Dr. Steve Grcevich sits down and interviews Dr. Lamar Hardwick on his new book How Ableism Fuels Racism. This is the final part of a 3-part series.
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Steve Grcevich: Hello, I'm Dr. Steve Grcevich. I am the president and founder of Key Ministry and I would like to thank all of you for joining us for this segment of Key Ministry, the podcast. This is the third segment in a three-part trilogy that I've had the honor doing with Dr. Lamar Hardwick, the famous autism pastor, our friend and colleague in ministry and author of the recently published book, How Ableism Fuels Racism, available through Baker Books and Amazon and other online outlets. So Lamar, thanks so much for agreeing to spend a little bit more time with us answering a few more of my questions. And so there are a couple of things I wanted to get into with this segment that come from the book that you just published. And one area I wanted to get into was there was a chapter in the book that you described, disability, blackness, and the medical profession.
One of the things that you had talked about in that segment that resonated with me because my daughter is a physician and a resident obstetrics gynecology at Mayo Clinic, you had talked specifically about impacts of racism on the mortality rates of black women giving birth compared to the general population in the United States. That's a very different way than I've heard other people think about these issues. But one of the things that's very much a real day-to-day issue in my line of work is that there's a great deal of documentation, for example, that black families are significantly less likely than other families to seek out mental health services. And the most recent statistics that I've seen from National Institute of Mental Health have suggested that relatively speaking, they're about 30 to 40% less likely. Can you talk a little bit more and elaborate on attitudes in the black community toward the medical profession, how that impacts this whole concept of disability and how you see that impacting how the black church in the future maybe goes about serving folks with disability who have not received the kind of care, or had the access to some of the support services from the medical profession that other people in our culture have had?
Lamar Hardwick: Yeah, so I think one of the goals behind that chapter was to try to help understand that, very early on in the book I talk about the ways in which disability was linked to being black, and so it led to theories even that residue still permeates the medical profession that in some ways because disability had been historically and in a lot of ways even theologically linked to being black, that there was some inherent unhealthiness about being black. And so now we know medically and we certainly have progressed, so I don't want to make it seem like we're still stuck in a lot of those ways. But what I wanted to do is just point out the residue, even though we've self-corrected a lot of things, there’s still things that are there, one of which is the impact that that has had on the black community's perception of the medical field.
Of course, in addition to some of the things that are still happening. But a lot of that is, as you know, and a lot of people, we have a lot of smart educated listeners, we know about things like the Tuskegee experiment injecting scores of black men with syphilis. We know about early gynecology and some of the brutal things that were done to women to kind of test different theories about black bodies. But every so often there are some other areas in which things happen medically that tend to reinforce some of those negative experiences. And I'll say most recently probably would be COVID, the COVID-19 pandemic, how there were people who were of color who were disproportionately dying of complications from COVID and for whatever reasons those deaths were happening, it still reinforces when you just look at the sheer numbers of black people dying, it reinforces some of the negative stereotypes and some of the negative feelings that the black community has had when it comes to the medical profession.
And so one of the reasons why I early on talked about some of the ways in which disability was linked to blackness is to kind of help pull that thread all the way through, because what we end up seeing is that, in addition to some of the things that are still a challenge, the residue that permeates is that the black community largely, especially when it came to disability back in the day, were forced, so to speak, to try to avoid any sort of labels that attached them to being considered to be unhealthy. And so to answer your question, I think a lot of the challenges, even with black families and mental health is some of what was passed down and some of the ways in which we were taught is to try to avoid any labels that further that the black community feels like will further disenfranchise them or discriminate against them.
