We need to talk about race and health coaching.

To be clear: This message is not political. I mention no political leaders, candidates, nor parties. Though it’s increasingly made out to be a “politically divided” issue, institutional racism is a human rights issue and a public health issue, both of which very much apply to us as health coaches and wellness professionals.

I sent out an email last week on “racism and health” to our general mailing list (which I also shared verbatim on our blog). That has more detail on my own personal experience (white identity, decade working in communities of color) and the action Four Wellness Co. will be taking moving forward.

I won’t repeat it all here. But the essential background info that applies to us all is:

Racism, particularly towards the Black community, has been deeply and atrociously rooted in our country’s history for over 400 years—and it’s still a very real and current problem.

Police violence kills Black Americans at 3-4 times the rate of white Americans. That’s all over the news.

But though police brutality towards people of color is a particularly visible and deplorable form of racism, there are countless other ways that quiet, institutionalized racism persists in all systems of our society: schools, housing, the judicial system, voting laws, access to employment and healthcare—the list goes on.

Institutional racism systematically distributes resources, power and opportunity in patterns that provide unfair advantage to white individuals and communities and unfair disadvantage to individuals and communities of color.

As health coaches, it is imperative that we are well-informed on issues that affect the physical and mental health of the people and communities we serve.

Racism is a public health crisis

A growing list of cities, counties and states have recently declared racism a public health crisis. They are certainly not the first to note this, though it is rightfully gaining more attention: Black Americans face drastic health inequities that, at their core, are due to pervasive systemic racism that influences all aspects of a person’s life and ultimately their health outcomes.

Black women are 4 times more likely to die of pregnancy related complications than white women.
Across all cancers, Black Americans have a 25% higher mortality rate than white Americans.
Black children are 6 times more likely to die from asthma than white children.
Black patients experience significantly longer ED wait times than white patients.
COVID-19 infections are 5 times higher in neighborhoods of color than white neighborhoods.
If Black and white Americans had the same mortality rate, nearly 100,000 fewer Black people would die each year.

Anti-racism for health coaches

Regardless of your own racial identity, cultural background or political leaning, an understanding of race and health is essential for professional work as a health coach.

As we take on a professional responsibility to assist our clients and communities in achieving better health outcomes, we have a special responsibility to understand and work against the systemic racism that unjustly hinders health outcomes for BIPOC individuals and communities.

While I am in no way an expert on racism from personal experience, I have worked in communities of color for about a decade, including in a healthcare setting, and in doing so have been involved in discussion and work around dismantling systemic racism.

Below I’m sharing 10 ways to actively practice anti-racism as a health coach.

I’m certainly not the first to suggest any of these, and also wholeheartedly support any other practice of anti-racism not included here, but thought it would be helpful to note action areas that are particularly relevant to professionals in the health coaching industry.

The opposite of racist isn’t ‘not racist.’ It is ‘anti-racist.’ What’s the difference? One endorses either the idea of a racial hierarchy as a racist, or racial equality as an anti-racist. One either believes problems are rooted in groups of people, as a racist, or locates the roots of problems in power and policies, as an anti-racist. One either allows racial inequities to persevere, as a racist, or confronts racial inequities, as an anti-racist. There is no in-between safe space of ‘not racist.’

— Ibram X. Kendi, How to Be an Antiracist

10 ways to practice anti-racism as a health coach

**These tips apply to all health coaches, though are especially important for white coaches, as we live in a white-normative culture and white people must work particularly consciously to get and stay educated on issues of racism and social justice.

1. Educate, and keep educating yourself on the diversity of experience in America

It is painfully clear that most Americans have much to learn about Black history and the experience of being Black in America. (Of course, there needs to also be systemic change to include this history and experience in education and social institutions, but most non-Black adults today will need to do our own work to improve awareness, as we weren’t educated/socialized in systems that taught this sufficiently.)

