Invulnerable, Inferior, or Invisible: Health Inequities & Narrative Tropes about Black Bodies in American Medicine

Racist ideologies have been deeply embedded in the history of American medical science (Rondini and Kowalsky 2021), which long propagated false belief in a since-scientifically debunked paradigm purporting that racial groups are delineated by innate biological differences. In this paper, we provide a theoretical apparatus through which to identify the dominant narrative tropes in American medicine that have reified white normativity and acted as rationales (albeit though seemingly contradictory logics) for directing diagnostic and/or therapeutic medical resources and interventions away from Black patients, thereby reproducing longstanding racial inequities in medical care delivery.

First, narratives of innate Black inferiority normalize lower baseline functioning of Black bodies as inevitable, thereby precluding standards of medical care delivery comparable to that undertaken for white patients with the same symptoms. This may take the form of “adjusting for race” or “race norming” through standardized testing procedures that determine eligibility for additional medical interventions, creating higher symptom severity thresholds for Black patients.

Second, narratives on innate Black invulnerability suggest that Black patients do not require the same degrees of care—those considered “best practice” for white or other patients—due to their “other than human” qualities—often linked to characterizations of animalistic capacities to, for example, withstand pain, or resist infection. While seemingly in direct contrast to the rationale of inferiority, the narrative of Black invulnerability nonetheless functions to analogously direct medical interventions and resources away from Black patients.

Lastly, mechanisms of invisibility shape the narratives implying that medical insight regarding Black bodies is simply unattainable. Narratives of Black invisibility in medicine reproduce white normativity by centering white bodies as the biological human “standard” against which assessment of disease indicators should be measured, rendering Black bodies invisible within the milieu of medical knowledge.