Topic 18: Power and privilege and the impacts on health

White privilege refers to the societal advantages white people have when compared to non-white people who experience racism. Francis Kendall explains that “white privilege is an institutional (rather than personal) set of benefits granted to those of us who, by race, resemble the people who dominate the powerful positions in our institutions” (Kendall, 2012, p. 62).

White privilege is a system that benefits all white people, regardless of class or gender. These unearned benefits are conferred to all white people systematically (Kendall, 2012). Whilst race impacts everyone, white privilege allows white people to potentially live their entire life without ever being made aware of these impacts (McIntosh, 1995). It is critical to name whiteness as a position of privilege to call attention to the inequities that continue to be produced along racial lines. For white people, acknowledging and being aware of one’s white privilege is the beginning of lifelong learning, where one can examine how race continues to shape and affect social life (Doob, 2015; Moreton-Robinson, 2000). 

In parallel, we can see that males have privileges that are not afforded to women (for example, higher wages, significantly lower risk of experiencing sexual violence, majority of positions on Boards, a belief that the male version of excellence and merit is the only version of merit and excellence). This unnamed privilege has very real consequences for women’s health and well-being. Similarly, the un-named whiteness of health systems and health education means health inequities get blamed on Māori, Aboriginal and Torres Strait Islander Peoples and their communities and cultures rather than the enabling environment that produced them (Phillips, 2015).

Learning of one’s white privilege is the first step to dismantling the institutional racism which maintains whiteness as the “invisible, unmarked and unnamed” (Moreton-Robinson, 2000, p. 111) centre, perpetuating a system that privileges white people based solely on the fact they are white. A health example of white privilege is when non-Indigenous physicians are insulated from the daily toll of racism that many Indigenous health professionals face. There are many reports of Indigenous health professionals completing their medical and health studies only to go on and experience racism from their own peers (Scopelianos & Docherty, 2019).

Understanding white privilege is key to disrupting the narrative of blame placed on Indigenous Peoples for their poorer health outcomes. Unmasking white privilege allows for the inequities between white and Indigenous Peoples to be better understood and better addressed.

For white Intensive Care Medicine specialists and trainees, it is paramount to being a culturally safe intensive care specialist that one understands the systematic benefits they have been granted during their career. Through this understanding, specialists and trainees will be well equipped to advocate and amplify the voices of Indigenous Peoples and to transfer power and decentre whiteness in health.