This personal “re-education” can come in the form of reading (here’s a list of books by Black authors, and books about racism in the U.S.), documentaries, TED Talks, IGTV, etc. Netflix has a Black Lives Matter collection.

And, yes, racism is horrible no matter which group it targets—and there have been many in our country’s history—but none have experienced it to the degree of the Black community, and that is the conversation we are currently having and *need* to have.

So, I’m highlighting the need to be much better educated on Black history and culture, but it’s also important to be educated on other unique racial/cultural experiences in the U.S., something that may vary based on your location, clientele, and your own background.

2. Understand the effect of race in health & healthcare

It’s our responsibility as health coaches to be sure we are aware of (and up-to-date on) racial disparities in health and healthcare, and prepare for how our coaching practices will work to counter this.

How can we fill in existing gaps in care? How can we improve racial and cultural sensitivity in our coaching? How can we set up structures that ensure we continue to improve as allies and are held accountable to doing that?

3. Understand the difference between equality & equity

There’s a key distinction between equality (providing everyone the same treatment) and equity (allowing everyone the same outcome). Here's a helpful visual:

How can we use this to inform our work as health coaches?

4. Know your language & how to use it respectfully

There are so many terms used to discuss racial/ethnic groups (some well-meaning, and some very much not). It can be confusing to know which is the most respectful, accurate or appropriate term to use—and what’s widely considered to be the “politically correct” term can change over time.

But despite all its complexity, it is incredibly important to understand the meaning behind the language we use to discuss race, as well as the origin of these terms, and any specific or negative connotation associated with them.

Here are a few important terms to know as a health coach. This is just a starting place (not an extensive list!), and I’m no expert—just sharing what I’ve learned over the years from scholars and activists about how to respectfully (and accurately) discuss race and racism. Some of this language is contrary to what many are taught is “polite” or “politically correct,” which shows how important it is to learn about preferred terminology from people the terms actually apply to.

BIPOC: An acronym for Black, Indigenous, and People of Color. This term highlights “the unique relationship to whiteness that Indigenous and Black . . . people have, which shapes the experiences of and relationship to white supremacy for all people of color within a U.S. context.” More info: The BIPOC Project

Black: This is typically a preferred term to “African American.” Gloria Atanmo explains why here. She goes into more detail (read her post!), but shares that some of the key issues with the term “African American” are: Besides the fact that not all Black people have immigrated from Africa to the U.S. (and thus it does not apply to a large number of Black individuals in the U.S. and around the world), hyphenating “American” can come across as diminishing someone’s full citizenship. (When was the last time you referred to a white person as “European American?”)

Also, capitalize the “B” in Black, to differentiate the people and culture from the color black. The AP style guide recently changed its grammatical convention to a capital B, something it has been called upon to do for many years, and something that should influence how we’ll be seeing the term in print moving forward.

Hispanic: Though Hispanic and Latino are often used interchangeably, they mean different things. “Hispanic” refers to people who speak Spanish or have Spanish-speaking ancestry. So, this refers to language more so than location.

Latino: Refers to someone of Latin American heritage. Some people who are of Latin American descent do not speak Spanish. So, this refers to location rather than language.

Latinx: A more inclusive term, including both “Latino,” the male form of the word, and “Latina,” the female form.

Indigenous: There has been much discussion and change over the years regarding the language used to describe native inhabitants of the Americas: Indian, American Indian, Native American, and Indigenous. These (like all other terms listed here) attempt to describe a large number of diverse communities as one group—something innately challenging and flawed. As such, there still is considerable variation in preference for the “best” term to use. Indigenous (with a capital “I”) is now considered to be the most politically correct among scholars (though it’s not necessarily the preferred term by all individuals).

Person of Color / People of Color / POC: A broad term used to describe people of many different backgrounds, who are not white or of European descent.

