A Vermont legislator told the state’s racial equity chief Wednesday that systemic racism in the health care industry doesn’t exist.
Rep. Arthur Peterson, R-Clarendon, grilled Xusana Davis, the state’s executive director of racial equity, over the notion that the health care system discriminates against people of color. The House Committee on Health Care was taking testimony on a related bill, H.210, about racial disparities in the health care system. The legislation would establish an Office of Health Equity.
Davis cited the disproportionate rates by which people of color in the state are affected by Covid-19, and recommended, based on recent research, that the state declare racism a public health emergency.
After her presentation, Peterson asked that Davis defend the premise that racism in healthcare is systemic.
“Commissioner Davis, I wonder if you could give me a specific, concrete example of systemic racism in the health care system,” he said.
Davis replied, presenting a slide with a photo of a medical textbook that included guidance for nursing students about how to treat patients according to their race and cultural backgrounds. “Blacks often report higher pain intensity than other cultures,” Davis said, quoting from the book. “They believe pain and suffering are inevitable.”
Medical practitioners often underprescribe pain medication for people of color, she said. Nursing schools used the textbook until 2015, when a backlash prompted the company to remove the page from the book.
“I would tell you that your example is not systemic racism, it’s people being racist,” Peterson said. “It’s not the system, it’s people. And I think, throughout this whole thing, that’s what it is. It’s people being racist. I think the field is level, I think people need to be changed.”
When Davis replied that systems are “collections of individuals,” Peterson pushed back again.
“I just would refute the idea that anyone would read that, and then underprescribe medication because they feel that a Black patient is more able to tolerate pain,” Peterson responded, referring to the textbook page. “I can’t imagine that.”
Studies have shown that practitioners are less likely to prescribe opioids to Black people for pain treatment.
Peterson, who is in his first term, raised similar issues before he was elected in his district, which includes Proctor, West Rutland, Clarendon and Wallingford.
His responses to Davis are part of a larger pattern.
When Reese Moore, the daughter of former president of the Rutland Area NAACP Tabitha Moore, proposed raising Black Lives Matter and Pride flags at Mill River Union High School in July, Peterson strongly objected. He helped organize a petition requesting a public vote on the matter, which received hundreds of signatures.
Several months later, he narrowly defeated incumbent Dave Potter, a Democrat, for the House seat.
Peterson told VTDigger on Friday that he believes systemic racism exists when policies explicitly discriminate according to race — something he doesn’t believe is taking place in Vermont.
“When someone in the system does something that’s racist or discriminatory, that’s the person, not the system,” he said. “And that was the only distinction I was trying to make.”
Asked whether, given his statements, he would support changes to the system that would support people of color, Peterson said he would need more information.
“Some people can overcome it and go right through it and have great and successful lives. Other people let it hold them back,” he said. “Without being there and seeing it in person, I have a hard time.”
“I just wanted to understand what was meant by systemic racism,” he added. “And that was the reason for my question.”
Other legislators responded to Peterson’s comments at Wednesday’s meeting. Rep. Mari Cordes, D-Lincoln, a registered nurse, said she’s seen the effects of racism in the medical field firsthand.
“If I, as a white woman, am not willing or able to listen or learn, then I will never know about systemic racism, because I don’t experience the deleterious impacts of it,” she said.
Rep. Leslie Goldman, D-Bellows Falls, echoed Cordes’ comments.
“I also agree emphatically that the individuals make the system, so we really have to accept the fact that the system allows it and reinforces it,” she said.
Rep. Taylor Small, D/P-Winooski, serves on the House Human Services Committee but attended Wednesday’s hearing because she knew the testimony would be relevant if her committee takes up the bill in the future.
“I think it is truly detrimental when we have failed to acknowledge [systemic racism], especially when people of color — especially women of color — are giving this knowledge and sharing it in committee,” she told VTDigger.
Speaking to VTDigger on Friday, Davis said that while she disagreed with Peterson’s comments, she appreciated that he was willing to engage in the conversation. Though she’s heard similar sentiments often in her time directing the Office for Racial Equity, Peterson’s views, she said, are not widespread among lawmakers in the state.
“One thing that I have noted is that in Vermont, this session, we have a lineup of legislators, many of whom really get it,” she said. “More than that, they have demonstrated that they’re committed to advancing equity.”
When Davis does encounter those who are doubtful, she said, they don’t often dispute the veracity of the disparities or the data, but rather the system that creates those disparities.
Davis said she isn’t interested in policing others’ thoughts. Her job, she said, is to ensure that everyone in the state is treated fairly.
“What I am interested in,” she said, “is people who are in positions of leadership being well-informed and sincere in their desire to serve all Vermonters.”