So it is one thing to have to deal with some of the residue of racial slavery and some of the discrimination. It's a whole other thing to willingly attach myself to a label that further, that daily, will feel that will further disenfranchise them. And so what you get is sort of this resistance to having official diagnoses of things, official labels that attach us to things. Because very early on, I talk about this in the book, that was a matter of survival for the black community. Anytime during slavery or even post-slavery, children that were born with a disability, the community had to hide that because of the ways in which the wider community saw those children as liabilities. And that thought sort of continues to permeate. And so one of the challenges then for the black church and even para-church organizations, historically black organizations in the black community, is that in order to sort of survive some of the racism and Jim Crow and all those things, and even though we progress, that sort of the ethos of the community was let's not further stigmatize our children and further stigmatize ourselves by attaching ourselves to labels even at the risk of not sometimes being able to get the early intervention and the support. Because there's a history there that tended to skew the black community's view of the medical profession.
And so the detriment is that, again, there are early interventions and there are things that we didn't always take advantage of because some of it was, “Well, we feel like in order to survive, we don't want to attach any labels that will further stigmatize our children.” That's the challenge for the church is even with disability ministry is, and I talk about this in the chapter about the black church, I think some of those things are done, some of the accommodations, some of the supports are there, but they're not publicized. They're not something that is readily attached to organizations outside of the community, because for a long time it was a sheer matter of trying to survive and trying to avoid further being stigmatized, especially because we know, and this is not even about race, mental health is still very much a stigma in the community as a whole.
And then you go inside the church, it's still very much something that's a stigma. So if you come from a community that feels like it can't afford to be even further stigmatized, you tend to avoid any labels of any diagnosis that will further stigmatize you. You see how people who aren't a part of the minority community are treated, and then you just have this history of mistrust because again, some of the other awful things that were done in the past. And so that's continuing to be a challenge for the black church, is sort of getting through that so that we can access the types of supports that are available to us if we can get through this history of mistrust and this history of not wanting to be further stigmatized by attaching ourself to mental health labels.
Steve Grcevich: So this is one of the things that's a challenge and it points directly to something that I encounter all the time in my line of work. So as a child and adolescent psychiatrist, I am aware when I am serving black kids that there's this perception when kids have behavior issues that perhaps folks in my position are more likely to whip out the prescription pad and prescribe certain things because of biases or some sort of racist perception about one's capacity for self-control. But the trade-off is this, that for kids to be able to get access to accommodations and supports and disability services in the school, it's my giving them a label or attaching a diagnosis to them that facilitates that process for them to be able to get services in the public sector. So I guess what would your advice be when I put this video up on LinkedIn and share it with my colleagues? For those of us who are in a situation where we're working with black kids and black families, given the stigma that's already out there about mental health, what do we need to be doing to be caring, supportive, and culturally competent in terms of serving families from the black community where there is this stigma and this burden, shall we say, about having your child identified as having a disability?
Lamar Hardwick: Yeah, and I'm glad you said that because one of the things I often teach is it's important for us to acknowledge that we've come a long way as far as it comes to race. But I think one of the things I help people understand is that the things that have happened in our country that you had nothing to do with, you're still very much a victim of it as much as anyone else, right? Because you have to, and I pastored a multi-ethnic church, and I would tell them you have to work through overcoming some of the decisions that were made that you didn't make, that you don't feel that way. But it impacts your ability to practice your faith, to practice your profession in ways that I think sometimes go under appreciated. So it's not just black people who have been impacted by that, it's all of us, right? Because you want to do the very best that you can for your patients and your families.
You also have to try to work through and overcome some of this negative baggage that you didn't create either. So I start there and say that because it puts us all in the same boat, especially as Christians, that's one of the ways that I try to help people understand that we're not fighting a different fight. We've all been impacted by this. None of us chose this, and it is impacting our ability to do the things that we want to do for each other.
The second thing I would say is I think, and I actually had a very intense conversation with the mother of two twin boys at the church that I previously pastored, they're since now grown men, this was probably 14 years ago, but who had that exact same scenario that you just pointed out. She did not want to have them prescribe the medicine. She did not want to basically have anything documented that could be pulled up in the future. One of the things I told her was is that, and even what I would say to physicians like yourself, there are certain goals that I think that families have for their children. Sometimes the language, and I talked about this before in a session I did with the University of Wisconsin Madison, with a group of health professionals, is to try to figure out, first of all what their goals are. What is the language surrounding how they experience the child's behavior or disability? Because what I found is that sometimes, so for example I used autism because that's what I was diagnosed with, things like nonverbal communication, eye contact, those things, there's a different language culturally that's used within the black community, and there's a different way in which black people experience what is defined as autism. And so some of those things sometimes may not be as important or as significant, or there's an underlying reason why that's so. For example, I'll share this.
