Trying to Avoid Racist Health Care, Black Women Seek Out Black Obstetricians

Trying to Avoid Racist Health Care, Black Women Seek Out Black Obstetricians

In South Florida, when people want to find a Black physician, they often contact Adrienne Hibbert through her website, Black Doctors of South Florida.

“There are a lot of Black networks that are behind the scenes,” said Hibbert, who runs her own marketing firm. “I don’t want them to be behind the scenes, so I’m bringing it to the forefront.”

Hibbert said she got the idea for the website after she gave birth to her son 15 years ago.

Her obstetrician was white, and the suburban hospital outside Miami didn’t feel welcoming to Hibbert as a Black woman pregnant with her first child.

“They had no singular photos of a Black woman and her Black child,” Hibbert said. “I want someone who understands my background. I want someone who understands the foods that I eat. I want someone who understands my upbringing and things that my grandma used to tell me.”

In addition to shared culture and values, a Black physician can offer Black patients a sense of safety, validation and trust. Research has shown that racism, discrimination and unconscious bias continue to plague the U.S. health care system and can cause unequal treatment of racial and ethnic minorities.

Black patients have had their complaints and symptoms dismissed and their pain undertreated, and they are referred less frequently for specialty care. Older Black Americans can still remember when some areas of the country had segregated hospitals and clinics, not to mention profoundly unethical medical failures and abuses, such as the 40-year-long Tuskegee syphilis study.

But even today, Black patients say, too many clinicians can be dismissive, condescending or impatient — which does little to repair trust. Some Black patients would prefer to work with Black doctors for their care, if they could find any.

Hibbert is working on turning her website into a more comprehensive, searchable directory. She said the most sought-after specialist is the obstetrician-gynecologist: “Oh, my gosh, the No. 1 call that I get is [for] a Black OB-GYN.”

For Black women, the impact of systemic racism can show up starkly in childbirth. They are three times as likely to die after giving birth as white women in the United States.

Nelson Adams is a Black OB-GYN at Jackson North Medical Center in North Miami Beach, Florida. He said he understands some women’s preference for a Black OB-GYN but said that can’t be the only answer: “If every Black woman wanted to have a Black physician, it would be virtually impossible. The numbers are not there.”

And it’s also not simply a matter of recruiting more Black students to the fields of medicine and nursing, he said, though that would help. He wants systemic change, which means medical schools need to teach all students — no matter their race, culture or background — to treat patients with respect and dignity. In other words, as they themselves want to be treated.

“The golden rule says, ‘Do unto others as you would have them do unto you,’ so that the heart of a doctor needs to be that kind of heart where you are taking care of folks the way you would want to be treated or want your family treated,” he said.

George Floyd’s murder in Minneapolis in May 2020, and the subsequent wave of protests and activism, prompted corporations, universities, nonprofits and other American institutions to reassess their own history and policies regarding race. Medical schools were no exception. In September, the University of Miami Miller School of Medicine revamped its four-year curriculum to incorporate anti-racism training.

New training also became part of the curriculum at Florida Atlantic University’s Charles E. Schmidt College of Medicine in Boca Raton, where students are being taught to ask patients about their history and experiences in addition to their bodily health. The new questions might include: “Have you ever felt discriminated against?” or “Do you feel safe communicating your needs?”

“Different things that were questions that we maybe never historically asked, but we need to start asking,” said Dr. Sarah Wood, senior associate dean for medical education at Florida Atlantic.

The medical students start learning about racism in health care during their first year, and as they go, they also learn how to communicate with patients from various cultures and backgrounds, Wood added.

These changes come after decades of racist teaching in medical schools across the United States. Adams, the OB-GYN, completed his residency in Atlanta in the early 1980s. He recalls being taught that if a Black woman came to the doctor or hospital with pain in her pelvis, “the assumption was that it was likely to be a sexually transmitted disease, something we refer to as PID, pelvic inflammatory disease. The typical causes there are gonorrhea and/or chlamydia.”

This initial assumption was in line with a racist view about Black women’s sexual activity — a presumption that white women were spared. “If the same symptoms were presented by a Caucasian, a white young woman, the assumption would be not an STD, but endometriosis,” Adams said. Endometriosis is not sexually transmitted and is therefore less stigmatizing, less tied to the patient’s behavior.

