A Note on Racism in America

by | Jun 2, 2020


In her important book, So You Want to Talk About Race, Ijemoa Olou says there are two definitions of racism.

The first definition is: “racism is any prejudice against someone because of their race.” Under this definition, you are not a racist so long as you don’t treat other races badly. This is the definition I had been operating under my entire life until reading Ms. Olou’s book. This definition is comfortable for me as my perception is that I’m not racist under this worldview.

The second definition, which is Ms. Olou’s preferred one, is “racism is any prejudice against someone because of their race, when those views are reinforced by systems of power.” Under this definition, we are either part of the solution or we are part of the problem. Ms. Olou explains: “systemic racism is a machine that runs whether we pull the levers or not, and by just letting it be, we are responsible for what it produces. We have to actually dismantle the machine if we want to make change.” This definition makes me uncomfortable – I do little to check my white male privilege and to support change in the system that benefits me.

With this second definition in mind, I offer to you the below message from the President and CEO of BJC Healthcare. If we are not part of the solution, we are part of the problem.

To:            BJC HealthCare Caregivers

From:    Rich Liekweg, President & CEO

RE:            It is past time to stand up against injustice

I grew up in Alexandria, Virginia, a suburb of our nation’s capital in the early sixties. I am the youngest of six children, the third son in an Irish Catholic family. My mother was a grade-school teacher and my father a federal government, civil servant. We lacked for nothing, and only later in life would I begin to understand the patterns and injustices of structural racism and the inherent privilege of being born a white male.

My early childhood was marked by the civil rights movement – riots in Washington, DC, my home town; the assassinations of President John Kennedy, Dr. Martin Luther King, Jr. and Bobby Kennedy. TC Williams High School opened and was in my backyard. Remember the Titans! TC Williams integrated high school students from the white high school, Hammond High, and the black high school, George Washington High. We were taught to respect everyone regardless of age, race or gender and to give back to help those who had less, lessons that have stayed with me. 

During my many summers in college, I worked for the City of Alexandria Parks and Maintenance Department. It was there that I learned the value of hard work, the value of a college education, and the value of not judging people based on race or first impressions. The black men I worked with those summers, including my crew chief, Mr. Boone, took this young “college kid” under their care. They embraced me, while the white men criticized me for working too hard and hanging out with those who did not look like me. When my father dropped dead of a heart attack the summer between my sophomore and junior year in college, it was Mr. Boone who kept an eye on me each day on the job until I returned to college. And, we checked in on each other every time I came home from school.

Before he died, my father encouraged me to pursue a career in hospital administration. The summer between my junior and senior year in college, my older brother helped open a door for me at a hospital in Michigan. That experience led to my attending the University of Michigan for graduate school in public health and business. It was my public health education that introduced me to the concepts of what are today known as the social determinants of health and health inequities. 

After graduation in the late eighties, I moved to Durham, North Carolina, to start my health care career. Durham was a segregated community with two hospitals. It was home to Duke University and to a large African American insurance and banking industry, known by some as the Black Wall Street. Duke University Hospital, where I started my work, and Durham Regional Hospital, where I would later work was like a tale of two cities. Durham Regional Hospital formed when a white hospital and a black hospital merged in 1976 to form the town’s public, community hospital. I became its President in 1998, shortly after Duke leased the hospital from the County. Because of the history, race was always a factor in every and all actions. Upon reflection it taught me a lesson I would later be able to put a name on: the Platinum Rule, which is to treat others the way they would like to be treated. And, it taught me the value of inclusion and diversity. 

Fast forward … and today I live in St. Louis, with my wife and daughter. My life lessons have helped prepare me for the honor of serving and helping to lead one of this country’s most successful health care organizations, BJC HealthCare, whose academic partner, Washington University, is recognized nationally and internationally for its basic and translational research and academics. In fact, BJC HealthCare is one of the earliest health care systems created through a series of successful mergers and joinder agreements dating back to the mid-nineties. It is a blended, inclusive organization – Christian, Jewish, safety net, rural, suburban, urban, academic, community, adult and pediatric. 

St. Louis is, much like Durham was, still challenged by decades of segregation, structural racism and pockets of socioeconomic despair that exacerbate health disparities between races. The shooting death of Michael Brown by a white police officer almost six years ago, exposed how volatile race relations were in St Louis. And, it placed a magnifying glass on the underlying root causes. Yet six years later, sadly, we have made little progress in improving the quality of life for those most at risk in our community. 

