“Viruses Don’t Discriminate”: Ruha Benjamin on Racial Biases in Medicine

This post is part of a series of reflections on the Center’s 2020-21 Series Epidemic // Endemic. On Friday, October 30, 2020, Dr. Ruha Benjamin (Princeton) delivered her talk, “Viral Justice: Pandemics, Policing, and Public Bioethics.” This event was co-sponsored with the Berman Institute of Bioethics.

Reflections by Kristin Brig // posted 11/13/2020

Racism is a disease that we are not born with but rather catch and let fester if left untreated. In her October 2020 lecture, Princeton sociologist Dr. Ruha Benjamin rightly asserted the presence of this disease in health-centered spaces, especially in the medical profession. “Viruses don’t discriminate,” she claimed, “and neither should we.” Through her lecture, she exposed how doctors, nurses, and other professionals show racial biases in their daily interactions with patients and how those biases contribute to social and cultural inequalities. Her insights underscore how medical professionals can recognize and root out racism to better serve all patients, no matter their background.

Through her talk, Benjamin argued that racism in medicine grew from rotten fruit produced in the seventeenth and eighteenth centuries. She showed how historical trends influence medical practices in the present day. Numerous scholars have discussed racism and bias in western medicine, yet Benjamin’s talk smoothly connected them to the present in a new and clear way. As Europeans began colonizing the Americas, Africa, and Asia, they constructed theories of the body that elevated whiteness at the cost of non-white races to claim the European right to colonize whole territories without much further justification. Benjamin noted how doctors during this period imbibed new notions of whiteness and applied them to medical theory and practice, especially in the Americas. Over time, these notions became embedded in medical education and research. They ultimately influenced how doctors, nurses, and other practitioners even today respond to their patients.

Yet as Benjamin demonstrated, racial biases of the body are not just in medicine; they permeate U.S. culture and society, affecting how we think and feel about different bodies. One of her illustrations highlighted these issues well. She shared two Google image searches side-by-side, both compilations of different search terms. One compilation focused on “professional hair.” It was filled with photos of white women with coiffed hair, with a single photo of a black woman with smooth black hair. The paired compilation centered on “unprofessional hair.” It was almost a reversal of the “professional hair”—black women with natural hair dominated the image landscape, with a single photo of a white woman with purplish hair color. Benjamin used the contrast to point out how racial biases about the black body are no longer just in medicine, but encoded in our algorithms, too.

In fact, such biases have significant impacts in people’s daily lives that often go unnoticed. For example, hairstyles can make or break a job interview for both black women and men, leading to higher rates of discrimination through just one part of the body. Additionally, Benjamin showed how facial recognition software used in criminal cases differentiates between white faces more than non-white faces, increasing the possibility for inaccurate findings in non-white populations. The software may manifest the bias, but human coders write the software based on scientific knowledge of the body. In viewing the black body as inherently lesser and less differentiated than the white body, medical perspectives thus influence how everyday people live and work both in and out of the clinic.

Although Benjamin centered her lecture on African-Americans, her analysis applies to other global spaces and populations. Consider Elizabeth O’Brien’s work on Mexican reproductive surgery and modern constructions of the indigenous female body, or David Arnold’s work on public health control over the supposed “diseased” Indian body. As a historian of nineteenth-century British colonial South Africa, I see Medical Officer of Health reports employ medical theories about the inherent filthiness of African and Indian bodies and habits to argue for increased public health surveillance in predominantly non-white neighborhoods.

Each of these spaces—Mexico, India, South Africa—continues to use prevailing historical medical theories about the non-white body in governmental, cultural, and societal control. They maintain the marginalized status of particular populations to allow other majority groups to lead countries, companies, and other social power brokers. While majority indigenous groups have often taken back power in these countries, among others, they then apply notions of dirtiness, weakness, and disease to less-powerful groups, notably immigrants and migrant laborers, to preserve their own authority. The elevation of whiteness and the white body also impacts how majority non-white countries continue to subsume themselves to majority white ones, especially in Europe and North America. In this way, imperial constructions of the non-white body sometimes map onto entire countries, perpetuating imperial injustices from the local to the international level.

Benjamin’s analysis thus moves beyond the United States and into other global spaces, demonstrating the power of her work. As groups like White Coats for Black Lives have shown, discrimination against non-white populations is still alive and well in the clinic, hospital, and laboratory. Yet perhaps more urgently, Benjamin argues that such discriminatory medical theories and practices must reckon with their effects on the cultures and societies around them. We can’t wear a mask or get a vaccine to cure this virus of racial bias. However, we can certainly begin applying a therapy of understanding and reconciliation to start reforming our thoughts, words, and actions, both in and out of the medical world.

Kristin Brig is a doctoral candidate in the Department of the History of Medicine at Johns Hopkins University. She tweets @PoxyGraduate.