That diagnostic rule of thumb is no longer taught, but doctors can still bring unconscious racial bias to their patient encounters, Adams said.

While they revamp their curricula, medical schools are also trying to increase diversity within their student ranks. Florida Atlantic’s Schmidt College of Medicine set up, in 2012, a partnership with Florida A&M University, the state’s historically Black university. Undergraduates who want to become doctors are mentored as they complete their pre-med studies, and those who hit certain benchmarks are admitted to Schmidt after they graduate.

Dr. Michelle Wilson took that route and graduated from Schmidt this spring. She’s headed to Phoebe Putney Memorial Hospital in Albany, Georgia, for a residency in family medicine. Wilson was drawn to that specialty because she can do primary care but also deliver babies. She wants to build a practice focused on the needs of Black families.

“We code-switch. Being able to be that comfortable with your patient, I think it’s important when building a long-term relationship with them,” Wilson said.

“Being able to relax and talk to my patient as if they are family — I think being able to do that really builds on the relationship, especially makes a patient want to come back another time and be like, ‘I really like that doctor.'”

She said she hopes her work will inspire the next generation of Black doctors.

“I didn’t have a Black doctor growing up,” Wilson said. “I’m kind of paving the way for other little Black girls that look like me, that want to be a doctor. I can let them know it’s possible.”

This story is part of a partnership that includes NPR, WLRN and KHN.

KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.

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Wilberforce University, AME Church school, cancels debt for 2020, 2021 grads

Wilberforce University, AME Church school, cancels debt for 2020, 2021 grads

 

Rodman Allen hugs his mother after the 2021 Wilberforce University Commencement, Saturday, May 29, 2021, in Wilberforce, Ohio. Courtesy photo

(RNS) — There are usually lots of cheers and applause at university commencements.

But 2020 and 2021 graduates of Wilberforce University, a school affiliated with the African Methodist Episcopal Church, had an extra reason to celebrate during their ceremony on Saturday (May 29) in Wilberforce, Ohio.

Their president announced that any debts they still owed to the historically Black university had been forgiven.

 

“Because you have shown that you are capable of doing work under difficult circumstances, because you represent the best of your generation, we wish to give you a fresh start,” said President Elfred Anthony Pinkard. “So therefore the Wilberforce University board of trustees  has authorized me to forgive any debt. Your accounts have been cleared and you don’t owe Wilberforce anything. Congratulations.”

As soon as Pinkard said the words “forgive any debt,” the masked students started screaming, shouting and jumping, prompting him to smile and laugh before he continued his surprise announcement, which was streamed live on Wilberforce’s YouTube channel.

When he added “accounts have been cleared” there were more cheers, jumps and hand-waving among the black-robed students wearing green and gold stoles.

In a statement on the university’s website, the school said the amount of debt forgiveness for both classes totals more than $375,000 for the 166 new alumni.

It said the “zero balance” was the result of scholarships from the United Negro College Fund Inc., Jack and Jill Inc. and other institutions that aided students in the spring and fall semesters of 2020 and the spring of 2021.

It noted all student also benefited from the Higher Education Emergency Relief Fund established through the CARES Act. In particular, that financial assistance had previously helped the students whose balances due to the school would have prevented them from registering for their fall classes in 2020.

One student spoke of the difference the debt forgiveness will make for him in the years ahead.

“I couldn’t believe it when he said it,” Rodman Allen, now a 2021 alumnus, said in a statement. “It’s a blessing. I know God will be with me. I’m not worried. I can use that money and invest it into my future.”

During the ceremony the university also awarded posthumous doctorate degrees to civil rights leaders Fannie Lou Hamer and Medgar Evers.

Wilberforce, the oldest private historically Black school operated and owned by African Americans, was founded in 1856.

Racism Derails Black Men’s Health, Even as Education Levels Rise

Racism Derails Black Men’s Health, Even as Education Levels Rise

Racism Derails Black Men’s Health, Even as Education Levels Rise

More education typically leads to better health, yet Black men in the U.S. are not getting the same benefit as other groups, research suggests.

