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Henrietta Lacks and Institutional Racism Module

Understanding and Creating Solutions to Institutional Racism in Healthcare

Learning Module

Abstract

This lesson starts with reading the book The Immortal Life of Henrietta Lacks by Rebecca Skloot. Throughout each section of the book students are developing their own sense of personal racial consciousness and working together to understand how institutional racism works in our current healthcare system. The culminating project is a peer reviewed paper written to propose solutions to the racism that is seen in healthcare.

Keywords

Race, Racism, Healthcare, Henrietta Lacks, Personal Work, Genetics

Overview

This lesson is a semester long module where students are reading the book The Immortal Life of Henrietta Lacks by Rebecca Skloot and participating in discussion diving into their personal racial consciousness and how both relate to institutional racism in healthcare.

This lesson is something that I have previously taught will students in my Genetics and Biotechnology course. This class is a mix of sophomores, juniors and seniors who collectively say they want to go into the healthcare field post high school. I believe as a teacher we are not only here to teach kids the content standards but to produce productive members of society. In this belief from the quantitative and qualitative data about our country as a whole and Dane County, WI where I live and teach racism is alive and well. I would not feel as though I am doing my job as an educator if I was not asking my students to think about who they are on a racial level and how that fits into a wider scope of the United States and the World. Previously this has been a one hundred percent in-person class discussion. I am interested to see the growth of kids by doing this in a hybrid model with online modules and then class discussions. My classes are 87 minutes long and I currently feel like we just scratch the surface in a discussion and I am always trying to pull in alternative perspectives for kids to hear first hand how people live who do not look like them. If the student does more of the individual work before the discussion happens it will leave more time for good whole class discussion.

 

Intended Learning Outcomes

Student

 

a. Students will grow their personal racial consciousness and are able to have a discussion while naming their race and personal journey with race.

b. Students can define institutional racism and use critical thinking to design a solution to current institutional racism.

c. Students will read a nonfiction novel in their science content class.

Teacher

The strudent outcomes are as follows with some extension for the teacher 

Student Outcomes Teacher Instruction 

a. Students will grow their personal racial consciousness and are able to have a discussion while naming their race and personal journey with race.

 Students will be working together to have a collaborative experience and support in developing their racial consciousness 
b. Students can define institutional racism and use critical thinking to design a solution to current institutional racism. This is a little easier in that they are defining institutional racism but then will work to use this definition to design solutions 
c. Students will read a nonfiction novel in their science content class. Kids may complain about this but it is good for them to have experience reading and working with a non-fiction text and reading outside of a language arts course. 

Below are some commen misconceptions that you may face. 

a. Misconception: Many students have grown up in a colorblind world where talking about race is participating in racism.

b. Misconception: Many students (especially white students) believe that institutional racism is something of the past and that especially in healthcare it does not exist any more. Many students will also give the idea that it doesn’t exist where we live in WI because racism is a southern problem.

 

Module Timing

Introduction: 45 minutes in class

Lesson 1: 4-6 weeks between Introduction Lesson and Discussion 1 

Discussion 1: 87 minutes in class

Lesson 2: 4-6 weeks between Discussion 1 and Discussion 2 

Discussion 2: 87 minutes in class

Lesson 3: 4-6 weeks between Discussion 2 and Discussion 3

Discussion 3: 87 minutes in class

 

Part 1: Life

Student

Part 1 of the book The Immortal Life of Henrietta Lacks is titled Life, between now and the scheduled Discussion #1 you will need to read this portion of the book and answer the reading guide questions attached.

_Part_201_20-_20HeLa_20Questions.docx

Along with reading you will be doing work related to your own personal racial conciousness. Then relating the book and personal growth to institutional racism in healthcare. You will do this work in the form of disucssions and updates as you work through this module.

Teacher

This section gives students the assignment of reading Part 1 of the book and gives the guided reading questions. These questions have been written my Rebecca Skoot the author and I have pared them down to just 1-2 question per chapter that I feel really captures the essence of that chapter and has kids thinking about the science going on in the book and the racism/healthcare themes.

Citation for the Chapter Questions: Skloot , R. (n.d.). The Immortal Life of Henrietta Lacks Teacher's Guide . Retrieved February 23, 2020, from http://rebeccaskloot.com/wp-content/uploads/2011/03/RHSklootTeachersGuideLORES.pdf

Update #1

Student

Racial Identity - Who am I and how do that affect the quality of my healthcare.

