Uprooting Racism in Medicine: Where Do We Go From Here?

In the US, Black and other ethnic minority groups are hit the hardest by Covid-19, creating a renewed focus on racism in healthcare. There are so many false beliefs that many doctors and other healthcare providers still work from about Black people, such as their skin being thicker, their blood coagulating differently, and that they feel less pain.  When doctors are blind to their racist beliefs and attitudes it can lead to less effective treatments, more pain, humiliation, and even death. It’s time that doctors, medical students, and other health care professionals take anti-racist study seriously and get support to see bias in themselves and in others.

On 1/18/21 we had a conversation on About Health (94.1FM KPFA.org) to discuss racism in medical care. We heard about personal experiences of racism and some of the history that has added to the mistrust of doctors based on racist practices. You can hear that show here: https://www.nurserona.com/racism-in-medical-care/  It seemed important to me to do a follow up show to continue the conversation.

What are ways to uproot racism in medicine?

Listen now to About Health on  KPFA.org—94.1FM (3/22/21)

**https://kpfa.org/player/?audio=353495**

Dr. Jeff Ritterman is a retired cardiologist from Kaiser Richmond where he worked for 29 years.  He was also a Professor and Clinical Coordinator for the Physician Assistant Program at Touro University and  worked for three years doing Adult Primary Care at Lifelong Medical in San Pablo. He is on the Board of Directors of San Francisco Physicians for Social Responsibility and served on the Richmond City Council when they introduced the first municipal Soda Tax. In the 1980s he helped start the Salvador Medical Relief Fund and the Committee for Health Rights in Central America.  He personally delivered medical supplies to Salvador Refugees in Honduras and Costa Rica.  In the 1990s he started the Southern Africa Medical Aid Fund and delivered medical supplies to the African National Congress’s Clinic in Lusaka, Zambia. He has helped start two Racial Equity Book Clubs, one with Kaiser Oakland and the other with San Francisco Physicians for Social Responsibility.  He is the author of two recent papers on combating Medical Racism.You can read one of them here: http://www.thepermanentejournal.org/issues/2021/spring/7609-the-ally-book-club-a-tool-for-challenging-racism.html

Dr. Nadia Gaber is a postdoctoral fellow in the Program on Reproductive Health and the Environment, studying the influence of the chemical industry on the science and regulation of toxic chemicals. She received her PhD in medical anthropology and is obtaining her MD at UCSF with support from the NIH Medical Scientist Training Program. Her research in Detroit and Flint looked at the politics of urban health and safety in the U.S. through the lens of water. She is continuing to develop that research in a book project called Life After Water that blends ethnography, grassroots epidemiology and critical race theory. She is a member of the new UCSF REPAIR Project, a three-year initiative to combat anti-Black racism in the health sciences and has organized off-campus with groups like Critical Resistance and the Arab Resource and Organizing Center.

 

Some References From Dr. Ritterman

1. Washington HA. Medical apartheid. New York, NY: Anchor Books; 2008.

2. Owens DC. Medical bondage. Athens, GA: University of Georgia Press; 2017.

3. Diangelo R. White fragility. Boston, MA: Beacon Press; 2018.

4. Kendi IX. How to be an antiracist. New York, NY: Random House; 2019.

5. Metzl JM. Dying of whiteness. New York, NY: Basic Books; 2019.

6. Hoffman KM, Trawalter S, Axt JR, Oliver MN. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci USA 2016 April;113:4296-301. DOI: https://doi.org/10.1073/pnas 15160471131073 Accessed August 20, 2020.

Racism in Medical Care

Not all patients are treated equally.

Racism affects many aspects of healthcare in our country, including pregnancy and infant mortality, emergency treatment, pain management, addiction, and mental health care. Actually, you can find racism in any part of the medical care system as long as there are people who are not doing the vital anti-racist work that we are all called upon to do.

***LISTEN NOW: https://kpfa.org/player/?audio=349349 ***

This show was on 1/18/21 on 94.1FM—KPFA.org

This was a timely discussion about racism experienced in medical care settings.

Some health care professionals actively discriminate against patients, even though it’s rare that they are held accountable.  During the Covid-19 crisis we have also seen how racism has caused more deaths in the Black, Indigenous, and people of color communities. “A May 2020 study estimates that in the U. S., Black people were 3.57 times more likely to die from COVID-19 than white people. Similarly, the risk of death within the Latinx population was nearly twice that of the white population.”

Guests:

J. Miakoda Taylor is the founder and Lead Steward of Fierce Allies (www.fierceallies.com), a body of worksuite of services, and community of practitioners catalyzing dynamics of power and privilege towards equity and justice. The work integrates the fields of Restorative Justice, Somatic Trauma Healing, embodied and popular education, group facilitation, conflict transformation, and storytelling. The community of practice is comprised of leaders from a wide range of sectors including: public health, environmental justice, child and family services, technology, immigrant rights, criminal justice, and food sovereignty. Together, Miakoda and the community of practice are creating a new road map for intersectional collaborations and coalitions. An award winning photographer, Miakoda has received several fellowships, including a J. W. Fulbright, to conduct photo-ethnographic studies of diverse cultures around the globe. Images from their work focused on street children and women working as domestic servants in South Africa from 1993-1996, have been exhibited throughout the world, most notably as part of the United Nations World Conference Against Racism and at the Metropolitan Museum of Art. They are also an avid meditator, yogi, and dancer.