One of the things that I noticed that is a barrier that goes unsaid is, and maybe you've heard this, about the talk that oftentimes black parents have to give to their children about how to interact with authority figures, how to interact with police, how to interact with principals and educators in order to keep them safe. One of the things that I discovered in my own diagnosis is part of that masked what would've gotten me diagnosed, because I was taught look straight at someone in their eye, and "Yes sir, no ma'am,” and so all of the tools that I was given to help me survive as a young black man also masked some of the symptoms that I had, if that makes sense. And so getting at the importance of some of those things. So I say that to say that something like eye contact, nonverbal communication wouldn't have been a big deal in my family because we were coached how to do that. Now having a conversation and understanding what the goals are of helping your kids interact with the world and some of the goals that the parents have and helping their kids manage themselves, self-regulation, those types of things.
You tend to peel back layers and learn that we're sometimes saying the same thing, but different language. There are some what I call the hidden curriculum of black families that are being taught that sometimes times parents would be more than welcome to find out that there are actually medical tools that can help with those things as well. And so I think it's just a conversation, finding out what are the goals, what are some of the challenges that they have socially, what are the things that they want to teach their kids and how to be able to self-regulate, and then what are some of the tools that medical professionals can bring to the table that kind of aid in assisting with those goals. And what I found in talking to parents and helping advocate with them is that they're kind of wanting the same thing, we just go about it differently because of some of the history that has been used against the black community.
And then again, there's some hidden curriculum, there's some language and there's some things that we're taught to do that sometimes mask. And I also think that one of the things that specifically even talks about autism is that a lot of times children are not diagnosed until the social demands exceed their ability to handle it. And so some of the, which is why a lot of times you see late diagnosis in persons like myself when you get to middle school, because the coaching that I've received on how to interact, it stops working at a certain point. And so knowing also some of the different social steps that are taken in society and the way that impacts how black families view disability, how they experienced the disability or the mental health issue, and how much of what they've taught their child to do and how they taught their child to respond, will work after a certain age. And those things are also important to just kind of know, and it just comes with conversation.
Steve Grcevich: So to follow up with that, living in a state of Ohio, and I've heard about this from folks in other states, within the last year or two due to changes in the laws and families with disability being able to go to private schools and to have state money funding that. A lot of our Christian schools for the first time are getting interested in serving kids and families who've been impacted by disability. So because, in a lot of cases, we're sort of starting from square zero and we're just beginning at some of our schools to conceptualize this, what advice would you have for Christian educators who are basically for the first time looking at significant disability inclusion within their schools, for kids who would qualify for special education services, what should they be doing if they're building this from square zero to be more welcoming and more supportive of kids from the black community?
Lamar Hardwick: My first most natural response would be to resource it if, like you said, there are now opportunities for funds to be allocated for that, for families to come in, that right there tells you that there needs to be either a match or something that exceeds the amount of dollars that are being put into it, by way of you having now access to that. What I'm basically is that there's a reason why those funds can now be allocated because it definitely needs to be resourced. So you need the professionals, whether it's consultations with persons like yourself, you need the professionals in your schools who have the experience and the education for special education. But then also, especially when it comes to the black families coming in, you may also need some administrators and some educators of color who can come in, whether it's consulting or on staff, to also help to navigate some of those waters, right?