Minority: This term refers to a quantity. So, a racial “minority” is a demographic that is a smaller group than a racial “majority.” However, saying “a minority neighborhood” is not an appropriate way to describe a neighborhood that is predominantly home to people of color, because that’s no longer a minority group, it’s a majority group.

Enslaved: When discussing slavery, it’s more accurate and appropriate to refer to an enslaved person by the condition of being enslaved (by someone else), rather than using the noun “slave” which infers that a person is innately a slave. No person is “born a slave”—they are enslaved by the actions of others.

For more information on other terms regarding discussion of race and racial equity, check out the Racial Equity Tools Glossary.

5. Take a stand in your business

Addressing controversial topics can be a tough decision to make as a small business owner. When every client or dollar matters, some people fear the risk of losing business if they take a “political” stance. But there’s a big difference between politics and human rights. And, in defending human rights, there’s really no “neutral” option.

“If you are neutral in situations of injustice, you have chosen the side of the oppressor.”

— Desmond Tutu

Since the message I sent out last week in my business, I received some unsubscribes and angry messages. But you know what? Less than 1% of my audience responded negatively to the message, either by replying or unsubscribing. And the person who called me “a racist terrorist” for sending out an email on anti-racism could not pay me enough to work with her. That’s not a client I’m willing to serve, and it was best that we part ways.

At the end of the day, it’s your responsibility to authentically communicate your business’ values, and realize that is part of the process of connecting with your ideal clients.

6. Consider your business practices

Consider how your business practices are influenced by race, and how they impact the broader social movement to dismantle racism in America. Depending on the size and specific operations of your business, some things to consider might be: your hiring practices, the racial composition of your team, the vendors you work with, the partnerships or collaborations you participate in, the resources you share, etc.

How do these promote inclusivity? How can you improve them to be more inclusive? How can this be done most authentically and sustainably?

A personal example (and another one below, in the next item): I looked into the business services I use and their stance on racial equity in general and Black Lives Matter specifically. As important as it is to vote on election day, it’s also important to consider how you’re voting with your dollar—a vote you cast much more often.

Do the companies you purchase from have a social mission? Are you refraining from supporting companies that use your dollar to work against the causes you care about? Are there opportunities to choose BIPOC-owned businesses or vendors?

Many people think the small amount of money they spend doesn’t make much difference. But it adds up over time and over scale. Collectively, purchasing power makes a difference.

7. Use inclusive messaging

Marketing your health coaching business is complicated. On the one hand, you’re told to narrow, narrow, narrow your target audience. And that’s true, you should, that will help you serve them better. (And, health and nutrition have a lot of socio-cultural nuances that we, as health coaches, need to consider in understanding who we can best serve. There are sometimes cultural differences that we are not attuned to because of our own cultural background and understanding.)

However, most methods of narrowing your business’ target audience tend to be more along the lines of “busy mother with a gluten intolerance,” which is not a racially-specific category.

So why might your messaging and marketing accidentally become racially-specific? Because, if you’re white, living in a white-normative culture, you can quite easily get used to assuming that an all-white (or mostly-white) marketing plan is “normal.”

I’ve reviewed Four Wellness Co.’s imagery and found it’s much more “white” than I ever intended it to be. This is a broader issue that involves a) my own error in not intentionally sourcing more diverse imagery or communicating with my team my desire for inclusive imagery (have taken some action there recently), b) my own oversight in not acknowledging the direction imagery had gone (which speaks to the ease of being white in a white-normative culture and not noticing anything “off” with primarily-white imagery), and c) the accessibility of diversity in stock photography in general (which was a legitimate problem, and something many stock photography sources are scrambling to remedy).

Imagery is just one aspect of messaging to consider, but the point is that we as health coaches need to practice inclusive marketing and messaging that helps clients of diverse backgrounds know they are welcome and valued in our businesses.

Inclusivity goes many ways (and there’s more to it than race!), but this is something for white health coaches to be particularly aware of, as societal norms make it easier to “accidentally” discount the existence and experiences of others.

