‘Be comfortable with being uncomfortable’

Binghamton University’s Department of Africana Studies owes its origins to the student activism of the 1960s. While many universities began similar programs then, Binghamton decided at the outset to create a department — among the first in the nation in 1969.

That foundation drew Associate Professor and Africana Studies Department Chair Titilayo Okoror to Harpur College in 2012; she also serves on the Master of Public Health program board. Originally from Nigeria, her research focuses on global public health and the role of context and culture in disease expression, health behaviors and decisions.

How do cultural context and health decisions intersect? She pointed to research she conducted at Purdue University on what constitutes a good sexual experience among college students, part of a larger study on the transmission of sexually transmitted diseases. Unlike white men and women, who respectively focused on anticipation and physical pleasure, Black women emphasized the need for emotional connection. They were less likely to leave their partners if sex wasn’t satisfactory, instead weighing factors such as the availability of eligible Black men.

The emphasis on emotional connection may date back to slavery, which thwarted the prospects of marriage for many Black couples, Okoror explains. Sexual pleasure wasn’t part of the deal, leaving emotional connection as the core of the bond.

“That legacy has influenced how people define good sexual encounters. It’s culture and context, values and morals, how history and institutions impact people’s choices and behaviors,” she says.

Okoror’s research has a global scope, with ongoing projects in Ghana and Nigeria, particularly exploring the cultural context of HIV stigma and treatment. Coronavirus has sparked a new project: a look at the pandemic experience of African immigrants and refugees, who are often reluctant to admit that they may have a virus, unlike African Americans. It’s an example of how cultural context can lead to different experiences of the same disease, Okoror says.

“I am fascinated by the question: Why do people do what they do?” she says.

Creating equity

A mentor in her Pennsylvania State University graduate program in biobehavioral health offered advice that she now gives to her own students: “You must be comfortable with being uncomfortable.”

The core lesson behind cultural competency is to put assumptions aside and consider the larger picture. Take, for example, the consumption of fast food in low-income communities. These individuals know fast food isn’t a healthy choice, but often it’s the only option available, Okoror points out.

In a similar vein, consider college students, who are more likely to participate in research studies for pizza at the end of the semester. Why? They run out of money by then and need to eat — a scenario familiar to many low-income communities.

“Change is never easy, but change is inevitable. We must be ready to face how the system has favored some of us over others, and what that has translated into over time,” she says. “We must be willing to say what needs to be said, and look for ways to create equity.”

Equity, she says, isn’t the same as equality; the latter focuses on everyone getting the same thing. When you consider the weight of American history, Black lives haven’t been accorded equal value, a legacy that has implications from policing to healthcare.

Okoror sees hope when she considers today’s young people, who are at the forefront of Black Lives Matter protests. She sees the thirst for change in Binghamton students as well, such as a white biomedical engineering major who took an Africana studies course several years ago.

While canvassing a neighborhood for an energy company, he didn’t understand why his Black coworker was reluctant to knock on doors until someone in the neighborhood called police and his colleague ended up in handcuffs. When the student objected to his partner’s treatment, the police threatened to arrest him, too.

“Please don’t say anything,” his coworker pleaded. “I want to make it home tonight.”

Recounting the experience, the student wept in Okoror’s office.

Africana studies give such students the tools they need to create change. That’s why Okoror recommends making Africana Studies 101 a required course for first-year students. It would be a step toward equity and set Binghamton apart from other universities — much like the formation of the department itself more than 50 years ago.

“Our students are yearning for direction. Our students are yearning for change. Our students are yearning for hope. We can give them direction by informing them, by providing the knowledge, by providing the hope they want,” she reflects. “That, at least, can be our legacy.”