The reasons for the gap are vexing, experts said, but may provide an important window into unique challenges faced by Black men as they try to gain not only good health but also an equal footing in the U.S.

Generally, higher education means better-paying jobs and health insurance, healthier behaviors and longer lives. This is true across many demographic groups. And studies show life expectancy is higher for educated Black men — those with a college degree or higher — compared with those who have not finished high school.

But the increase is not as big as it is for whites. This comes on top of the many health obstacles Black men already face. They are more likely to die from chronic illnesses like cardiovascular disease, diabetes and cancer than white men, and their life expectancy, on average, is lower. Experts point to a variety of factors that might play a role, but many said the most pervasive is racism.

Researchers note that Black women face many of the same challenges as Black men, but Black women generally have a longer life expectancy than Black men. (They also point out that it is hard to draw conclusions about Hispanic residents because of a lack of studies on the issues.) As a result, many experts said that the health problems stem from a persistent devaluation of Black men in U.S. society.

“At every level of income and education, there is still an effect of race,” said David Williams, a professor of public health at Harvard University who developed a scale nearly 30 years ago that quantified the connection between racism and health.

The precise difference in health gains between educated white men and educated Black men is hard to pinpoint because of differences in study designs. Some studies, for example, look at life expectancy, while others look at disease burden or depression.

Experts said, however, that the evidence is strong and convincing that these gaps have persisted over many years. A 2012 study published in Health Affairs, for example, found that life expectancy for white men with the most education was 12.9 years longer than for white men with the least education. For Black men, the difference was 9.7 years.

In addition, other research shows how that gap plays out. A 2019 study examined years of “lost life” — years cut off because of health challenges — between the groups. Educated Black men lost 12.09 years, while educated white men lost 8.34 years, according to the study, published in the Journal of Health and Social Behavior.

Racism affects Black men’s health and it is persistent, experts said.

“No matter how far you go in school, no matter what you accomplish, you’re still a Black man,” said Derek Novacek, who has a doctorate in clinical psychology from Emory University and is researching Black-white health disparities at UCLA.

S. Jay Olshansky, a professor of epidemiology and biostatistics at the University of Illinois in Chicago and lead author of the 2012 study, said possible risk factors for various diseases and environmental issues could also play a role: “I’d be very surprised if this wasn’t part of the equation. The risk of diabetes and obesity is much higher among the Black population, even those that are highly educated.”

Among other possible causes that researchers are probing are stress and depression.

“When you follow other groups, with more education depression declines,” said Dr. Shervin Assari, associate professor of medicine at Charles R. Drew University of Medicine and Science in Los Angeles County, California, who studies race, gender and health. “But when you look at Black men — guess what? Depression goes up.”

Depression is often an indicator of physical well-being as well as a contributing factor to many chronic illnesses, such as hypertension, obesity and diabetes.

Isolated at Home and Work

Researchers who study the health of various racial and ethnic groups, as well as the social factors that influence health outcomes, see cause for concern. The findings suggest that the power of discrimination to harm Black men’s lives may be more persistent than previously understood. And they could mean that improving Black men’s health may be more complicated than previously believed.

“What has surprised me is how powerfully and consistently discrimination predicts poor health,” said Williams.

Covid-19 has underscored the issue. As early as last April researchers noticed higher death and hospitalization rates for Black people. The patterns have persisted, with Black patients being nearly two times as likely as whites to die of the virus and Black men have the highest rates of covid deaths.

The covid outcomes, Williams and others suggested, helped point out that the health and well-being of middle-class, educated Black men have been overlooked.

Higher education hasn’t brought about the health equity many experts had expected. While Black men have worse health than other groups if they are not educated, they can’t catch up to their white peers even when they are.

“What society has done to Black men is to corner them,” Assari said.

Black men, even with an education, have less of a financial and social safety net than white men. That brings added stress, the experts said. Also, as Black men climb a corporate, academic or managerial ladder, many feel isolated. And social isolation harms health.

Thomas LaVeist, a sociologist and dean of the school of public health at Tulane University, said that in a white-dominated society Black men are less likely to have family members with high incomes or social and business connections who can open doors for them. And once hired into the workplace, they are less likely to have mentors, LaVeist said, and that lack of connections is associated with stress, depression and other factors that can lead to poorer health.