One of the things that I've often said was the greatest challenge of integration back in the day when schools were integrated is that they integrated the students, but they didn't integrate the teachers and administrators. And so now you have, which I still believe in, it was a great move forward, and Dr. King talks about this, it is a great move forward to stop desegregation, but they didn't really consider that we also need some of the teachers and educators and administrators to integrate the schools as well as the children in order to make it more successful. And so I would say the same thing is whether it is consulting on the side or preferably having that one or two people, is anytime you try to do full inclusion for anything, you need representation at the highest levels to help navigate those waters. And that includes disability, includes some of those families with disabilities who will come in who are families of color, is to have some experts and some educated people and some consultants who will help you to navigate those new challenges. And that just takes resources.
Steve Grcevich: So one last question. A number of years ago, I was actually a finalist to be Dean of the medical school that I graduated from. And one of the things I think that's especially important is that I think that some of our Christian colleges need to start medical schools because it's very important that the medical profession, given some of the issues that we're dealing with now, be informed from a biblical worldview and a biblical perspective about what it means to care for people. If I had been selected to be Dean of the medical school, what advice would you want to give me in terms of how we need to train and teach our physicians differently, so that the structural racism that you describe in the book doesn't get perpetuated?
Lamar Hardwick: Wow, that's a tough question. I think a lot of work has been done, so I don't claim, especially when its on the medical profession, a lot of work has been done. A lot of things have been changed. Definitely conversations like this one are great. I think primarily it would probably be the same advice I just gave, is to try to partner with someone who can help to navigate those waters and to continually sort of investigate the ways, and I always say residue because I do believe we've progressed tremendously. But stuff like what happened, there's still lots of residue. And so I think that those are the places that can be spots that we miss or overlook or don't understand, that are still sort of working its way behind the scenes in ways that have influenced the way that medicine is practiced and views in which were used.
For example, I talk about in the book John Harvey Kellogg, who was a minister and a surgeon, but he had a significant influence on the way in which we determine someone's health. And even to this day, some of those things are still used as barometers. But the reality is, and he says this himself, is that he created that system to try to ensure the legacy of white women so that the white race would outlive the black race. So you kind of have a tainted way of measuring what it means to be healthy, because your goal was never to decide what it meant for everyone to be healthy. And so again, those are things that I think are still part of the residue does impact a lot of things medically, probably not. It may impact 10 to 15% of the way things are seen, but we still have to go back and say, well, if we're using those standards, and that was never his intention to be equitable, how much of that do we need to pay attention to?
So that doesn't become a blind spot for us. So I think just continue to have these conversations and revisiting some of the tools that have been handed down to us medically to assess health. I actually just listened to a great podcast the other day with my wife on race-based medicine, and how there's still some things that don't just impact black people but impact other people. One of the things they talk about with sickle cell, how we were told that it's something that only African-Americans get, and that's not true. And so you have people who are not black who could have sickle cell, but because we've been told that they're not getting the care that they should get either. And so just things like that that we have to investigate. Is it more likely for African-Americans? Yes, but it's not true that it’s only them. So those are things that I think we just need to continue to investigate because we were handed tools that we just need to rethink and to continue to talk about and investigate to make sure that we are living up to the Christian standard of treating everybody justly, equitably, and how Christ would treat all of us. And so that just requires ongoing discussion and investigation of the tools that were handed to us.
Steve Grcevich: So Lamar, thank you so much for all the time that you've been willing to spend, and for the leadership that you've shown on these issues. For folks who are interested in learning more about you and your ministry, what's the best way for them to check you out?
Lamar Hardwick: Yeah, I would say visit autismpastor.com. You find all the links, books, my social media, even when it's updated, I'll be speaking and those, so that's the best way. Everything is housed at autismpastor.com
Steve Grcevich: Anyway. Dr. Lamar Hardwick, author of How Ableism Fuels Racism. Thank you so much for taking part in this three-part conversation, and thank you to all of our podcast listeners. I'd ask that you would share a link to this podcast and previous podcasts in the trilogy, with friends, folks at church, others that would be interested in what Lamar is writing about. We appreciate your reviews and your ongoing support of Key Ministry. So thank you so much for being a part of the podcast. Lamar, thank you for taking the time to do this.
Lamar Hardwick: Thanks for having me.
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