Read the following essay by Mitalia Perkins titled Magic Carpet.  

Mitalia Perkins
Link to the Article

When finished reading the short story: 

  1. Comment on this post thinking about one or more of the following prompts. 
  • Describe the author’s childhood experience of cultural boundaries. How did she respond to these boundaries? How would she respond differently now? What might have happened to cause her to write about these experiences?
  • Have you ever been made fun of because of a cultural trait, such as your home language or traditional clothing or food? Describe the experience.
  • Have you ever made fun of someone — or witnessed others doing so — because of a cultural trait? Describe the experience.
  • What does the author mean by "magic carpet"?

2.   Create an Update:  Do you have a "magic carpet" that you and only a few others share? What are the qualities of that "magic carpet"? With whom do you share it? What would enable you to share this secret part of your identity with more people? 

  • Include some type of multimedia 

 

Teacher

This update has the purpose of getting kids to start thinking about their differences as an asset and that they are all valuable and have something to offer the class, our community and society as a whole. 

 

As a teacher it can be difficult to start conversations about race and racism.  If you are struggling with where to start I highly suggest the below article from the Anti-defamation League. 

https://www.adl.org/education/resources/tools-and-strategies/race-talk-engaging-young-people-in-conversations-about

Update #2

Student

Media embedded February 24, 2020

My Identity : Race is made up of Skin Color, Culture, and Consciousness

Comment thinking about your different identities and how they have affected your day to day life?

Racial Identity___________________________________


Ethnic Identity ___________________________________

How have these identities affected your day to day life?

Teacher

Preparing for this lesson as an educator you must know yourself first.  I highly recommend watching the video and responding to the comment prompt first as a model for the students and it shows the students taht you are open and willing to go deep into these uncomfortable conversations. 

Discussion #1

Student

Today is our first dicussion we will be discussing the following prompts in three different ways 

  1. Individually you will respond to the prompts. 
  2. Small group discussion (3-4 members). 
  3. Whole class discussion. 

This small to big format is for you to feel increasingly confident in bringing your voice to our space and conversation. 

Discussion Prompts 

  • Part 1 was titled “Life” why was this an appropriate title? If if could have been titled something different what would you suggest?

  • What do you think of the following quote and how does it relate to our current healthcare system?

    Like many doctors of his era, TeLinde often used patients from the public wards for research, usually without their knowledge. Many scientists believed that since patients were treated for free in the public wards, it was fair to use them as research subjects as a form of payment. (30)

  • Healthcare Conversation 

-  How did Henrietta Lacks’ racial identity affect the healthcare that she received?

-  Have you ever been aware of your racial identity in a healthcare situation?

-  Can you think of a time when your racial identity could have affected the healthcare that you received?

-  Have you ever had a conversation with your parents, guardians or trusted adult about how to talk to doctors and nurses?

  • How would you define Institutional Racism? Do you think this exists in Healthcare?  Explain. 

  • React to this statement: I can choose bandages in “flesh” color and have them more or less match my skin.

    Often True-Sometimes True -Seldom True

  • How do you feel?

1 ----------------------------------------------------------5-------------------------------------------------------10

Same                                           Questioning                                         Earth Shattering

Explain why you chose your number.


 

 

 

Teacher

This will be the first in person conversation, be prepared for this discussion to be a little bit difficult.  The prompts start centered on the book and story and then move into conversations about the personal work that the kids have been doing.  In my courses we have already done work on group norms for dicussions but before starting if you have not done this in your class you need to set parameters for difficult conversations.  

 

I recommend leaning into the four agreements from the Pacific Education Group: 

1. Stay engaged 

2.  Experience discomfort 

3.  Speak your truth 

4.  Expect and accept non-closure 

 

When I facilitate these discussions I try my hardest to stay out of the conversation and allow the students to have a safe conversation together as peers.  I do also highly recommend that if you do not have a diverse group of students to seek out the alternative perspective and bring them into the classroom through any means possible.  

Part 2: Death

Student

Part 2 of the book The Immortal Life of Henrietta Lacks is titled Death, between now and the scheduled Discussion #2 you will need to read this portion of the book and answer the reading guide questions attached.

Part Two Reading Guide Questions

Along with reading you will be doing work related to your own personal racial conciousness. Then relating the book and personal growth to institutional racism in healthcare. You will do this work in the form of disucssions and updates as you work through this module.