“There needs to be a designated effort to provide an on-ramp” for Black men, he said.

And they may have experienced more cumulative adversity and continued racism.

“Your high socioeconomic status doesn’t protect you from the impact or from the incidence” of racism, said Dr. Adrian Tyndall, associate vice president for strategic and academic affairs at University of Florida Health.

“That is difficult,” added Tyndall, who is Black. “If I were to walk out of this institution and into the community, where people don’t know me, I could be called the N-word. And yeah, that’s pretty depressing.”

The Need to Prove Yourself

The cumulative effect of discrimination takes a toll psychologically and physiologically — but so does the anticipation of it.

“It’s not just the actual exposure in dealing with these kinds of experiences, but it’s ‘What do you do before leaving home?’ You’re careful about your dress, your behavior, the way you look because of the threat of discrimination, and so you react,” said Williams, the Harvard professor.

For example, when Williams, who is Black, first became a professor at Yale University, he wore a coat and tie every day. No one else in his department did that. And yet, he said, he kept up the practice for years.

LaVeist remembers getting onto an elevator at an academic medical center around 1990, shortly after earning his Ph.D., and a passenger wearing a white coat — presumably a doctor — assumed LaVeist worked in housekeeping. The man asked LaVeist, who was dressed in a suit, to clean up a spill on the sixth floor.

“When I told him that I was a professor, he didn’t speak,” said LaVeist. “He simply didn’t speak.”

Greg Pennington, 67, of Atlanta, has a doctorate in clinical psychology from the University of North Carolina and an undergraduate degree from Harvard, owns a professional consulting firm and has worked with hundreds of men individually as well as dozens of Fortune 500 companies. “It’s not so much that [Black men] experience discrimination and depression ‘even after’ they have advanced degrees,” he said. “It’s more descriptive to say ‘throughout the whole process.’”

Despite their academic credentials, Black men said, they often feel they need to prove themselves, which adds another layer of stress.

“It’s almost like I can’t fail; I’m representative of other Black males,” said Woodrow W. Winchester III, director of professional engineering programs at the University of Maryland-Baltimore County. “Your value and your success are around advancing the collective.”

The bottom line, experts agreed, is that discrimination has a lingering effect on health.

Dana Goldman, director of the USC Schaeffer Center for Health Policy and Economics, was co-author of the 2012 Health Affairs study on these chasms. Goldman said he agrees that the underlying cause is racism and added that he thinks one solution is to improve education. He and others suggested that schools, starting in the lower grades, need to provide Black students with more culturally appropriate curricula that bolster their self-image and help build social relationships between white and Black youngsters. Those efforts need to continue as students progress into higher education.

“The policy remedy is not just less racism but to improve the quality of our schools, occupational safety and public health,” Goldman said.

Others agree that the findings suggest a need to reconsider broad policy changes — in education, housing and the justice system — so that Black males feel confident and supported in pursuing better educations and jobs. 

It will be a long-term project, said Williams, the Harvard professor.

“We need a Marshall Plan for all disenfranchised Americans,” he said, but one that especially addresses implicit biases and how American society views and treats Black males.

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100 years later, Black church leaders seek reparations for Tulsa massacre

100 years later, Black church leaders seek reparations for Tulsa massacre

(RNS) — On the first Wednesday in May, as the centennial of the Tulsa massacre approached, the Rev. Robert R.A. Turner stood outside Tulsa City Hall with his megaphone, as he does every week.

“Tulsa, you will reap what you sow and that which you have done unto the least of these my children, Jesus said, you have done also unto me,” said Turner, 38, the pastor of Historic Vernon African Methodist Episcopal Church, captured on a video posted on Facebook.

“We come here to say, for your own benefit, you ought to do reparations not tomorrow, not even next week, not next month, not next year, but we demand reparations now!”

Turner’s Vernon AME is one of the plaintiffs in a suit filed in September that calls for the city of Tulsa and other defendants to pay reparations to relatives of victims and survivors of the May 31, 1921, massacre that destroyed a part of town known as “Black Wall Street.”

