The arrival of the New Year marks a historic moment in the pursuit of justice for Stephen Lawrence's family. Finally, two of his murderers have been convicted after 18 years during which time the Lawrence family remained steadfast. Singlehandedly, and against all odds, they challenged the status quo of the most powerful institutions and actors of the state: the police, the criminal justice system, and the government. By applying pressure to expose the rank injustice they had experienced at the hands of the state they catalysed the momentum which would result in the Macpherson Inquiry in 1999.1
The family's own experiences of being treated with suspicion from the outset, rather than with compassion, and of being denied the highest level of professional competence to which they were entitled;2 along with the stereotyping by the police of Duwayne Brooks, with Stephen Lawrence at the time of the murder, and whose evidence was dismissed in court as ‘inadmissible’, did not dim their desire to see their son's killers convicted. Eventually, their efforts moved a mountain and we have seen a shift in cultural attitudes.
But as Doreen Lawrence reminds us, with her quiet dignity and wisdom borne of personal suffering, this is not a time for celebration. The ‘stop and search’ policy of community policing is now used more extensively than in the 1990s. Recent data shows that young black men are six times more likely to be stopped by the police than their white counterparts:3 a lamentable finding which has been shown to have been instrumental in fuelling the riots on the streets of many of our cities in August last year.4 The blatant racism exhibited by the Metropolitan Police Force and highlighted by the Macpherson report1 ultimately resulted in no one taking responsibility for the heinous crime until January 2012. The police and other monolithic institutions, including the NHS, have all benefitted from the period of reflection following the inquiry and consideration of the report's recommendations, but the data from ‘community’ policing suggests that more of a cultural change is needed.
Many young people in Britain today are facing a battery of structural barriers in the shape of the highest youth unemployment for a decade; the ending of the Educational Maintenance Allowance for students from low income families; and university tuition fees are soon to rise to an unprecedented maximum of £9000 per annum from September this year. In this uneasy and iniquitous economic climate if powerful institutions of the state treat people differently because of the colour of their skin, then the health of individuals as well as social cohesion is threatened by these added attitudinal barriers.
Racism damages health. It can undermine personal ambition and compromise a sense of self-worth; breeding frustration, resentment, and compromising intimate relationships. As GPs we see the effects of enduring repeated stressors everyday in our surgeries, manifest as ‘feeling tired all the time’; frequent headaches; or ‘pain all over’. One approach which demonstrates a commitment to addressing the somatic consequences of racism is to teach the next generation of medical students and GP registrars that bodily symptoms can be ‘caused by oppressive social conditions or interpersonal strife as anything that biomedical theory would recognise as disease’5 is one tranche of a strategy which would demonstrate our commitment to tackling the consequences of racism. Referring to the growing body of evidence which documents the neurobiological effects of trauma augments our own professional development and is important to communicate with younger recruits into medicine at a time of growing inequality for the UK (as well as globally).
Looking at the culture within individual general practice surgeries is another strategy although the days of ‘race relations’ training programmes have long been confined to the past. ‘Race’ has been subsumed into ‘cultural diversity’ which may have muted our awareness of its impact on the biology and biographies of our patients.
However, to conclude on this historic occasion, the jury's guilty verdict affords some peace for the Lawrence family who in turn have left a legacy to British society which put race on the nation's conscience. We owe it to them to remain alert to the insidious contamination of hidden racism in all our organisations and institutions today. There is no room for complacency.
- © British Journal of General Practice 2012