Side note: This, of course, does not apply in the same way to businesses that do serve a specific racial/ethnic group, such as Therapy for Black Girls, an online space that specifically addresses the unique mental health climate for Black females.

8. Amplify Black voices

This is way more than a buzz-phrase. Black voices are notoriously marginalized, including in the wellness industry. I task all of us (myself included!) to better acknowledge and share Black voices specifically, and voices different from our own in general.

But this work is, in many ways, internal before it is external. “Amplify Black voices” does not mean to do so out of tokenism. It means to authentically care about, listen to, engage with, and share perspectives and experiences different from your own; and to refrain from speaking on behalf of a group you don’t belong to and work instead to share those voices (something I will be taking to heart—this initial message feels very Melissa-centric, which I apologize for, but want to clearly share my company’s stance and my intentions for moving forward).

9. Donate

Something I’ve personally struggled with as a health coach/business owner who used to work in underserved communities is that my services price out many of the people I used to serve. The nature of small business operations in general (and coaching, a 1:1 practice, in particular) is that you need to set prices that sustain your business. Not really any way around that, or your business goes bankrupt.

But if your prices result in your services being inaccessible to an audience you would like to serve, what can you do?

One option is to donate a portion of business income to causes or organizations you’re passionate about. (This year, Four Wellness Co. & Five Design Co. are donating 5% of income to the NAACP Legal Defense and Education Fund.)

Depending on your business model, some other options might be:

Buy one / give one.
Offer a reduced rate or complementary spots based on certain criteria.
Develop a pro bono program to offer your services free of charge. (An example of this is the pro bono web design program we just launched via Five Design Co.—check it out if you know of an organization/business with a social mission that would like to apply!)

10. Be open to discussion & correction

It can be quite challenging to talk about race and racism in a culture that is currently grappling with its terrible entrenchment. Many people are waking up to the fact that racism “still exists,” which of course speaks to the privilege of not having been aware of its daily impact on millions of people, as well as the fact that they are unknowingly perpetuating it.

There is no “right” way to speak about race, racism or the Black Lives Matter movement. (Though there are some wrong ways… which include discounting their existence.)

Many people avoid speaking about these tough topics out of fear of saying something wrong or causing offense.

First, if you work to get and stay educated on these topics, you will be less likely to inadvertently say something ignorant or offensive.

But, the reality is that if you are white (or, in the current Black Lives Matter discussion, if you are not Black) you likely will say something ignorant, ill-informed, or even offensive at some point because you don’t know better—you did not learn better from your own education or experience (or perhaps you were not open to learning).

Be open and willing to engage with different perspectives and experiences, and to be corrected when needed, so you can learn from others what you can do better.

By staying away from discussion out of fear of saying something wrong, we lose out on meaningful experiences that teach and unite. By being defensive or close-minded when we’re corrected or presented with new information, we miss the opportunity to grow and be better humans and allies.

Being “anti-racist” does not mean being perfect. It does not even mean you’re not racist in some way (we all have unconscious racial biases, no matter how much we think we don’t).

To be “actively anti-racist” means you commit to the conscious dismantling of racial bias and oppression and you are engaging in the personal and collective work to get there.

On that note, I’m sure this post is imperfect in many ways. I’m human (aka a work in progress), and white (aka not an expert on the experience of being Black in America).

I share this with the best intentions to provide helpful information and support self-reflection regarding what we can each do better as health coaches to dismantle racism in our industry and country.

Here are some resources to continue this work:

Anti-racism Resources

The Anti-racism Daily Newsletter, created by Nicole Cardoza, a mindfulness teacher, offers daily reminders for a conscious commitment to anti-racism.

The Ally Resource Guide by @glographics is 30 days of stories, resources, conversation starters, journal prompts, videos, and personal anecdotes about how you can better unpack your internal bias and be a better ally for the Black community.

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