Teacher

This section gives students the assignment of reading Part 2 of the book and gives the guided reading questions. These questions have been written my Rebecca Skoot the author and I have pared them down to just 1-2 question per chapter that I feel really captures the essence of that chapter and has kids thinking about the science going on in the book and the racism/healthcare themes.

Citation for the Chapter Questions: Skloot , R. (n.d.). The Immortal Life of Henrietta Lacks Teacher's Guide . Retrieved February 23, 2020, from http://rebeccaskloot.com/wp-content/uploads/2011/03/RHSklootTeachersGuideLORES.pdf

Update #3

Student

Experiences with Race and Racism 

​Now that we have defined your race let's start to think about your experiences with race and racism.  

First watch the following videos put together by the New York Times "A Conversation About Race" Series. 

Media embedded February 24, 2020
Media embedded February 24, 2020
Media embedded February 24, 2020
Media embedded February 24, 2020
Media embedded February 24, 2020
Media embedded February 24, 2020

Create an Update answering the following prompts: 

  • What was your first experience with race or racism?

  • What was your most recent experience with race or racism?

  • What significance is there to thinking/talking about your experiences?

  • Interview someone of a different race than you and ask the same questions.

Teacher

This update will really start hitting hard for the kids. Many kids will start questioning their life experiences and those of their peers.  Depending on where your personal racial consiousness journey these conversations could become harder for you as well.  

Update #4

Student

Equality VS Equity 

Media embedded February 24, 2020

 

Create an Update answering the following prompts: 

  • Create a venn diagram comparing and contrasting Equality and Equity. 
  • What does equality look like in healthcare?
  • What does equity look like in healthcare?
  • Do we have equality or equity in healthcare in the USA?

Use multimedia elements to demonstrate your ideas. 

Teacher

Discussion #2

Student

Today is Discussion #2 

  1. Part 2 of the book focuses on the science that happened with the HeLa cell line. What are some of the medical breakthroughs that happened because of Henrietta's cells? Where would modern medicine be without her?
  2. What are your thoughts on this quote? What is the moral dilemma going on with the HeLa cell line?

“Black scientists and technicians, many of them women, used cells from a black woman to help save the lives of millions of Americans, most of them white. And they did so on the same campus—and at the very same time—that state officials were conducting the infamous Tuskegee syphilis studies.” (97)

        3.  Who is benefiting  from the HeLa cell line? Do you think these people were in it for the  money and fame or for the betterment of human health? 

Next we will split into 4 groups and each read one article.  Fill out the below prompts related to your article and be prepared to share in a small group.

  • Write an overview of each article
  • How does this article relate to Henrietta’s story
  • How does this article relate to current healthcare practices?

 

 

Teacher

Article Titles and Documents 

Is a Lack of Cultural Diversity in Healthcare Harming Our Patients?

ACFrOgAEJ3hyvJxzt6_XQPWht68W3Lwvt2L5OvD3zN7HjlkBPJ1oEgbkd1NBIs-9DBbT8yfw_B2lkYv1B6Yi5pdASs6KeG0Mt-JnRTel7IxsqFe5bG25hsxFHm7QA7o_3D.pdf

Medical Testing on Prisoners Is Unethical and Should Be Outlawed

Medical_20Testing_20on_20Prisoners_20Is_20Unethical_20and_20Should_20Be_20Outlawed.pdf

This doctor breaks down language and cultural barriers to health care

Racial bias in a medical algorithm favors white patients over sicker black patients

Racial_20Bias_20in_20Algorithm.pdf

I like to update these articles every year.  The newest addition was the article about the Algorithm and it has really added a new element to our disucssions.  

Part 3: Immortality

Student

Part 3 of the book The Immortal Life of Henrietta Lacks is titled Immortality, between now and the scheduled Discussion #3 you will need to read this portion of the book and answer the reading guide questions attached.

Part Three Reading Guide Questions

Along with reading you will be doing work related to your own personal racial conciousness. Then relating the book and personal growth to institutional racism in healthcare. You will do this work in the form of disucssions and updates as you work through this module.

Teacher

This section gives students the assignment of reading Part 3 of the book and gives the guided reading questions. These questions have been written my Rebecca Skoot the author and I have pared them down to just 1-2 question per chapter that I feel really captures the essence of that chapter and has kids thinking about the science going on in the book and the racism/healthcare themes.

