Naming the harms


This is the 9th in a series of EQUITY BLOGS that explores the contexts of longstanding disparities in the health and well-being of King County residents. In addition to looking at the root causes of disparities, the blogs reveal how tightly history is woven into our lives and our children’s futures. Blogs in the series acknowledge the rich variability of responses within and across groups and generations, from strength and resilience to lasting harm embedded in policy and everyday life.

Advertisement card for the “Great Negro Mart” in Memphis, TN, 1859-1860. Collection of the Smithsonian National Museum of African American History and Culture.

Advertisement card for the “Great Negro Mart” in Memphis, TN, 1859-1860. Collection of the Smithsonian National Museum of African American History and Culture.

There is no shoving the four hundred years’ racial oppression and violence toothpaste back in the toothpaste tube.  ~~  Ijeoma Oluo, So You Want to Talk about Race

 Why can’t they just get over it”?

 Indians should just accept the fact that there was a war and they lost. ~~ Comment to Dino Gilio-Whitaker, All the Real Indians Died Off

 America should not be held liable for something that happened 150 years ago, since none of us currently alive are responsible. ~~ Senate Majority Leader Mitch McConnell, on reparations for slavery

Unfortunately, “just getting over it” isn’t an option. Like it or not, we are living the current chapter of our history. Past events shape our daily lives – the apprehensions felt when encountering someone from a different race or background, policies that restrict opportunities for some while expanding them for others, educational and social expectations, even our health and well-being.

An alternative to “getting over it” has emerged from “truth-and-reconciliation" commissions, modeled by South Africa and subsequently established by more than 40 countries. Whether reconciliation or reparations are ever achieved, the first step — truth — is to publicly acknowledge the harms caused in the past and their effects on people today.

Naming the harms

The 4 kinds of harm discussed here – emotional harm, socioeconomic harm, negative expectations, and persistent health disparities – differ in many ways, but are so tightly entwined that they reinforce one another, making it difficult to separate their effects in daily life. 


As a basic survival mechanism, humans are wired to pick up on the emotional messages embedded in the facial expressions, gestures, vocal timbre, and other behaviors of the people around them. Even infants have this ability, so efforts to deny or hide the effects of trauma are unlikely to succeed.

EMOTIONAL HARM is often associated with historical trauma – a kind of suffering that affects entire communities and is so extreme that some of its consequences (anxiety, fear, anger, resentment) are experienced by subsequent generations, who may show symptoms that resemble those of Post-Traumatic Stress Disorder (PTSD). 

In America, the historical traumas are well documented.

Starting 4 centuries ago and lasting for close to 250 years, African men, women, and children were captured, shackled, packed like sardines into the holds of ships for passage across the Atlantic, and sold – much like livestock is sold – to work as unpaid labor and to serve as breeding stock. Not incidentally, they were often tortured and separated from family and community. 

Native Americans also experienced the traumas of slavery, in addition to explicit genocide, repeated forced relocations, and vigorous efforts to eradicate their cultures by separating children from their families and forcing them to attend far-away boarding schools.  

Ongoing cultural oppression and structural violence have ensured that emotional harms would be experienced by new generations. 

Whenever society begins to create policies and laws rooted in fear and anger, there will be abuse and injustice. ~~ Bryan Stevenson, Just Mercy

After slavery was abolished in the US, 3 waves of organized vigilante terrorism swept across the country – during post-Civil War Reconstruction in the 1860s and ‘70s; in the 1920s (mostly in opposition to immigration); and again during the 1960s Civil Rights movement.  The Equal Justice Initiative, a nonprofit legal advocacy group, reports that terror lynching in the American South continued from 1877 to 1950, a period when “more than 4,400 African American men, women, and children were hanged, burned alive, shot, drowned, and beaten to death by white mobs.”  As illustrated in the photograph below, vigilante terrorism was not confined to the Deep South.

Ku Klux Klan Gathering at the Crystal Pool (2nd and Lenora) in Seattle, WA. March 23, 1923. 1997.10.19,  Washington State Historical Society , Tacoma (Wash.).

Ku Klux Klan Gathering at the Crystal Pool (2nd and Lenora) in Seattle, WA. March 23, 1923. 1997.10.19, Washington State Historical Society, Tacoma (Wash.).