Beginning with false rumors spread though the Oklahoma city that a young Black man had assaulted a white female elevator operator, within about 16 hours, a white mob killed an estimated 300 Black people and destroyed thousands of homes, businesses and churches.

As Tulsa pauses to mark the somber centenary in its Greenwood district, where Black Wall Street was located, Turner and other Black people of faith are among those saying the time has come to repay as well as to remember.

The lawsuit argues that the tragedy is a continuing “public nuisance” that Tulsa should remedy through monetary means.

Among the suit’s petitions to the Tulsa County District Court are payments to descendants of those who were killed, injured or displaced by the massacre; development of educational and mental health programs for individuals and organizations in Greenwood and North Tulsa; and a scholarship program for “Massacre descendants” for post-secondary education in Oklahoma.

The suit states that Vernon AME Church, “founded in 1905, is the only standing Black-owned structure from the Historic Black Wall Street era and the only edifice that remains from the Massacre. Vernon’s sanctuary burned in the Massacre. The basement was the only part of the red brick building that remained.”

The church joins other plaintiffs in charging that they never received resources to recover from the trauma and damage of the massacre.

The city, responding in court documents to the suit, questioned the framing of its claims and the idea that the city’s current problems can be attributed to 100-year-old wrongs.

“At its base level, Plaintiffs are attempting to seek reparations for the events of June 1921 while working around the inherent statute of limitations problems that have thwarted other lawsuits bringing similar claims,” the city argued.

It added that the suit’s claims of continuing racial inequalities are “nebulous” and said “community wide issues such as racial disparity are caused by a number of factors and cannot be traced to specific actions or omissions to act of or by the City, nor is it a nuisance that can be simply abated by the City.”

In 2001, the Oklahoma Commission to Study the Tulsa Race Riot of 1921 called for reparations for the massacre, including payment to survivors and descendants, a scholarship fund, establishment of an economic development zone in the historic area, and a memorial for reburial of remains of victims found in unmarked graves.

“Perhaps this report, and subsequent humanitarian recovery events by the governments and the good people of the state will extract us from the guilt and confirm the commandment of a good and just God — leaving the deadly deeds of 1921 buried in the call for redemption, historical correctness, and repair,” wrote then-state Rep. Don Ross in the prologue of the report.

Turner, who arrived in the city in 2017 to lead his church, agrees with all of the commission’s recommendations and hopes for a full criminal investigation. His petition for reparations has been signed by more than 26,000 people.

“This is about sin and an abominable sin — racism,” said the minister, who calls the massacre a “genocide of people simply because of the color of their skin.”

Gregory Thompson, co-author of a new book, “Reparations: A Christian Call for Repentance and Repair,” said the Tulsans’ demands show how the movement for reparations has extended beyond atonement for the United States’ involvement in slavery to repairing societal ills, and that not just the federal government but local and regional officials are being called to account.

“It’s not to say that I don’t think the federal government should be involved — I do,” said Thompson, a white scholar who directs Voices Underground, a team of researchers and community members focused on the history of the Underground Railroad in the Philadelphia area. “But I think community-based reparations allow African American leaders a lot more agency in this conversation than if it’s located at the federal government, which is not equitably representative of African Americans.”

Regional reparations initiatives have become more common of late. Since the 1990s, descendants of survivors of the 1923 massacre in the majority-Black enclave of Rosewood, Florida, have received state scholarships.

In March, the Evanston City Council, in Illinois, began approving reparations that provide mortgage and other housing assistance to local Black residents to make amends for racially discriminatory housing practices. In April, Virginia Gov. Ralph Northam signed a bill mandating that five of the state’s older public universities pay for scholarships or community redevelopment programs, starting in 2022, to benefit descendants of enslaved workers who built them.

Vernon AME is one of 23 churches in Greenwood that predate the massacre, of which 13 survived, according to a tally by Faith Still Standing, an ecumenical group of congregations that have rebuilt in the area or beyond it.

The Rev. Robert Givens pastors Christ Temple Christian Methodist Episcopal Church, a congregation that was founded in Greenwood but has since moved. Its original building was still new when it was destroyed in the massacre.

