Breaking the Silence: Time to Talk about Race and Racism
Academic Medicine; by Acosta, David MD; Ackerman-Barger, Kupiri PhD, RN
March 2017: Academic Medicine: March 2017 - Volume 92 - Issue 3 - p 285-288. doi: 10.1097/ACM.0000000000001416. "Recent events in the United States have catalyzed the need for all educators to begin paying attention to and discovering ways to dialogue about race. No longer can health professions (HP) educators ignore or avoid these difficult conversations. HP students are now demanding them. Cultural sensitivity and unconscious bias training are not enough. Good will and good intentions are not enough. Current faculty development paradigms are no longer sufficient to meet the educational challenges of delving into issues of race, power, privilege, identity, and social justice."
Changing How Race Is Portrayed in Medical Education
Academic Medicine: by Nieblas-Bedolla, Edwin MPH; Christophers, Briana; Nkinsi, Naomi T.; Schumann, Paul D.; Stein, Elizabeth
December 2020: - Volume 95 - Issue 12 - p 1802-1806
doi: 10.1097/ACM.0000000000003496. "The medical community has been complicit in legitimizing claims of racial difference throughout the history of the United States. Unfortunately, a rigorous examination of the role medicine plays in perpetuating inequity across racial lines is often missing in medical school curricula due to time constraints and other challenges inherent to medical education. The imprecise use of race—a social construct—as a proxy for pathology in medical education is a vestige of institutionalized racism. Recent examples are presented that illustrate how attributing outcomes to race may contribute to bias and unequal care. This paper proposes the following recommendations for guiding efforts to mitigate the adverse effects associated with the use of race in medical education...."
Hidden in Plain Sight — Reconsidering the Use of Race Correction in Clinical Algorithms
New England Journal of Medicine; by Darshali A. Vyas, M.D., Leo G. Eisenstein, M.D., and David S. Jones, M.D., Ph.D; edited by Debra Malina, Ph.D
August 27, 2020, N Engl J Med 2020; 383:874-882. doi: 10.1056/NEJMms2004740: Physicians still lack consensus on the meaning of race. When the Journal took up the topic in 2003 with a debate about the role of race in medicine, one side argued that racial and ethnic categories reflected underlying population genetics and could be clinically useful.1 Others held that any small benefit was outweighed by potential harms that arose from the long, rotten history of racism in medicine.2 Weighing the two sides, the accompanying Perspective article concluded that though the concept of race was “fraught with sensitivities and fueled by past abuses and the potential for future abuses,” race-based medicine still had potential: “it seems unwise to abandon the practice of recording race when we have barely begun to understand the architecture of the human genome.”3"
From Race-based to Race-conscious Medicine: How Anti-racist Uprisings Call us to Act
PubMed: NIH, National Library of Medicine; by Jessica P Cerdeña, Marie V Plaisime, Jennifer Tsai
Lancet. 2020 Oct 10;396(10257):1125-1128. doi: 10.1016/S0140-6736(20)32076-6. The brutalisation of Jacob Blake and murders of George Floyd, Breonna Taylor, Ahmaud Arbery, Tony McDade, and countless others—coupled with horrifying statistics about the disproportionate burden of COVID-19 on Black and Brown communities—have forced the USA and the world to reckon with how structural racism conditions survival. Although clinicians often imagine themselves as beneficent caregivers, it is increasingly clear that medicine is not a stand-alone institution immune to racial inequities, but rather is an institution of structural racism.