 

Diane Barnes an actor, writer, speaker and physician. She is a graduate of Stanford University and the Yale University School of Medicine, with postdoc training at UCSF and Stanford. Her award winning solo show, My Stroke of Luck, developed with David Ford, shares her story of stroke, recovery, and reinvention as a single mother and working physician. Extended multiple times at The Marsh, it has played internationally, at numerous theater festivals, universities, and medical schools.  The murder of George Floyd inspired her new work, Not One of Us,  a comedic/dramatic exploration of the intersection of class, race, gender and privilege in her life. Also developed with David Ford, Not One of Us, premiers at the Playground Solo Performance Festival Jan 22-Feb 7th, 2021. This version revolves around her experiences in medicine: from training at Yale Medical School to Lagos Nigeria, from practicing medicine to becoming a patient. Diane is a Meisner-trained actor and BATS trained improvisor.  She completed the Global Identities Workshop with Anna Deveare Smith, ACT Summer Intensives and Berkeley Rep Spring Intensive.

Resources from Diane Barnes:

  • Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the Present, by Harriet A Jackson

  • Fatal Invention: How Science, Politics, and Big Business Re-create Race in the Twenty-first Century, by Dorothy Roberts

  • Killing the Black Body: Race, Reproduction, and the Meaning of Liberty, by Dorothy Roberts

  • Medical Bondage: Race, Gender, and the Origins of American Gynecology, by Deirdre Cooper Owens

  • https://www.nejm.org/doi/full/10.1056/NEJMms2025768 Misrepresenting Race — The Role of Medical Schools in Propagating Physician Bias, New England Journal of Medicine.

Talking With Kids About Racism And How To Be Antiracist

It’s vital that we all reflect on how we talk with children about racism and understand how our spoken and unspoken words and actions shape them. Are you raising your kids to be anti-racist and compassionate people? How do we help them see that Black Lives Matter? And do they see you stand up for antiracist policies?

As parents, grandparents, teachers, aunts and uncles, we have a big responsibility. Our kids are always watching us and listening to how we understand the world. Let’s help each other, for our kids sake.

Allison Briscoe-Smith, Ph.D—6/15/20 on KPFA.org—94.1FM

Listen Now https://kpfa.org/player/?audio=335307

 

Allison Briscoe-Smith, Ph.D., is the Director of Diversity, Equity, and Inclusion and a full-time faculty member at the Wright Institute in Berkeley, CA. She is also a senior fellow at UC Berkeley’s Greater Good Science Center, where she serves as one of the hosts of the center’s popular Science of Happiness podcast. After earning her Ph.D. in clinical psychology from UC Berkeley, Dr. Briscoe-Smith’s research has focused on trauma/Post Traumatic Stress Disorder, and how children understand race. She lectures widely and leads workshops on these issues for parents, educators, and many others.

Roots of Health Disparities

If you missed the January 16th show on KPFA  about The Roots of Health Disparities you can hear it now at https://kpfa.org/player/?audio=251021

 

images“Of all the forms of inequality, injustice

in health care is the most shocking and

inhuman.”

—Dr. Martin Luther King Jr.

“Decades of racially discriminatory policies have marginalized people of color in every way, including in areas of housing, transportation, education, employment, and health. In spite of civil rights laws passed 50 years ago—people of color still face barriers on nearly every quality-of-life measure.”

—”Health Equity As a Critical Civil Rights Issue,” PolicyLink, 2015

GUESTS:

Dr. Muntu Davis is the Public Health Department Director and County Health Officer in Alameda County, California. He advises the County Board of Supervisors, local government agencies, and community members and organizations on medical and public health issues and on the development and implementation of public health policy and practices. He also provides oversight, strategic direction, and fiscal management of the department and all of its divisions. He joined the ACPHD in October 2005. Prior to working Alameda County, he worked in the Immunization Branch of the California Department of Health Services on pandemic planning and education on febrile rash evaluation. He also practiced medicine in urban and rural primary care and urgent care clinics in Northern and Southern California. He held multiple positions at the Continuity of Instruction to Reinforce Our Children’s Learning Environment (C.I.R.C.L.E.) program at the Tom Bradley Elementary School including co-director and member of the board of directors. Dr. Davis completed a residency in Family Medicine at Presbyterian Intercommunity Hospital in Whittier, California. He completed The California Endowment Scholars in Health Policy Fellowship and received his Master of Public Health degree from Harvard School of Public Health.

Dalila Butler, Associate Director, works with the PolicyLink Center for Health Equity and Place to promote social, economic and health equity through environmental and policy change, particularly in low-income communities and communities of color. Dalila serves as the California Department of Public Health Office of Health Equity Advisory Committee Chair. She also provides technical assistance to communities across the country and supports research and writing for health team projects. She supports the Boys and Men of Color team by working with networks in advancing policy and practice to advance equity in the areas of health, education, employment, and juvenile justice. Prior to joining PolicyLink, Dalila supported health equity projects at Prevention Institute. She holds a B.S. in Chemical Engineering from North Carolina State University and a Masters in Public Health from San Diego State University.