my work became health-focused.  I was looking at how inequality affects the health of certain populations.”

In the Fall 2020 semester, Haile taught Black Lives Matter: US Health Inequities for the first time.  The class focuses on the intersection of the BLM movement and population health, examining ubiquitous health inequalities among African American communities in the US.  Students examine the entrenched social structures that cause African Americans to have shorter life spans than their white counterparts.  According to Haile, “Public Health acknowledges health inequities and the harm they cause.  However, as a discipline, Public Health sometimes lacks a historical perspective on where these inequities come from.  If you wish to dismantle a system that’s been in place for hundreds of years, you need to understand its origins.  My goal is to give students this perspective.”  Haile claims that Black Lives Matter: US Health Inequalities is one of the most rewarding classes she has ever taught.  She explains, “The class speaks to students and their experience.  For example, when we discuss housing discrimination, many students realize that it’s something they’ve experienced.  We discuss the fact that Black individuals often don’t feel that the police are protecting them.  My students often tell me they are afraid of the police. This class provides a space for students to talk about their experiences and gain insights.”   

In addition to teaching, Haile is engaged in research focused on how policing and mass incarceration impact the Black community.  The Robert Wood Johnson Foundation, an organization committed to studying inequality, has awarded a grant to Haile and two other researchers to study the effects of hyper-policing and the carceral state on health in the Black community.  The work of Haile and her colleagues focuses on residents of Brooklyn.  In Haile’s words, “Many predominantly Black communities have, in a sense, become police states.  We often think of incarceration as an isolated event.  There’s a misconception that when an incarcerated person is let out, everything goes back to normal.  When a person disappears from their family, there are long-term consequences.  It often falls on women to put the pieces together.”  Haile notes that in addition to the lost income when a partner or spouse is incarcerated, women usually bear the cost of visits and phone calls.  Another aspect of Haile and her colleagues’ research is studying the ways in which incarceration impacts children.  One in four African American children currently has a parent in prison.  These children often feel as if the penal system has taken their parents away from them. 

The COVID 19 pandemic has illuminated class and race-based inequities in health.  In Haile’s words, “For those of us that study racial inequities in health, these issues have always been visible.  The Black community has always fared poorly in terms of population health.  One positive consequence of the pandemic is that the lay population is now more aware of health inequities and is interested in learning why they exist.”  At this stage of the pandemic, the issue of vaccine hesitancy has gotten a lot of attention in the media.  According to Haile, “Many racialized populations in the US have a distrust of doctors and the medical establishment.  That skepticism is rooted in experience – it is not simply irrational paranoia.  When we address vaccine hesitancy, is it important to realize that it is rooted in history.  Dialogue on vaccine hesitancy needs to be informed and acknowledge past injustices.”

The US Public Health Department Syphilis Study at Tuskegee, taking place between 1932 and 1972, is an infamous example of abuses of African Americans by the government and the medical community.  In an attempt to observe the progression of syphilis, the US Public Health Department studied a group of 600 African American men, 399 of whom had syphilis.  The men were only told they were being treated for “bad blood.”  In exchange for their participation, the men received free medical exams, meals, and burial insurance.  When penicillin became the treatment of choice for syphilis in the 1940s, the men were left untreated so researchers could observe the progression of the disease.  In 1997, President Clinton issued a formal presidential apology to survivors of the study.  In his words, “It was a time when our nation failed to live up to its ideals.” 

In discussing vaccine hesitancy, Haile also pointed to a study by faculty at the University of Virginia that has shown that Black patients are systematically undertreated for pain compared to their white counterparts.  In addition to her work at Old Westbury, Haile is involved with the Brooklyn Movement Center.  The organization is a Black-led community-based organization in Central Brooklyn that Haile calls her activist home.  The Brooklyn Movement Center organized an educational event that featured members of the health department discussing the vaccine with Bed-Stuy residents.  According to Haile, “They spoke in a way that honored the rationality of hesitancy and acknowledged previous abuses by medicine and the government.”  Haile believes that this the type of dialogue that will increase vaccination rates in minority communities.

For Haile, forming connections with students is one of the most rewarding aspects of her work.  “I’ve formed so many positive relationships with Old Westbury students, and I’ve learned a lot from them.  I study social and health inequities.  Many of our students have expertise on these subjects that goes beyond my own.  For example, I live in Brooklyn.  My students have taught me a lot about the ways that racism and inequality manifest itself on Long Island.”  Haile particularly enjoys watching students grow during their time at Old Westbury.  She notes, “When students begin college, they’re often tentative and quiet in the classroom.  As they progress, they recognize how powerful and important their voice is.” 

 

Written by Jon Kleinman

Health Inequities