Commentary on The Hate U Give

The advent of COVID-19, coupled with the murders of Breonna Taylor and George Floyd, among others, once again brought America’s long-standing racial inequity to the surface. Black Americans are disproportionally represented in the numbers of both positive COVID cases and COVID-related deaths. 1 Black American men have a 1-in-1,000 chance of being killed by police. 2 These 2 glaring examples of health inequity are a byproduct of centuries of institutional racism. To reach health equity, we must educate future physicians on the personal and institutional racism sustaining such inequities. 3 Learning about the many levels of racism offers medical students the skills needed to reduce bias when interacting with minority patients. 4 Angie Thomas’s novel The Hate U Give provides a springboard for educators to begin the discussion necessary to actively dismantle racism within the health care system. In conjunction with other antiracism curricula, 4 discussing the novel in a small-group setting increases knowledge of racism’s impact on health equity and promotes antiracism through self-awareness and individual action. The narrator, 16-year-old Starr Carter, lives in Garden Heights, a poor Black neighborhood, but attends Williamson Prep, a predominately White private school located in a White, affluent neighborhood. Feeling out of place in both worlds, Starr must constantly negotiate her double existence. This split comes to a head when she witnesses the murder of her childhood friend, Khalil, by a White police officer after the 2 are pulled over for a broken taillight. The novel follows Starr and her family as they deal with the mental, social, and physical repercussions of the shooting. Thomas shows multiple viewpoints of the incident while exposing the reality of being Black in 21st-century America. On the day of Khalil’s funeral, the community learns he was unarmed and the police are not pressing charges against “One-Fifteen,” the shooting officer. A peaceful protest is planned for after the funeral, but police action leads to neighborhood riots. The scene excerpted here takes place the next day, as Starr and her father, Maverick, drive to get supplies for his small Garden Heights grocery store. At this point, Starr’s role as witness has not been made public, although a lawyer for Khalil’s family has been encouraging her to speak out. In the scene, Thomas encourages us to reflect on our assumptions and biases. The media, the White community, and even Starr’s White friends believe Khalil deserved to die because he was “a drug dealer.” Starr grapples with her own anger toward Khalil, having learned of Khalil’s trade only moments before the officer pulled them over. As the novel progresses, the reader, alongside Starr, discovers the many complex reasons someone might turn to selling drugs. In Khalil’s case, his mother, Brenda, stole drugs from a local gang leader, and Khalil started selling to save his mother’s life. Maverick himself turns the stereotype of the Black American male as a violent or absent father on its head. Starr and Maverick’s close relationship is revealed as they engage in an honest conversation that is more discussion than lecture. A devoted father and husband, grocery store owner, and upstanding member of his community, Maverick is also a former gang member and drug dealer who served time in prison immediately after Starr’s birth. Like most people, his story is complex, and he should not be judged by his past. During discussion, medical students consider the assumptions and stereotypes the novel defies and reflect on a time when their own biases, or another’s, affected patient care. An exchange of strategies for promoting antiracism follows. Students immediately recognize Khalil’s death as a result of fear born of race-based assumptions. Starr’s Williamson peers, especially her best friend, Hailey, fail to view events through a lens broader than their own White racial frame. Starr’s narration of her dual position in both White and Black communities prompts students to examine their own behaviors. As one student noted, “At one point or another, we’ve all been Hailey.... I tried to use this novel as an opportunity to see how I act like the White people in Starr’s life, and how this can be a problem.” Students also focus on Starr’s struggle to speak out, equating it with their own silence and complicity in the medical setting. Just as Starr finally goes public and stands up to her friends at Williamson, students realize they too can make an impact by using their voices to share perspectives, support others, and challenge peers. A few weeks before George Floyd’s murder, I read The Hate U Give with a group of medical students. After the incident, one student wrote to say how reading the novel was now helping him communicate with others about racism in America. For more reasons than can be listed here, this novel is a valuable tool for medical educators at this time in this America

Affirmative action · Criminology · Feeling · Health care · Health equity · Institutional racism · Officer · Political science · Racism · Sociology · Food Security and Health in Diverse Populations · Gender Studies · Law · Migration, Health and Trauma · Psychology · Racial and Ethnic Identity Research · Social Psychology

• Risk of being killed by police use of force in the United States by age, race–ethnicity, and sex

  Open Access•Frank Edwards, H Lee et al.•Proceedings of the National…•2019

  Add to list

• Structural racism and health inequities in the USA

  Open Access•Zinzi D Bailey, Nancy Krieger et al.•The Lancet•2017

  Add to list