More recently, like everyone around the world, we have been consumed these past few months responding to the spread of the invisible COVID-19 pandemic. We know this virus has disproportionately attacked those most vulnerable: the aged, those with underlying health conditions, and those who are challenged with access to housing, food, health care, transportation, jobs, and more. In most communities across the U.S., those most challenged by social determinants of health, are people of color. And in St. Louis, they are our African American neighbors. As my colleague, Dr. Alex Garza of SSM Health, who has been leading our region’s Pandemic Task Force, reminds me, the virus has pulled the veil back on what we have always known, but maybe choose as a community to ignore – your health status is best determined by your ZIP code, not your DNA code. So, not surprisingly, this virus is attacking those who live in the most underserved ZIP codes in a disproportionate manner. Another friend who emailed this week painted a picture that was even more raw: “….young black folks in high violence areas of North St. Louis said: I don’t know each day whether I’m gonna’ live or die, so how is COVID any different? They are not taking any precautions and that helps the virus proliferate.”  

Finally, last week we all witnessed the brutal, tragic, inhumane death of George Floyd. A death of a black man at the hands of a white man in a position of power. A senseless death that followed so many others including Ahmuad Arbery, Breonna Taylor, Eric Garner, Philando Castile, Trayvon Martin, Michael Brown and an even longer list. 

Which brings me back to my life lessons and what role I must play as someone who entered this world at birth with a privilege based on my race and sex, and now privilege as CEO of a large health care provider organization that also happens to be the largest private employer in the St. Louis region and among the largest in the state of Missouri. I firmly believe everything happens for a reason, and you are where you should be at every moment of every day. And with privilege comes enormous responsibility.  That responsibility was underscored this week by another email a black friend sent Thursday with a subject line that read:  Email to White Friends. In it, he told his story about how close relationships between races led to great success on the football field in high school. It also taught him, “Right is right, and wrong is wrong.” He ended with a call to action for his white friends:  “Please step forward right now within your station in America. Don’t be silent. History tells us what we can expect from silence and tolerance to hate.”

My parents taught me to give back, to stand up for those not as economically fortunate, to be principled, and to speak the truth at all times. These tragic events this week, the 100,000+ deaths accelerated by COVID-19, and the continued health care and racial disparities in our community, highlight the stark realties of our public health crisis in St. Louis and across America. This public health crisis is not the result of COVID-19, it is not the result of poverty, it is not the result of gun violence, it is not the result of underfunding our public health system. I firmly believe it is the result of racism in America – structural and institutionalized racism that privileged white men have perpetuated for far too long. I can’t deny my privilege, but I can stand up, step forward, and call out these injustices that people who look like me have perpetuated, supported and promoted far too long. And I will do just that each and every day going forward. I now call on my white friends to do the same. Use the unearned privilege of birth for the benefit of all. If you cannot, then step aside, sit down, and get out of the way. The health and future of all God’s children depend on it. 

Sincerely & Respectfully,

Rich Liekweg

President & CEO

BJC HealthCare

I think the message from Rich Liekweg is fantastic. Let’s work to be part of the solution. Our society of systemic racism needs to change. According to Ijeoma Olou, “when we identify where our privilege intersects with somebody else’s oppression, we’ll find our opportunities to make real change.”

President Obama penned some good thoughts on this topic with some suggestions about what we can do: https://medium.com/@BarackObama/how-to-make-this-moment-the-turning-point-for-real-change-9fa209806067


  1. As always John, incredibly thought-provoking. By doing nothing, we are all allowing systemic racism to exist. I am grateful for your hard work.

  2. John,

    Thanks for this very thoughtful edition. As usual, it caused me to think.

    Shortly after I read it, I overheard a talking head on CNBC ask Art Cashin why today’s market action seemed to indicate that the pictures of protest, anger, and violence had no effect on stocks, as they rose throughout the morning. Cashin responded by saying that it’s the difference between the weather and the climate. Those images of anger, frustration, and violence are the weather, not the overall climate, which is what the market cares about. Metaphors and analogies are rarely perfect, and Cashin was only giving his thoughts about the stock market’s driver this morning, but I wondered if it may have occurred to him that for many of the protesters, George Floyd’s death was less a passing weather front than it is the real climate they experience each day.

    Gotta get the talking heads signed up for The IFOD!

  3. If there is a spousal abuse problem in Estonia, and I don’t stop it, I am a misogynist? Nice try…..
    Individual self initiative, and less self-absorption is the first step.

    • Do you live in Estonia?

  4. John, thank you for posting this. Really respect and appreciate your mindset on this. Empathy and action are only really powerful when combined together.

    “Nearly all men can stand adversity, but if you want to test a man’s character, give him power.”
    ― Abraham Lincoln

    “Those who deny freedom to others, deserve it not for themselves”
    ― Abraham Lincoln

  5. Rich’s letter is fantastic–thanks for sharing. What a remarkable background for someone in his important position. We are so fortunate to have him lead BJC at this time. If everyone does their part, we can change things for the better. Luv2Nap

  6. Ms. Olou’s view about turning a blind eye to systemic racism is very deserving of consideration. I appreciate you using your platform to share ideas that can be uncomfortable for some people to think about, and doing it in a respectful way!

  7. Thanks for sharing this deeply insightful thinking.

  8. Great piece. Thank you for sharing, John.


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