This legacy of terror continues. Ta-Nehisi Coates wrote his 2015 book, Between the World and Me, as a letter to his 15-year-old son, explaining, “I am writing you because this was the year you saw Eric Garner choked to death for selling cigarettes; because you know now that Renisha McBride was shot for seeking help, that John Crawford was shot down for browsing in a department store.” The vigilantism continues, often – as with the murder of 17-year-old Treyvon Martin – under the protective umbrella of Stand Your Ground laws.

African American children and their families are burdened with the terrible fear that, due to their identifiable membership in a racial group that has been vilified, ostracized, feared, and demeaned as inferior, they could be shot and killed in the course of an ordinary day. This fear is supported by data: in King County, for example, Black males are 14.4 times more likely than white males to die from homicide. Members of this diverse group continue to be at the effect of racist beliefs and behaviors that are permitted – and often condoned – by the prevailing culture.


SOCIOECONOMIC HARM has been compounded over generations of institutional, systematized practices – often embedded in policy – that impede or prevent equal access to opportunity in areas such as housing, education, employment, criminal justice, and health care.  Any one of these functional barriers can influence disparities in income and the ability to accumulate wealth and pass it on to the next generation.  A hundred years of Jim Crow laws in the United States legitimized residential and educational segregation; discriminatory lending and law enforcement; and disenfranchisement of those who, by national law, should have been able to vote.

Black women only earn 65 cents for every white man’s dollar, and Hispanic women earn even less at 58 cents for every white man’s dollar … black men making 73 cents for every white man’s dollar … ~~ Eileen Patten, Pew Research, 2016

The enduring effects of these inequities are well-documented nationally and locally.  On average, white families in America have 10 times the wealth of Black families. And while a college education is linked to greater wealth in white households, the opposite is true in Black households. As shown on our local Health Disparities Dashboard and Community Health Indicators, African Americans and Native Americans in King County consistently experience higher-than-average rates of poverty, housing cost burden, and unemployment -- all of which exacerbate other disparities (the pressures of poverty diminish cognitive function, independent of other factors).  Similar inequities show up in local data on school discipline, youth detention, and adult incarceration. A new film, Just Mercy, based on Bryan Stevenson’s book of the same name, presents the work of the Equal Justice Initiative in the context of our society’s increasing tolerance of injustice and inequality. 

Our police forces were born from Night Patrols, who had the principal task of controlling black and Native American populations in New England, and Slave Patrols, who had the principal task of catching escaped black slaves and sending them back to slave masters. ~~ Ijeoma Oluo, So You Want to Talk about Race

By the time Jim Crow laws were abolished, the beliefs and attitudes behind those laws – especially about racial inferiority and white privilege – had become part of American culture.  Practices that reinforced those beliefs and attitudes had morphed into today’s structural racism -- “the totality of ways in which societies foster racial discrimination through mutually reinforcing systems of housing, education, employment, earnings, benefits, credit, media, health care, and criminal justice.”  


Shaped in part by centuries of exclusion and relegation to inferior roles, the roots of NEGATIVE EXPECTATIONS are linked to both EMOTIONAL HARM and SOCIOECONOMIC HARM. Examples of this kind of harm include negative outcomes – on multiple fronts – as well as erosion of self-esteem when faced with the negative expectations and implicit biases of teachers (even in preschool), potential employers, police, store personnel, and even well-intentioned strangers

The greatest evil of American slavery was not involuntary servitude but rather the narrative of racial differences we created to legitimize slavery. Because we never dealt with that evil, I don't think slavery ended in 1865, it just evolved. ~~ Bryan Stevenson

 We still saw how much less our teachers expected from us. ~~ Ijeoma Oluo, So You Want to Talk about Race

 … if you have a “black-sounding” name, you are four times less likely to be called for a job interview…. ~~ Ijeoma Oluo, So You Want to Talk about Race


BODILY HARM is reflected in persistent disparities in health outcomes. A recent Pediatrics article links multigenerational “racism, segregation, and systematic economic disenfranchisement” to the likelihood that children fail to accumulate the “health capital” that facilitates high levels of educational attainment, good relationships with peers, and strong parenting skills.