Citation for the Chapter Questions: Skloot , R. (n.d.). The Immortal Life of Henrietta Lacks Teacher's Guide . Retrieved February 23, 2020, from http://rebeccaskloot.com/wp-content/uploads/2011/03/RHSklootTeachersGuideLORES.pdf

Update 5

Student

The Words of Diversity and Equity 

You will be exploring the vocabulary associated with diversity and equity.  Go to the below link and watch the short videos and fill out the below graphic organizer.  

https://projects.seattletimes.com/2016/under-our-skin/#

Task 

Institutional Racism

Person of Color

 Racist  Ally Microagression  All Lives Matter  Poliitcally Correct  Colorblindness Safe Space Diversity White Privilege White Fragility

Write down your first reaction to this word from the video. 
 

                        
Define the word.                                                                                
What impact does this word have on our Community                        
What impact does this word have on Healthcare                         

Create an update chooing one of the above words.  Relate this word to your life, the book and our discussions about institutional racism.  

Be sure to include multimedia elements. 

 

Teacher

For this section you will need to go through all of the videos and feel like you truly understand these words before you assign your students to define them. 

Update 6

Student

Implicit Bias 

You will be using the website http://www.lookdifferent.org/ to create an update around the following prompt: 

Choose one of the types of Bias (Racial, Gender, Anti-LGBTQ+) and explore it through the above link.  Create an update answering the questions 

  • What is this type of bias?
  • How does it work?
  • Why does it matter? 
  • How does this bias show up in healthcare?
  • Action plan of how to reduce this type of bias in our community. 

 

Teacher

This activity is based on the Harvard study of Implicit Bias. I would highly suggest completeing the Harvard test for yourself. 

https://implicit.harvard.edu/implicit/takeatest.html

 

This update will really start pushing kids to think about soutions to the bias and racism that is so prevalent in our society. 

 

Discussion #3

Student

Today's discussion will begin with a culminating activity about personal identity work called My World View.  

My World View Activity

Discussion Prompts: 

  1. Zakariyya uses the term “disrespect” to describe Gey’s treatment of Henrietta and the family. Explain the specific reasons why Zakariyya feels disrespected. Do you believe Gey was disrespectful? Explain your answer.

  2. First Listen to the NPR Report:

    https://goo.gl/fbmxBd   What is your initial Reaction to this report?

  • What questions do you have after thinking about the situation for a minute?

3.  After looking at the infographic: What ideas or questions do you have with the information that you are looking at?

Health Disparities Infographic

4.  Institutionalized Racism is Racial discrimination that has become established as normal behaviour within a society or organization. Do you think that Institutionalized racism exists in our healthcare system? Explain your stance.

 

Final Thoughts

  • Tell me what is the single biggest idea that you learned from reading The Immortal Life of Henrietta Lacks and/or from the discussion we have had about the book.

                    Note: Don’t hold back =) This is your time to tell me exactly what you think… I use

                              these to make the discussions and learning better for the next round of

                              students

 

Teacher

This discussion is always very interesting!  Typically kids have grown to be confident in their voice around race and racism and we have a really great conversation!  

 

Here is the document for the questions that I ask for the My World View Activity. 

My_20World_20View_20Questions.pdf

I suggest completing this activity ahead of time so you know where you stand in your world view.  This activity can really bring up some fragility and anxiety in kids.  Especially white kids who think that their life is very diverse and find out that the people who is closest to them oftentimes looks most alike them.  

A good discussion point is to then brainstorm how to widen your world view. 

 

Peer Reviewed Project

The Immortal Life of Henrietta Lacks Conclusion Paper

Prompt: Throughout the course of reading the book The Immortal Life of Henrietta Lacks by Rebecca Skloot our class has had discussion that center on institutional racism and bias in healthcare. Your summative assessment is a paper where you focus on a specific type/incidence of bias/racism in healthcare and propose a solution to that problem. You will also need to identify any counterclaims or negativity that would arise with this solution and debunk/counteract them.

 

Rubric for Paper

 

This paper will be due one week from today and we will complete peer reviews and revisions to the work before you turn in your final product. 

Student Survey

Student_20Survey.pdf

 

References

  • Skloot , R. (n.d.). The Immortal Life of Henrietta Lacks Teacher's Guide . Retrieved February 23, 2020, from http://rebeccaskloot.com/wpcontent/uploads/2011/03/RHSklootTeachersGuideLORES.pdf
  • Picture of author Mitalia Perkins . (n.d.). Retrieved from https://mitaliperkins.com/