A series from the Race & Health podcast and The Lancet Voice - an introduction

Welcome to a series of podcasts produced as a collaboration between The Lancet Voice and the Race & Health podcast. The upcoming series will host a diverse array of experts, activists, and storytellers. We will take a deep dive into issues ranging from COVID-19, to history, to populism. This series offers expert perspectives, technical background, and field accounts to provide listeners a better understanding of racism and its impact health around the world.

For this introductory episode, host of the Race & Health podcast Delan Devakumar speaks with Senior Executive Editors at The Lancet Pam Das and Jessamy Bagenal, about what racism and health means to them.

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Transcript

This transcript was automatically generated using speech recognition technology and may differ from the original audio. In citing or otherwise referring to the contents of this podcast, please ensure that you are quoting the recorded audio rather than this transcript.

Delan: Hi everyone, welcome to the news podcast series on racism and xenophobia, which is a collaboration between the Race and Health podcast and the Lancet Voice podcast. My name is Delan Devakumar, I'm a professor of global child health and a public health consultant in University College London. The Lancet Voice podcast.

Seeks to unravel the stories behind the best global health policy and clinical research of the day and what it means for people around the world. The Race and Health Podcast explores how racism, xenophobia, and discrimination affect health, particularly focusing on how power systems shape unequal health outcomes.

This series follows on from the Advancing Racial and Ethnic Equity episode from December 2022, and we'll be picking apart some of the topics from the Lancet series on racism, xenophobia, discrimination, and health. I'm joined today by not one, but two senior executive editors from The Lancet, Drs. Pam Das and Jessamine Baganel.

Pam co leads the global health work at The Lancet with editor in chief Richard Horton, and was one of the lead editors on the special issue. And Jessamine is also a co host of The Lancet Voice. And Pam and Jessamine are both closely involved and co lead the work on racism at The Lancet. Pam, Jessamine, in our last episode, I opened with a question, what does racism mean to you?

And because we talk about issues in a very abstract way and racism is obviously a very personal thing so can I put that question to you? 

Pam: It's really hard without coming out with a definition, so I'm going to stick to definition because I do feel that it is that but it, for me, it's a system.

It's a social construct and it, that consists of structures, policies, practices, beliefs and norms create a form of discrimination against people. Individuals, people who are largely based on their race and ethnic background. For me, it's a form of aggression. I have experienced that sadly in different situations and thereby it's denies that individual an opportunity.

It's disadvantages them. 

Jessamy: Hi, Dylan. Thanks so much. And it's lovely to be talking today. I feel a bit disingenuous in that I'm a white middle class, very privileged person, and I haven't personally experienced racism. But I agree with Pam, it's a system and it assigns value based on certain characteristics.

and unfairly disadvantages people. And I think it's about the fact that we know that's I think Kamara Phyllis Jones describes it as sapping the strength of society, that, that, that system saps the strength. And I completely agree with that. And I also think that it's about, it's the personal, it's the individual, but it's also on a sort of, understanding and exploration point of view, which, which feels a bit abstract and potentially painful when it's such a human thing, but it's about understanding where we are now.

And I, I love the sort of the thought that really where we are now it's not based on the sort of three great revolutions of industry, science, and politics. It's based on genocide, slavery, and colonization, and that until we really appreciate that, and we understand the systems that have built the way that we live our lives today, then we can't really do anything about it.

I think that's what it, that's what it is for me, and I feel quite awkward talking about it almost, and it's something that I've had to really work at, because you, there's such a human element to it that you want to be able to talk about it personally. But then you also need to be able to understand it from a kind of system base, as Pam says.

Delan: Can we move on to what The Lancet is doing? So The Lancet has come out with commitments and specific activities. And can you just tell us a little bit about what The Lancet is doing on racism and xenophobia? 

Pam: We have made serious commitments to being an anti racist organisation. More recently it was the events around George Floyd's murder in the US that really made us look as an organization at ourselves and reflect on that.

And as a result we've made various commitments. The major one being to advance equity, diversity, and inclusion first in our research and publishing in our practices and policies. But particularly in the groups that we work with, increasing the representation of women and colleagues from low and middle income countries to ensure that they are very much present and a voice at the table editorially as peer reviewers, as authors, and as contributors.

We've also issued a apology. As the Lancet is a 200 year old journal. Its foundation is on colonial medicine. Some of the work that was published in that time would not be acceptable now. And we are cognizant of that and we have made a statement to, to apologize for the past. But now we are in an era where we are hoping that we can shape.

and dismantle those various structures that are preventing millions of people around the world from accessing health, good health for all. So that's one part. Another part is an employee led group. So a group of us who do come from racial and ethnic backgrounds came together and we are called the group for racial equity.

