Employment of African-American men in the healthcare professions

Is Self-Image the Problem? “America is false to the past, false to the present, and solemnly binds herself to be false to the future. ” – Frederick Douglass, 1852 “Slavery’s twin legacies to the present are the social and economic inferiority it conferred upon blacks and the cultural racism it instilled in whites. ” – James W. Loewen, 2007 (143) Loewen’s comment, in effect, verifies Douglass’ prediction. Based on an analysis of 18 American-history textbooks (435 – 436), Loewen concluded that the “lies” or minimizations told about post-civil war racism prevent recognition of current biases rooted in our past.

An example might be an implicit cultural racism in the way we phrase questions. Questioning the effect of the self image of African-American men implies that another question already has been answered affirmatively, i. e. , that there is something negative in the way African-American men view themselves. Is it possible that people assume their own views are shared by African-American men? Perceptions of African-American Men How many times have we heard about the alarming percentage of young African-American men who are in or had been in prison?

The percentage is large and it is alarming (Battle 81 – 91). However, the percentage of African-American men with low socioeconomic status (SES) also is much larger than the percentage of whites with low SES – and among the many variables predicted by SES, criminal behavior is one (Battle). We also need to ask about conviction rates for African-American and white men. Loewen’s “cultural bias” hypothesis makes sense in the context of the American tradition of lynching African-American men who must have been guilty any time a white woman was raped.

Research has provided evidence supporting an implicit (i. e. , without conscious awareness) perception of African-American men as criminals, for example, “recognizing” made-up names that were stereotypically African-American as belonging to criminals (Banaji and Bhaskar 137 – 175). Why are these guys criminals? High unemployment rates for African-American men (Battle; Eckholm 1 – 18; Moorehouse – 6) are accompanied by low SES, which, as noted above, is associated with criminal behavior (Battle).

It’s also true that a disproportionate number of African-American men are high-school drop-outs (Eckholm), which might be rooted in the first years of school, a time when many boys, who are later to mature than girls, find it difficult to sit still for long periods of time. While both middle- and lower class boys are suffering from an unfortunate educational practice, the middle-class boys are diagnosed with attention-deficit hyperactivity disorder and get Ritalin – and the lower-class boys are diagnosed with a need for “special ed.

” Perhaps the simplest explanation is that discrimination in employment did not end with passage of the 1964 Civil Rights Act (Birzer and Smith-Mahdi 23 – 37; Ziegert and Hanges 553 – 562). So, then, doesn’t it make sense that being perceived as an uneducated, criminal loser would result in having a poor self image, i. e. , low self-esteem, or that low self-esteem is why one is an uneducated, criminal loser? Or does “cultural bias” (Loewen) result in the belief that African-American men should have low self-esteem?

Research on Race and Self-esteem Research has consistently provided evidence that the self-esteem of both African-American males and females of varying ages is as high or, in some studies, higher than the self-esteem of white males and females (reviewed in Hines and Berg-Cross 271 – 281). For example, in a study of third- to twelfth-grade children and adolescents, although the African-American students knew they were negatively stereotyped by others, their self-esteem was higher than the self-esteem of the white children (272).

In a study using students from a predominantly white university (Phelps, Taylor, and Gerard 209 – 216), there also were no differences in self-esteem, despite the African-American students expressing distrust of the university culture. Thus, under-representation of African-American males in a number of professions cannot be attributed to poor self-esteem. African-American Males in the Healthcare System Based on visits to a number of hospitals, African-American women are well-represented in nursing and nursing-assistant positions, and more white males than in the past are holding these stereotypically female jobs.

Why aren’t there more African-American males in these positions? Is there concern that women patients would perceive their African-American male nurses as potential rapists? Or is it that African-American men can’t meet what have become not very rigorous training requirements? In fairness, no-one could have failed to read about the serious shortage of nurses in this country (or about the low pay and poor working conditions), and it would seem quite possible that there’s a shortage of African-American men choosing to train for these jobs.

