Whom do we honor, and how? The powerful installation More than Conquerors: A Monument for Community Health Workers of Baltimore, Maryland 2021-2022 asks these questions while bringing attention to the efforts of many community health workers (CHWs) who heroically served Baltimore patients during the COVID-19 pandemic.
The artist behind the installation, LaToya Ruby Frazier, was first connected with CHWs through Dr. Lisa A. Cooper, Bloomberg Distinguished Professor and Founding Director, Johns Hopkins Center for Health Equity. What follows are two excerpts from Dr. Cooper’s book Why Are Health Disparities Everyone’s Problem? (Johns Hopkins University Press, 2021).
Preface
We’re all formed by our environments, experiences, and opportunities. In my case, those influences are rooted in my childhood in sub-Saharan Africa. I’m descended from members of the rural West African Gola tribe as well as freed slaves and free Blacks who, with the aid of James Monroe, Francis Scott Key, and other members of the American Colonization Society, crossed the Atlantic aboard the USS Harriett in 1829 from Norfolk, Virginia, bound for the new colony of Liberia. The colonization of free Blacks in Africa was a divisive issue among Blacks and Whites in the 1800s, and prospects for the success of Liberia were uncertain.
However, in the decades following [the] independence [of Liberia] in 1847 from the American Colonization Society, my ancestors experienced Liberia as one of the most promising countries on the continent, fueled by income from natural resources, including rubber, iron, and timber, that bolstered its economic development. You can still see vestiges of that wealth today in the iron ore, gold, and diamond mining operations and a few beachfront resorts, but you’ll also witness the extreme poverty resulting from decades of conflict and its attending economic collapse, leaving people able to earn a mere $900 average annual household income as of 2017—one third of which came from Liberians living abroad.
Even as a child in the capital city of Monrovia in the 1960s and 1970s, I could see how opportunity and privilege—or the lack of them—shape each individual’s trajectory. I was keenly aware of how fortunate my family was in terms of our quality of life and good health. From inside the safety and comfort of the car I traveled in to school and my piano and ballet lessons, I watched little children even younger than I was carrying their siblings on their backs, walking barefoot, and needing to contribute to their family’s incomes by selling things on the street.
While I lived in a comfortable home that overlooked the Atlantic Ocean, many of these children lived in small, crowded homes with dirt floors; I’d see them carrying buckets of water on their heads because there was no plumbing. Most children went to schools that had few chairs and desks, much less the books, equipment, and well-trained teachers that my school had, right in the same city. It felt unfair that I’d been blessed with safety and security while those around me suffered from poverty and poor health. The disparities were all around me—they were hard to overlook.
How Health Disparities Affect Everyone
I began writing this book in the first half of 2020 when the COVID-19 pandemic spread across the world, bringing to light health disparities that have existed among minority and at-risk communities worldwide for many generations. Another trauma burst into view in the United States a few months later sparked by the brutal killing of George Floyd in Minneapolis, which set off worldwide protests against systematic racism. Like other health disparities, the epidemic of Black men and women dying violently at the hands of police is one of very long standing. The extent of anti-Black racism becomes evident when people see an unarmed African American man suffocated by police, but many other inequities are less obvious. By the fall of 2020, more than a million lives had been lost around the world due to the pandemic—more than 200,000 in the United States alone—and racial tensions persist.
Both crises fostered a sense of community bereavement—a collective, cumulative grief—here and abroad that in turn prompted civic actions like marches and deeper examinations of everything from police apprehension tactics to the designs of state flags to “vaccine nationalism”—when countries, particularly those with more wealth, secure doses of vaccines for their own citizens before the vaccines are made available in other, typically poorer, countries. They demonstrate the essential need for societies to achieve not just health equity but social justice as well. Before the pandemic, minority communities were already disproportionately affected by systemic racism. They endured a confluence of factors—not having access to healthy food or effective education, multiple generations living crowded in small houses, having to rely solely on public transportation to travel to essential jobs that pay low wages and offer few benefits, and having less access to health care, both financially and geographically. This history of institutionalized, sanctioned mistreatment made minority populations especially vulnerable when the COVID-19 pandemic struck.
Yet the pandemic and the protests also revealed how interconnected and vulnerable we all are. Because we’ve all felt their impacts on our daily lives and freedoms, as well as on the economic stability of the entire country, they showed that our well-being depends as much on those around us as on ourselves. The striking racial and ethnic disparities reported for COVID-19 are a clear reminder that failure to protect the most vulnerable members of society not only harms them but places everyone at risk. COVID-19 disparities are not solely the responsibility of those experiencing them. People from high-risk groups live in neighborhoods where opportunities to access health care and obtain safe housing and healthy food are limited. Essential workers, many of whom are from these groups, often don’t have benefits such as sick leave and health insurance, which would permit them to self-quarantine or to access health care without penalties. Disparities reflect social policies and systems that we, as a society, have allowed to create these everyday injustices that become magnified in times of crisis.
The United States and other countries must develop a new kind of “herd immunity,” where all racial, ethnic, and social class groups become protected from the effects—those easily witnessed, and those less visible—of societal discrimination and disadvantage.1 Physical and emotional well-being are human rights—everyone deserves the opportunity to live a healthy life. The basic needs we all require for this are stable housing, safe environments, food security, access to a good education, jobs that pay a living wage, and high-quality health care. My hope is that through reading this book, your awareness will be sharpened so that you’ll be able to see the injustices around you and call them out. It may not be possible for one person to reverse the tide, but together, through conversations that prompt policy-shaping actions, we can raise our collective consciousness. The great seal of the United States includes the motto e pluribus unum—out of many, one. We’re each a part of America, and we all deserve equal treatment across all available opportunities and hard-won rights. But each of us must also contribute to making that vision a reality.
Why Are Health Disparities Everyone’s Problem? is available at the BMA Shop.
LaToya Ruby Frazier: More Than Conquerors: A Monument for Community Health Workers of Baltimore, Maryland 2021-2022 is on view through March 23, 2025.
© 2021 The Johns Hopkins University Press. All rights reserved.
- David R. Williams and Lisa A. Cooper. 2020. COVID-19 and health equity—A new kind of “herd immunity.” Journal of the American Medical Association 323(24): 2478–2480.
LaToya Ruby Frazier: More Than Conquerors: A Monument for Community Health Workers of Baltimore, Maryland 2021-2022 was curated by Jessica Bell Brown, Executive Director of the Institute of Contemporary Art at Virginia Commonwealth University in Richmond and former BMA Curator of Contemporary Art, with Antoinette Roberts, BMA Assistant Curator of Contemporary Art. The exhibition is on view in the BMA’s May Gallery through March 23, 2025, and is part of the Turn Again to the Earth initiative.
This exhibition is sponsored by Johns Hopkins University & Medicine and CareFirst BlueCross BlueShield. Additional support provided by John Meyerhoff, M.D., and Lenel Srochi Meyerhoff.
