Having been raised in the South by my grandmother, I was taught there were topics that were inappropriate to discuss in public. There often was a culture of silence around issues of sexuality, marital infidelity, homophobia and other forms of sexual difference, poverty, neglect and abuse, and specific health problems people were experiencing.
It wasn’t that people didn’t talk about these matters; they just didn’t regularly talk about them in public spaces. Instead, we whispered about them in safe, private spaces with people who shared our sensibilities. Any public talk that would expose, embarrass, alienate, or bring harm to a member of our family or close social network was avoided. While some of this silence was meant to be protective, there were unintended negative health consequences that emerged.
In this blog I argue that a culture of silence continues to exist in some communities, and that silence can be a risk factor for health disparities.
In deference to scholars like Paulo Freire who have more fully and theoretically described the existence of a “culture of silence,” my purpose is more practical and interpersonal in that I want to spark a conversation about ways silence can undermine important health decisions and enable preventable health disparities.
I conclude with the idea that giving voice to issues that have been silenced and related to health outcomes might contribute to reducing and eliminating health disparities.
Dr. Leandris Liburd is the Director of the CDC’s Office of Minority Health, serving as the agency lead in coordinating CDC engagement with HHS, other federal agencies, national organizations, and the public on issues of health equity to improve minority health. Dr. Liburd is a respected health care leader with many years of experience addressing community health, health disparities, and social determinants of health.