Levels of Racism: A Theoretic Framework and a Gardener's Tale, (companion article for the video The Gardener's Tale)
American Journal of Public Health; by Camara Phyllis Jones, MD, MPH, PhD
August 2000, Vol. 90, No. 8: abstract: "The author presents a theoretic framework for understanding racism on 3 levels: institutionalized, personally mediated, and internalized. This framework is useful for raising new hypotheses about the basis of race-associated differences in health outcomes, as well as for designing effective interventions to eliminate those differences. She then presents an allegory about a gardener with 2 flower boxes, rich and poor soil, and red and pink flowers. This allegory illustrates the relationship between the 3 levels of racism and may guide our thinking about how to intervene to mitigate the impacts of racism on health. It may also serve as a tool for starting a national conversation on racism. (Am J Public Health. 2000;90: 1212–1215)"
Racism in Medicine: Shifting the Power
US National Library of Medicine: National Institutes of Health, articles provided courtesy of Annals of Family Medicine, Inc.; by Jacqueline Nwando Olayiwola, MD, MPH
2016 May; 14(3): 267–269. doi: 10.1370/afm.1932 : abstract: "Medicine has historically been a field where the provider of the service (physician, nurse) has a significant amount of power as compared with the recipient of the service (the patient). For the most part, this power is relatively consistent, and the power dynamic is rarely disrupted. In this essay, I share a personal experience in which a racist rant by a patient seemingly reverses the power dynamic. As the physician, I faced the realization that I may not have as much power as I believed, but fortunately I had some tools that allowed for my resilience. It is my hope that this paper will strengthen other family physicians and professional minorities that are victims of racism, discrimination, and prejudice for their race, sex, ability, sexual orientation, religion, and other axes of discrimination."
Things we do for no reason: Routine inclusion of race in the history of present illness
Journal of Hospital Medicine; by Jonathan Gau, MD, Christle Nwora, MD, Shaden T. Eldakar-Hein, MD, MSc, Mita Sanghavi Goel MD, MPH, Tim Lahey, MD, MMSc, Allen B. Repp, MD, MSc
2021 May 4: 1-4. doi: 10.12788/jhm.3650: Choosing Wisely: Things we Do for No Reason: "Inspired by the ABIM Foundation's Choosing Wisely® campaign, the “Things We Do for No Reason™” (TWDFNR) series reviews practices that have become common parts of hospital care but may provide little value to our patients. Practices reviewed in the TWDFNR series do not represent clear‐cut conclusions or clinical practice standards but are meant as a starting place for research and active discussions among hospitalists and patients. We invite you to be part of that discussion."
American Sociological Association; by Elijah Anderson
2015, Vol. 1(1) 10–21 © American Sociological Association 2014 DOI: 10.1177/2332649214561306: abstract: "Since the end of the Civil Rights Movement, large numbers of black people have made their way into settings previously occupied only by whites, though their reception has been mixed. Overwhelmingly white neighborhoods, schools, workplaces, restaurants, and other public spaces remain. Blacks perceive such settings as “the white space,” which they often consider to be informally “off limits” for people like them. Meanwhile, despite the growth of an enormous black middle class, many whites assume that the natural black space is that destitute and fearsome locality so commonly featured in the public media, including popular books, music and videos, and the TV news—the iconic ghetto. White people typically avoid black space, but black people are required to navigate the white space as a condition of their existence."
Addressing Race and Racism in Medical Education
AAMC Journal Staff
Academic Medicine is committed to assisting medical schools and teaching hospitals, their faculty and trainees, and the public in dismantling racism. This collection of articles was curated with the intent to help readers engage in necessary conversations about race and to inform strategies to eliminate structural racism in their institutions. Read more about the collection's creation at http://academicmedicineblog.org/new-collection-of-articles-on-addressing-race-and-racism-in-medical-education/.
Case Studies in Social Medicine
The New England Journal of Medicine
A series of Perspective articles that highlight the importance of social concepts and social context in clinical medicine. The series uses discussions of real clinical cases to translate theories and methods for understanding social processes into terms that can readily be used in medical education, clinical practice, and health system planning.
New England Journal of Medicine
The Race and Medicine collection reflects NEJM’s commitment to understanding and combating racism as a public health and human rights crisis. Our commitment to antiracism includes efforts to educate the medical community about systemic racism, to support physicians and aspiring physicians who are Black, Indigenous, and people of color, and ultimately to improve the care and lives of patients who are Black, Indigenous, and people of color.