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Black health experts say surgeon general's comments reflect lack of awareness of black community

“The Adams statement is, at best, irresponsible and, at worst, reflective of systemic structural racism.”
Image: Vice Admiral Jerome Adams, the Surgeon General, attends a coronavirus task force briefing at the White House on April 10, 2020.
Vice Admiral Jerome Adams, the Surgeon General, attends a coronavirus task force briefing at the White House on April 10, 2020.Kevin Dietsch / Bloomberg via Getty Images

Black health care professionals are offering unsolicited advice for Surgeon General Jerome Adams after his much-publicized remarks about “drugs, tobacco and alcohol” and “big momma” related to the black community and the coronavirus: Watch your mouth.

At least that’s the view of Linda Goler Blount, the president and CEO of the Black Women’s Health Imperative in Washington, D.C., an organization that addresses the most pressing health concerns of African American women.

Blount, an epidemiologist, said she did not take offense to the way Adams responded last week to a question from Yamiche Alcindor of PBS. But his failure to lay out a framework for his thoughts has caused a stir that has lasted for days.

“He needs to be aware of how people interpret what physicians in particular have to say,” Blount told NBC News. “So he has to put his thoughts into context to prevent misleading interpretations.”

When asked by Alcindor about the disparity between the rate at which black Americans are contracting COVID-19 as opposed to othe racial groups, Adams said, “African-Americans and Latinos should avoid alcohol, drugs and tobacco.

“Do it for your abuela, do it for your granddaddy, do it for your big momma, do it for your pop-pop,” he said. “We need you to understand, especially in communities of color. We need you to step up and stop the spread so that we can protect those who are most vulnerable.”

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Adams, 45, an anesthesiologist from St. Mary’s County, Maryland, became surgeon general in 2017. He once said that President Donald Trump was in better physical condition than him. Asthmatic, Adams said he does not go anywhere without his inhaler. He defended his language, saying he calls his grandmother “big momma” and can relate, as an African American, to the disparities in infection rates.

But Blount said: “There’s nothing wrong if that’s how he talks among his family. I didn’t take offense to the ‘big momma’ comment. But wait a minute: Why are you not personally outraged that you have some 40 percent or more people that have underlying, preventable chronic diseases? Why isn’t this a problem for you, and why aren’t you addressing that? He says it like it’s just a given that should be accepted.”

Adam’s call for the underserved to abide by stay-at-home orders was devoid of understanding or empathy, Blount said.

“And I get the message: ‘Stay at home.’ But, she said, “it comes across as if he’s lecturing when the fact is, 20 or 25 percent of blacks and Latinos have to get on a bus, get on a train and go some place to work on a job where they are in front of people. So understanding how life and the economy are organized (should) frame your comments in that context.”

Adams’ remarks come as health experts continue to highlight the disproportionate number of African Americans who are dying from coronavirus. As of Tuesday, there are more than 580,000 confirmed cases of coronavirus in the United States and more than 23,000 deaths associated with the disease, many of them African Americans.

In Wisconsin’s Milwaukee County, for example, African Americans make up 25 percent of the population, but 75 percent of the confirmed deaths.

For Dr. Henry Louis Taylor, Jr., a University of Buffalo professor and researcher, there isn’t much of a controversy. The surgeon general missed the mark. And it’s not what he said, but what he did not say.

“It is irresponsible to talk about the elimination of drugs and alcohol without talking about eliminating the neighborhood-based social determinants that produce drug and alcohol abuse,” Taylor told NBC News.

Taylor’s research focuses on a historical and contemporary analysis of distressed urban neighborhoods, social isolation and race and class issues among people of color, especially African Americans and Latinos.

“The Adams statement is, at best, irresponsible and, at worst, reflective of systemic structural racism,” Taylor added. “Black people live under enormous stress in places that are service deserts that lack gyms and are not suitable for jogging or even walking. At the same time, alcohol and tobacco companies target these communities. The ‘step-up’ question does not reflect the realities of black America. It suggests that African Americans themselves are responsible for their plight.”

Dr. Pierre Vigilance was not enamored with Adams' comments but he attributed the backlash to Adams' association with the Trump administration.

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Vigilance, a former associate dean for practice at George Washington School of Public Health, said: "I think, when taken in context of all that he mentioned, including ‘buela’ and ‘op pop,’ these terms are used to describe certain people in some families. Had he used 'big momma' in isolation, there may have been more cause for concern. But I think some people may want everyone in this administration to be a villain."

The controversy was magnified by last week’s exchange between Alcindor, who is black, and Trump, who was asked why there was not a plan to protect the most vulnerable citizens:

Trump: “Well, we do have a plan. And one of the things I'm most proud about is what I've been able to do for the African American community, the lowest job numbers in the history of our country. This was—“Alcindor: “--for the--the virus of course?”

Trump: “Excuse me. Yeah, just before the virus came. Well, I'm just saying because, you know, this has been here for three weeks, right? So, just before the African American community had the lowest unemployment, the best employment numbers. More African American people and communities have been thriving.“Ifyou look at our opportunity zones and what we did--Tim Scott who is fantastic, a fantastic senator came to me -- opportunity zones. More jobs for African Americans than ever before, better health care than they've ever had before, all of these things. The surgeon general spoke to it and he spoke to it, I thought, really brilliantly.”

Adams added that he had spoken with the NAACP to inform his comments, but some black health care experts were not impressed.

“The NAACP is not a health care organization,” Blount said. “So much of this is data driven, and researchers, scientists, doctors, epidemiologists are the ones who understand it and have to relay what it means to the public in a way that the public can understand, put it into context.”

Further, she said Adams sent an unintended message when he talked about tobacco in the same way he did consuming alcohol and drugs.

“He may as well have said that black and brown people are more likely to abuse drugs and alcohol,” she said. “He provided no context for his comments. Making these simple comments with no context leads people to believe that black and brown people are more predisposed to abusing alcohol and drugs.”

“He’s a physician,” she said, “so he knows better.”