Since African-American men are well-represented as orderlies, it’s hard to attribute their small numbers in the former jobs as attributable to avoiding a stereotypically white male doctor as “boss. ” It’s certainly possible that African-American men are threatened by the prospect of doing “women’s work,” suggesting educators might make efforts to help change gender stereotyping of work. It would seem that misplaced “pride,” rather than low self-esteem, might be the culprit. Beginning in the 1970s, numbers of African-American men and women have been admitted to and graduated from medical schools.

Not surprisingly, they have had to cope with prejudice from other students, staff, and patients, including “racist jokes”… [and] “mundane daily practices which intentionally or unintentionally convey disregard, disrespect, or marginality” (Beagan 852 – 860). In a study of physicians graduating from medical school in the 1980s, a clear finding was that African-Americans were over-represented in HMOs, relative to settings such as private-practice (Briscoe and Konrad 1318 – 1325).

Reasons include African-Americans being unable to afford the investment required in entering a private group practice, as well as discrimination on the part of the white physicians who had established these practices. While HMO physicians do earn less money than those in private practices, one certainly can’t consider them financially disadvantaged. Perhaps because of having no financial investment in HMOs, physician turnover rates are higher than those in private practices. Thus HMO patients receive less continuity in their care.

At least at the time of the study, African-Americans were over-represented as patients using HMOs, so the benefits of a greater presence of African-American physicians was offset by the disadvantage of lack of continuity. Conclusions Whatever the work setting, image has been a problem for African-American men, but there is no evidence that problems stem from their own images, as opposed to the images or stereotypes others have of them. Based on evolution, both within and between species, being feared physically was advantageous to survival.

This has never been true in America, as evidenced not only by the treatment of African-American men, but also by the aftermath of “9/11,” where Muslim-Americans have come to be perceived as likely terrorists (Zinn 680). It’s currently fashionable to express respect for cultural diversity, but it seems clear that Frederick Douglass would recognize the phrase as once again “false References Banaji, Mahzarin, R. , and Bhaskar, R. “Implicit Stereotypes and Memory: The Bounded Rationality of Social Beliefs. ” In Schacter, Daniel, & Scarry, Elaine (Eds.).

Memory, Brain, and Belief. 2000: 139-175. Cambridge, MA: Harvard University Press. Battle, Stanley F. ”African American Males at a Crossroad. ” Journal of Health and Social Policy 15 (2002): 81-91. Beagan, Brenda L. “Is this Worth Getting into a Big Fuss Over? ” Medical Education 37 (2003): 852-861. Birzer, Michael L. , & Smith-Mahdi, Jackquice. “Does Race Matter? The Phenomenology of Discrimination Experienced among African Americans. Journal of African American Studies 10 (2006): 22-37, Briscoe, Forrest, & Konrad, Thomas R.

“HMO Employment and African-American Physicians. ” Journal of the National Medical Association 98 (2006): 1318-1325. Douglass, Frederick. “What is the 4th of July to a Slave? ” Retrieved January 6, 2007. Eckholm, Erik. “Plight Deepens for Black Men, Studies Warn. ” New York Times 155 (2006): A1-A18. Hines, Paulette, & Berg-Cross, Linda. “Racial Differences in Global Self-Esteem. ” The Journal of Social Psychology 113 (1981): 271-281. Loewen, James W. Lies My Teacher Told Me. 2007. New York: Simon & Schuster. Moorehouse, Lateefa.

“Schumer Addresses Black Male Unemployment. ” The New York Amsterdam News (2006): 6. Phelps, Rosemary, Taylor, Janice D. , & Gerardm Phyllis. “Cultural Mistrust, Ethnic Identity, Racial Identity, and Self-Esteem. Journal of Counseling & Development 79 (209-216). Ziegert, Jonathan C. , & Hanges, Paul. “Employment Discrimination: The Role of Implicit Attitudes, Motivation, and a Climate for Racial Bias. Journal of Applied Psychology 91 (2005): 553-562. Zinn, Howard. A People’s History of the United States. 2003. New York: HarperCollins.

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