“When we think of Black Wall Street, it was tremendously a thriving area of all-Black businesses,” said Givens. “So a lot of the churches were just now getting started in that area” when they were burned down.

“Nothing was ever done for them or to help them in that situation,” said Christ Temple’s trustee board chairperson, Annette Gathron, of the people who lost homes, businesses and belongings along with their churches.

Some of those whose families survived the massacre have become key figures in the city’s Black history. The late John Hope Franklin, the famed historian, was a member of Christ Temple, and his father, attorney B.C. Franklin, helped pay off the church’s mortgage on the brick building it constructed after the massacre.

Gathron said she hopes to attend some of the worship services marking the centennial.

A ” Unity Day Worship Guide ” for congregations to use on the last Sunday in May is included in an online list of options for commemorative activities.

Gathron said she also intends to keep younger members of her family aware of the history of the city where she has lived for more than 60 years.

“I think that it’s good that we are remembering and I plan to take my great-grands to some of this so they can understand the struggles that we have had,” she said.

She traditionally takes nieces and nephews visiting from across the country on a walking tour through historic Greenwood, including a stop at Vernon AME.

“I think it’s important for them to know that they can achieve because this, at one time, was a very thriving community.”

On May 31, Tucker’s 130-member church, which opened in a rebuilt sanctuary in 1928, plans to dedicate “a prayer wall for racial healing” that will include an exterior wall of the basement that survived 100 years ago.

Once built, Turner hopes it will draw people of all faiths and none for prayer and meditation. “The idea behind it is to have people of all nations come and to pray and talk to God to help us with this racial healing that we need in the world,” he said.


You can hear from Pastor Robert Turner alongside other leaders virtually tonight (June 2, 2021) at Friendship West Baptist Church in Dallas, TX as they commemorate the Tulsa Race Massacre of 1921 in A Sankofa Moment. Conversation will also feature Nancy St. Jacobs, VP of Community Business Development for Truist Bank, and Lamar Tyler, Founder of Traffic Sales & Profit moderated by Dr. Frederick D. Haynes III.

 

Tennessee State University offers coding classes in Africa

Tennessee State University offers coding classes in Africa

FILE – In this April 13, 2021, file photo, Tennessee State University President Glenda Glover smiles during a press conference in Nashville. Tennessee State University announced on Wednesday, MAY 26, 2021, that it will begin offering an online app design and coding class in two African countries this fall. (George Walker/The Tennessean via AP, FILE)

NASHVILLE, Tenn. (AP) — Tennessee State University announced on Wednesday that it will begin offering an online app design and coding class in two African countries this fall.

Robbie Melton, who runs TSU’s coding program, said the idea is to get African students interested in STEM careers and increase the number of Black students entering those fields. App design and coding is an easy introduction.

The courses are offered through a partnership between the historically Black university and the African Methodist Episcopal Church, which operates several schools in Africa. The participating schools are the African Methodist Episcopal University and its feeder high school, Monrovia College, both in Monrovia, Liberia, and Wilberforce Community College, which serves high school and college students in Evaton, a township in South Africa.

TSU already offers the app coding program to more than 30 historically Black colleges and universities in the United States, and more than 2,000 students have participated since it started in 2019, Melton said. Around 20% have gone on to pursue STEM degrees, she said.

In addition to teaching students, TSU faculty members train participating school faculty to be able to give the courses themselves. The same will be true for the African schools, which have signed up 500 students to take the course over the next three years. That includes both college students and high school students who will take advantage of dual-enrollment.

If some of the students decide to continue their studies with TSU, the school is now able to offer degrees remotely through virtual classes, TSU President Glenda Glover said.

“Our global mission is to empower underserved populations,” Glover said. “Access to education is challenging in parts of Africa. We’re meeting that challenge and breaking those barriers.”

 

Religion plays a role in the renewed conflict in Israel, but it may not be what you think

Religion plays a role in the renewed conflict in Israel, but it may not be what you think

Originally published May 12, 2021

(RNS) — Violence between Gaza and Israel intensified this week to levels not seen for years, with Hamas shooting hundreds of rockets toward the Tel Aviv metropolitan area and Israel retaliating with heavy strikes on Hamas targets in the Gaza Strip.

