Originally published in the October 2022 issue of the Notes on Antiracism, Justice, and Equity newsletter.

Sociologist Howard Becker coined the term “hierarchy of credibility” to describe the tendency to believe those with a lot of privilege and power, and consequently not believe those with little privilege or power. Racism strengthens this hierarchy. We have seen this phenomenon play out in multiple ways, from historically racist medical assumptions that lead providers not to believe our pain, to ignoring women such as Anita Hill testifying about assault and harassment to the dismissal of Black people with COVID symptoms. This lack of trust in marginalized voices has and continues to contribute to significant health inequities.

Black birthing people face disproportionate barriers to high-quality and respectful care due to racial discrimination and interpersonal racism. Serena Williams, the 23-time Grand Slam tennis champion, fought for her life after the birth of her daughter because health practitioners refused to listen to and believe her when she requested blood-thinning medication for a blood clot she knew she had. Williams said that as a world class athlete, “I know my body,” and that this experience “was a test for how loud and how often I would have to call out before I was finally heard.” This is especially frustrating when we acknowledge that Black women are three times more likely to die from pregnancy-related causes than white women. Our lives and livelihoods are dependent on being believed. But racelighting creates scenarios wherein we are not considered reliable narrators of even our own experiences. This is part of what makes experiencing racism so infuriating; we have to live it and then prove it.

Discounting the voices of the marginalized has been a recurring theme through American history, and it is still experienced today. Being antiracist requires us to actively validate and uplift the voices of those who have been historically disbelieved. Ask yourself these questions as you interact with others:

• What might it mean to someone to be believed? 
• What might it mean for someone to feel fully heard and seen in a moment of crisis?

Our work toward antiracism is to push beyond dominant narratives and build coalitions of dignity, restoration, and action. As shared stewards of this world, our liberation is reliant on us trusting and believing each other. I invite you to have difficult but intentional conversations about credibility and power with folks around you, with an eye towards radical inclusion. Let me know how it goes (lljones@umn.edu). 

Toward justice,

Lauren Jones
Director, Diversity, Equity, and Inclusion
UMN School of Public Health
she/her/hers

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Readings and resources:

• How culturally centered care could help mothers and babies (2018 NPR interview featuring SPH’s Rachel Hardeman) 
• The Protest Psychosis
• Researchers Call for Exploring Racist Roots in Healthcare Inequities

Parting words from Toni Morrison: “The function, the very serious function of racism is a distraction. It keeps you from doing your work. It keeps you explaining, over and over again, your reason for being. Somebody says you have no language, so you spend twenty years proving that you do. Somebody says your head isn’t shaped properly, so you have scientists working on the fact that it is. Somebody says you have no art, so you dredge that up. Somebody says you have no kingdoms, so you dredge that up. None of that is necessary. There will always be one more thing.”