Rewriting the present: post traumatic slave syndrome as a foundation for social determinants of health
Presumey-Leblanc, Garssandra I.
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Social determinants of health (SDOH) are often used to discuss health inequities and systemic barriers experienced by minority populations. In the United States, the intersection of SDOH leaves these populations vulnerable to negative health outcomes. Missing from the SDOH discourse are the underlying historical causes for these disparities. Medical-Legal Partnerships (MLPs) have undertaken the role of educating the health and human services (HHS) workforce on interdisciplinary collaboration, cultural competence, and the skills to recognize experiences of negative SDOH. However, current research does not explore the foundational impact of historical trauma, more specifically Post Traumatic Slave Syndrome (PTSS), on experiences of negative SDOH. This ethnography primarily uses the personal accounts of black female HHS workforce members and participant observation from within a MLP to examine how historical trauma acts as a foundation for understanding the complex interactions of SDOH. The SDOH discourse does not challenge the medical and legal institutions that contribute to how minority populations experience negative SDOH. As currently structured, MLPs unintentionally reproduce a pedagogical narrative that erases the lived experiences of SDOH by only focusing on individual factors and not systems. Black female HHS workforce members agree that historical context is missing (e.g. PTSS) from the SDOH discourse and contemporary experiences of racism and discrimination. Historical context would change how HHS workforce members advocate for their patients as well as engage in system-challenging praxis within the medical and legal institutions. This suggests the need to examine how American institutions exclude particular histories and reinforces a white supremacist and patriarchal narrative.
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