Lisa, a White staff nurse, expresses her condolences to Michelle, a Black nursing assistant who recently lost another family member to COVID-19. Lisa exclaims, "You're so strong and resilient. I admire that about you." Michelle, sounding exasperated, retorts, "I'm tired of being resilient!" Lisa, confused by her colleague's comment and not knowing how to best respond, walks away. What happened?
Resilience is characterized as an asset. However, a heightened emphasis on resilience may overshadow the etiological factors that necessitate its existence. Michelle had buried several family members because of COVID-19. The pandemic has disproportionately burdened members of historically stigmatized communities and magnified the ways in which structural racism influences health disparities.
Being told she was resilient only reminded Michelle of the perpetual muting of disparities, discrimination, and inequities she routinely observed and experienced. Although she was aware Lisa may have been confused by her response because the pervasive effects of structural racism were foreign to her, Michelle experienced Lisa's comment as blindness to one of the root causes of her grief. She saw it as a disregard for what Bailey and colleagues (Lancet, 2017) described as "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."
Structural racism impacted Michelle on a personal level. She saw how the lack of educational and employment opportunities for her parents perpetuated generational poverty and reinforced an ongoing historical trauma that shaped her lived experience. When Michelle attempted to purchase a home in an area where the school district would provide her children with broader opportunities, she was repeatedly confronted with the reality that racial steering and housing discrimination, although illegal, were still covertly operating.
The literature amplifies the benefits of resilience, roughly defined as the ability to overcome adversity, lauding it as a commendable strength. Without resilience, it's postulated, individuals might respond to trauma, despair, and even ordinary disappointment with depression-or even worse, suicide. While not all individuals possess high levels of resilience, a 2017 study by Assar in the Journal of Race and Ethnic Health Disparities posited that Black women in the United States possessed higher levels than White women. As two African American women, we agree that resilience shouldn't blind us to how structural racism operates.
According to the American Psychological Association, resilience explains one's ability to overcome a myriad of obstacles, including trauma, adversity, tragedy, and stressors. However, if taken in isolation from root causes of inequities related to structural racism, the resilience model can be a counterproductive approach to overcoming trauma. The failure to address factors that undergird trauma and the repetitive nature of structural racism could have led to Michelle's frustration and belief that she was once again being asked to discount her lived experience.
Expanding models of resilience to incorporate awareness of the need to dismantle the causes of racial inequities could prove beneficial. Acknowledging what is happening while presenting solutions alongside resilience is key. Lisa could have authentically engaged Michelle by adding, "How can I help?" Such a query could begin to acknowledge the veil of resiliency obscuring the structures that support racism.
Calls for resilience should never serve as a proxy for sustaining racial inequities. Rather, the discourse should center on ways to address structural racism and the harm that ensues. Members of the health professions team should recognize, and join their colleagues in dismantling, structural racism. Resilience coupled with actionable steps that address the root causes of racism could provide deeper healing while creating a more humanistic society where all can thrive with dignity, and not just survive.