 … racism is a visceral experience, that … dislodges brains, blocks airways, rips muscle, extracts organs, cracks bones, breaks teeth. ... You must always remember that the sociology, the history, the economics, the graphs, the charts, the regressions all land, with great violence, upon the body. ~~ Ta Nehisi-Coates, Between the World and Me

 Advances in biomedical knowledge have enhanced our understanding of the mechanisms that transform chronic stress into bodily harm. While the body’s response to short-term stress is adaptive – improving memory, promoting immune function, adjusting blood pressure to match activity levels, and replenishing energy reserves when needed – chronic stress pushes these adaptive responses into overdrive. The resulting cumulative wear and tear on the body – commonly dubbed “weathering” or “allostatic overload” – increases risks for cardiovascular disease, stroke, abdominal obesity, diabetes, immunosuppression, and other serious health conditions. 

Until friends helped Frederick Douglass purchase his freedom, “everything he did felt provisional; he lived with the incessant fear of someone who could be plunged back into captivity at any moment.” ~~ Jennifer Szalai, New York Times book review

EMOTIONAL HARM, SOCIOECONOMIC HARM, and NEGATIVE EXPECTATIONS all contribute to chronic stress. Uncertainty about housing, food, money, neighborhood safety, education, and injustice can elevate anxiety, depression, fear, and hypervigilance. Poor health outcomes are not far behind.

Imagine the cumulative effect of daily worrying that your young son might be gunned down on his way home from school. While less dramatic, the everyday microaggressions experienced by people of color can have equally dire consequences. In the United States and King County, differences in education, poverty, age, marital status, or access to healthcare fail to fully explain well-documented disparities in birth outcomes. Increasingly, high rates of maternal and infant mortality are being attributed to physiological adaptations to the “… stress of being a Black woman in American society.”

In her recent book, So You Want to Talk about Race, Seattle author Ijeoma Oluo lists some common microaggressions and emphasizes, “Microaggressions are cumulative, perpetrated over time by different people, among whom many do not consciously realize what they’re doing”:

“The woman who grabs her purse as you walk by.”

“The store clerk following you around to see if you need ‘help.’”

“The person locking their car doors as you walk past their vehicle.”

“People who decide to ‘take the next elevator instead.’”

“The professor who asks to check your sources, and only your sources, ‘just to be sure.’”

“The not-so-random random security checks at airports.”

“The crowded bus where nobody will sit next to you.”

“The cab that won’t stop for you.”

Responses to racism-related microaggressions may not even be consciously perceived, but their effects nevertheless accumulate over time and have been linked to increased vulnerability to infection, premature cellular aging, early onset of chronic diseases such as hypertension and diabetes, and – most critically in this context – preterm birth.

What doesn’t kill you may make you stronger --- but you have to see it.

To focus exclusively on harms can leave communities and individuals feeling weak and defeated.  But to ignore longstanding harm is potentially even more dangerous and can help maintain a false narrative in which the original travesties are sanitized or edited out altogether, with enduring harms attributed to other factors or even blamed on the victims.

 … I’m not sure what’s worse, the fear and anxiety and fatigue brought on by yet another encounter with an officer that you are hoping and praying to make it out of intact, or the never-ending denial by the rest of society of the fear and anxiety and fatigue you experience as a valid response to the near-constant reminder that those assigned and empowered to protect you see your skin color as evidence of wrongdoing, and could take your freedom or even your life at any time, with no recourse. ~~ Ijeoma Oluo, So You Want to Talk about Race

Stories of resilience are woven into every chapter of our national history, and we celebrate them enthusiastically.  When unfairness or suffering continues, however, it is sometimes easier to turn away – out of shame, denial, frustration, or the improbable hope that the problems will somehow resolve themselves.

The healing process of truth and reconciliation starts with truth – a straightforward but excruciatingly difficult process of acknowledging the harms that have been caused. Committed to telling the truth about America’s racist past, in 2018 the Equal Justice Initiative unveiled 2 monuments in Montgomery, Alabama. The Legacy Museum: From Enslavement to Mass Incarceration calls on a mix  of media, narrative, and deep research to “shine[s] the light of truth on the destructive violence that shaped our nation, traumatized people of color, and compromised our commitment to the rule of law and to equal justice.” Nearby, the National Memorial for Peace and Justice combines the power of sculpture and landscape design to commemorate the thousands of victims of lynching in the United States.

Similarly, the New York Times’ 1619 Project, launched in August, uses words and imagery to realign our national narrative with historical truth. At times, the brutality of our history has been blurred almost to the point of invisibility, but – like a shadow – it never really leaves us. Under a bright and steady light, even those who turn away will see a shadow, sharply defined. That’s a start.