Detail of gold embossed book cover for Savage Survivals

What It Means to Talk about Race and African American Health

Naa Oyo A. Kwate, PhD gave the annual James H. Cassedy Memorial Lecture on February 11, 2021 at the National Library of Medicine on “Savages cry easily and are afraid of the dark”: What It Means to Talk about Race and African American Health.”  Dr. Kwate is Associate Professor of Africana Studies and Associate Professor of Human Ecology, Rutgers University, and recipient of a 2018 NLM G13 Award for Scholarly Works in Biomedicine and Health/Publications for Race and the Transformation of the Food Environment: Fast food, African Americans, and the Color Line, 1955–1995. Circulating Now interviewed her about her work.

Circulating Now: Tell us a little about yourself. Where are you from? What do you do? What is your typical workday like?

A formal photograph of a black woman.
Courtesy Christoph Delory

Naa Oyo A. Kwate: My family is from Ghana, and so I’m a second generation Ghanaian immigrant who grew up in Chicago. My degree is in clinical psychology, but after graduate school I became more interested in the social determinants of health, particularly the role of racial inequalities. So over time I have moved further and further from what I studied in graduate school.

Everyone’s workday is upside down now because of the COVID-19 pandemic, but for the most part, a typical workday includes preparing lectures and other course materials for online learning; grading student work; and conducting research and writing. Then there are things like faculty meetings, working on grant proposals, doing peer review, but that’s not every day. Currently, my writing is focused on the book I’m writing about fast food’s historical relationship to African American communities. It’s tentatively titled Paint it Black: Race and the Transformation of the Food Environment and is under contract with the University of Minnesota Press. It will be a while before it’s in print, but the manuscript will finally be complete and going out for peer review at the end of this month!

CN: Congratulations on the completion of your manuscript! How did you originally become interested in the history of medicine? What inspires you to ask questions about health?

NOK: My switch from clinical psychology to broader questions about health occurred after my clinical training in community settings. The patient population of New York City’s large hospitals (Black and Latino, low-income youth and their caregivers) carried a stark burden of chronic illness and conditions. Additionally, it was clear that mental health was critically shaped by racial discrimination, socioeconomic position, and neighborhood social and material contexts. Confronting this reality, and the relative lack of attention to social context in clinical psychology at the time inspired me to investigate the social factors that put people at risk for poor health in the first place. Both during my graduate study and today, a particular point of interest in the history of medicine has been how psychiatric and psychological constructs, diagnostic systems, and treatment have been applied to African Americans, and how Blackness has figured in that domain of medical discourse. But my own historical research has been on how fast food has transformed racially and spatially over time, from a focus on White consumers and White neighborhoods/suburbs to Black urban consumers and communities. The inspiration for this work was the research my colleagues and I conducted on racial patterning in the spatial locations of fast food; and also living in cities like Chicago and New York, where you can see that patterning as plain as day on city streets.

CN: Thank you for your fascinating talk, it was both well attended and well received and is now archived. In it you discussed the quote you selected for the title, “Savages cry easily and are afraid of the dark.”  Will you tell us here briefly where it comes from and what  it means in the context of your talk?

NOK: The quote came from a book entitled Savage Survivals, written by a J. Howard Moore, and published in 1916. The book has no introduction, so I don’t know what the overarching argument of the book is. But at one point in the book, the author argues that there are evolutionary differences between the races, with people classified as White as the race that is “most talented and enterprising and which has played the most distinguished role in the affairs of the world.” In contrast, he asserts that Africans are either savages, or in the stage of barbarism (a stage in between savagery and civilization). He describes the savage temperament as: “Savages cry easily and are afraid of the dark; they are fond of pets and toys; they have weak wills and feeble reasoning powers; they are notoriously fickle and unreliable; and exceedingly given to exaggeration of their own importance.”

In the context of my talk, I used the quote to argue that while researchers today generally do not espouse such nakedly racist views, that there still tends to be a focus on racial differences in health outcomes and health behaviors as either biologically-determined or as the result of behavioral and cultural pathology.

CN: Where do you do your research and what kinds of documents do you find useful in your work?

NOK: It depends on the project. Up until now, the majority of my work has been community-based; quantitative surveys with human participants, or spatial studies of retail and other resources in Black neighborhoods.  The fast food book that’s in progress, and the short work that I published along the way (Burgers in Blackface: Anti-Black Restaurants Then and Now) were quite a departure from what I normally do, as these were archival studies. Besides accessing materials online, through the university library and other data sources, I visited several archives and libraries in person, such as the Smithsonian’s National Museum of American History, the Library of Congress, city archives in Alexandria, VA and Baltimore MD, the Chicago Public Library, and many more. One of the most useful kinds of documents has been trade (industry) periodicals. They lend insight into the inner workings of corporations, their goals, plans, obstacles, and discourse about African American consumers. The work of marketing and advertising firms has also been a boon.

CN: In your talk, you shared a study of outdoor advertisements. Could you say a bit more about the data you looked at and the conclusions you drew?

NOK: In the talk I showed pictures of some of the advertisements we observed, from data we collected in Central Harlem in 2005–2006. We found that approximately 25% of all the ad spaces contained marketing for alcoholic beverages, and of these, the majority (72%) were for beer. Overwhelmingly, these were for lager/ale/stout, and less than 10% were for malt liquor (like the Colt 45 ad I showed). This contrasted with the 1990s, when malt liquor was aggressively marketed to young Black men. Among distilled spirits, it was a mix of cognac, gin, rum, and vodka. In a separate paper we showed that almost half of these ads fell within a 152-meter buffer of schools, churches, and playgrounds—in violation of what outdoor media companies purport to refrain from doing.

To examine the impact on drinking patterns, we used the CAGE, a screening measure that identifies problem drinking. The questionnaire asks:

  1. Have you ever felt you ought to Cut down on your drinking?
  2. Have people Annoyed you by criticizing your drinking?
  3. Have you ever felt bad or Guilty about your drinking?
  4. Have you ever had a drink first thing in the morning as an Eye-opener to steady your nerves or get rid of a hangover?

Potential abuse or dependence is defined by answering yes to two or more of these items. For the sample of Black women who participated in the study, we assigned participants the exposure value of advertising for the block group in which they lived. And we found that that exposure was associated with the odds of problem drinking.

Naa Oyo A. Kwate’s presentation is part of our ongoing NLM History Talks series, which promotes awareness and use of the National Library of Medicine and other historical collections for research, education, and public service in biomedicine, the social sciences, and the humanities. All lectures are live-streamed globally, and subsequently archived, by NIH VideoCasting. Stay informed about the lecture series on Twitter at #NLMHistTalk.

This talk was co-sponsored by the National Endowment for the Humanities, Office of Digital Humanities, as part of the recently reaffirmed partnership between NLM and NEH to collaborate on research, education, and career initiatives.

Naa Oyo A. Kwate’s talk was covered in The Washington Post.

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