The buildup to the current conflagration — some are already calling it a new “intifada” or “uprising” —  began several weeks ago in a Jerusalem neighborhood near the Old City, close to the Al-Aqsa Mosque, one of Islam’s holiest sites for more than 1,200 years.

While Muslims pray at Al-Aqsa year-round, the mosque attracts even more worshippers during Ramadan. Wednesday (May 12) marked the end of Ramadan and the start of Eid al-Fitr, a joyous time for millions of Muslims concluding a monthlong fast.

There’s no doubt that the most extreme Jewish nationalists would like Israel to recapture the Al-Aqsa Mosque because they say it sits on top of the ruins of the ancient Jewish Temple, the only remainder of which is the Western Wall.

But except for the setting of the conflict, faith is only tangentially related to the violence. Here’s a quick explainer on the conflict of the past few days, and what, if any, role religion plays.

Why did Israeli police raid the Al-Aqsa Mosque to begin with?

The Israeli government said the police responded after the Palestinians started throwing stones at them. Palestinians say the fighting really began when police entered the mosque compound on May 10 and started firing rubber-tipped bullets and stun grenades. More than 330 Palestinians were wounded. Israel said 21 of its officers were, too.

But the underlying tensions may have more to do with a set of clashes in the larger east Jerusalem area, which was captured by Israel in the 1967 Six-Day War and is home to about 350,000 Palestinians.

For weeks prior to the mosque violence, Palestinians had been protesting the threatened eviction of Palestinian families from the Sheikh Jarrah neighborhood of east Jerusalem. At night they would clash with police and far-right Jewish settlers.

Those clashes are in turn part of a long legal battle over who owns the property. Some Palestinians  were relocated to Sheikh Jarrah by the Jordanian government in the 1950s after fleeing their homes during Israel’s War of Independence in 1948.

On May 10, the Israeli Supreme Court was set to decide whether to uphold the eviction of six families from the Sheikh Jarrah neighborhood in favor of Jewish settlers. The court has since postponed the ruling.

So this is a land dispute?

On a large scale, yes. In Sheikh Jarrah, in particular, the dispute originates in the 19th century, when Jews living abroad began returning to what is now Israel and buying properties from Palestinians who lived there. The Jordanians took over the land between 1948 and 1967. Israelis are now claiming it’s theirs again.

The dispute in Sheikh Jarrah takes on political overtones because the neighborhood is part of east Jerusalem, which Palestinians want name as the capital of a future Palestinian state encompassing the West Bank and Gaza. Many Israelis, regardless of their views about a Palestinian state, believe Jerusalem must remain “a Jewish capital for the Jewish people,” and under Israeli control.

What’s Hamas got to do with it?

The clashes between Israel and Palestinians in Jerusalem have united Palestinians far and wide, as have the larger disputes over their displacement and disenfranchisement by Israel. Hamas, the Islamist militant group that controls the Gaza Strip, located about 60 miles south of Jerusalem, sees itself as a defender of Palestinians.

Hamas is at root an Islamic organization born from members of the Muslim Brotherhood, and so it also cares deeply about the Al-Asqa Mosque, which Muslims call the Noble Sanctuary.

On May 12, Israel assassinated several Hamas commanders in retaliation for the barrage of rockets on Tel Aviv, Ashkelon and Israel’s main international airport in the city of Lod.

What role does Judaism or Islam play in this?

At heart, the Israeli-Palestinian conflict is a dispute over land. But religion is often the proxy for those disputes, pitting two different ethnicities and religions. Little wonder those tensions tend to flare around religious holidays, both Jewish and Muslim.

But Hamas’ main goal is not war with Judaism, but rather with Israel, which is occupying land it believes is inherently Palestinian.

As Hamas has become more emboldened over the years, so too, have Jewish nationalists. On Monday, May 10, which was Jerusalem Day, a national holiday celebrating the unification of Jerusalem, Jewish nationalists marched through the Old City of Jerusalem, including the Muslim Quarter, in a display that provoked and angered many Palestinians.

As often happens, the exclusive claims to parts of the holy city often turn deadly.