And we've been running now for about, gosh, three years, two and a half years. And it's a fantastic group of employees who are very committed to the issues and also holding the Lancet accountable. And that's really important as you'll hear from the rest of the work we're doing. 

Jessamy: Yeah. And I think Pam's given a sort of great overview of what we're doing internally.

And then I think with that internal. All of those internal activities comes also the external responsibility that we have in our content and, all the other things that we are able to have a platform for. And so we've got these three different commissions which have started, they're in fairly early stages, but I think they're all exploring a really crucial part of this and I think synergistically they'll work very nicely to, develop a whole new body of work, which you, Delen, laid the foundation for in your, original series, which we published last year.

So we've got your commission, which I'll leave you to talk about and then we've got two other commissions, one which is more focused on the U. S. and health systems, and one that's more with the O'Neill Institute that's looking at global health and global architecture and the power asymmetries there.

So I, I think. Our commissions are designed or have that aim of trying to harness the sort of activity and the energy of the academic community and really translating them into some bold visions that are going to be transformative. And so they are a great space for this type of work, I think.

And I think we're all really excited about what's going to come from them. 

Delan: Brilliant. Thank you. And the commission you mentioned is going to be on racism and child health. We're just starting now. And this takes a very broad perspective looking at children across the ages, within the families that they live in and across the world.

So a global health perspective, and that's just starting very soon. So onto this podcast series, and this series looks back at the academic series of papers that we published last year. And what we're doing is, we've got seven episodes picking out specific issues from that series. It's a discussion with three guests, a mixture of series authors and other experts.

And the first episode, which will be released shortly, is looking at COVID 19. And COVID 19 was quite a good, in inverted commas, example of how racism can play out in many different ways. And what we'll do is, with the guests, get into some of the specifics of that. for tuning in. Differential mortality who was excluded, who was targeted, particularly in the early days the idea of vaccine inequities as well.

So that provides an overview with a specific topic of COVID 19. We then go on to talk about eugenics. We've got an episode on the history of medical experimentation. We've got an episode on human biology and the ways that it could be altered by racism. an episode on populism and politics one on epistemic injustice, and that's the distortion of knowledge and the silencing of voices, and then finally an episode on intersectionality.

So this series delves into a bit more detail on some of the issues and hopefully talks about it in slightly different ways. Can I ask a kind of more general question to both of you, what do you think? This podcast series and just me, maybe I'll come to you first because you've been doing this with an answer points.

What are you trying to achieve?

Jessamy: It's a good question and I sometimes think to myself, really what we're doing is talking. We're just talking. How can that possibly ever achieve anything? And I think that there's a very real criticism there, that it's very comfortable to sit and talk about big issues. And many people who are more campaigning or on the sort of advocacy end of things would say it's not enough.

And it doesn't. It's not enough. It doesn't do anything, it doesn't change anything. But I think for this topic and for many topics, the Lancet has an incredible reach and we do many different things, but we are still quite constrained in a very formatted way of disseminating knowledge and that knowledge is a very sort of western way of doing it.

And in a podcast, you can tell stories and you can talk and it's a much freer platform just to be able to discuss things that you wouldn't really be able to get the nuance across. or sometimes the joy across or the energy across in a written piece. And so I think that in the best case scenario, what you can achieve with a podcast is a huge reach and a much deeper understanding and we know that particularly within this, for this topic that having a sort of anti racist approach is not something that comes naturally or easily to many people and it's a very uncomfortable space for a lot of people to be in because they feel that you're somehow calling them racist or, that we're all doing something wrong on an individual level.

Delan: Thank you, Jessamine. I think for me, it's the podcast. When we set up the Raising Hell podcast, it was to reach this wider audience, the audience that maybe doesn't pick up journals like The Lancers, the more academic end of things. And it's to, it's also to get people to talk in their own voice, their own way of saying things, their own intonations of saying things and to tell their stories, as you said.

And so we've done that in many different episodes and I hope this series will do the same to really get into those topics, to try to understand in more details what those things mean. Thank you very much. Thank you to both of you for joining us today. 

Pam: I think, Delen, what you're doing, I think what we're all doing is fantastic because we're all coming at this issue in different ways.

And I think we need different mediums and platforms, be it podcasts, be it, rigorous research. Be it the stories that we tell, these are all going to interplay and strengthen in, indeed our sort of commitment a commitment to change. And so I'm really excited about this podcast series and working with you on it.

And of course, the commission on racism and child health. Thank you very much.