Health

Doctors Address Impact of Racism on Health Care

Racism in America puts Blacks in far greater danger than the rest of the population from infection and death due to COVID-19 than any other group, the Centers for Disease Control and Prevention said Dec. 4.

The internal report said “fundamental problems of inequality and discrimination are putting Black Americans at higher risk of contracting the coronavirus, and also making COVID-19 deadlier for them.”

The American Medical Association (AMA) concluded that earlier in a statement recognizing racism as a public health threat.

“The groundwork for the new policy on racism was laid out by the AMA’s Commission to End Health Disparities, which was created by NMA, NHMA, and AMA in 2002,” said Willarda V. Edwards, MD, MBA, a member of the AMA board of trustees.

Willarda V. Edwards, a member of the American Medical Association (AMA) board of trustees, also led the AMA Task Force on Health Equity and created AMA Center for Health Equity. (American Medical Association)
Willarda V. Edwards, a member of the American Medical Association (AMA) board of trustees, also led the AMA Task Force on Health Equity and created AMA Center for Health Equity. (American Medical Association)

“This pandemic has exacerbated longstanding health inequities in these communities and has also “ripped off the Band-Aid” to reveal deep disparities in health care, such as the lack of access to comprehensive care and higher rates of chronic disease that put Black and Brown patients at a higher risk of COVID-19 disease, complications, and death.

A close look at health care disparities by race began in 1982 through research and reports by Deborah Prothrow-Stith, MD, who is currently dean and a professor at Charles R. Drew University College of Medicine in Los Angeles, Calif. The AMA’s work on its new policy began on the heels of the 2002 Institute of Medicine’s (now the National Academy of Medicine) Unequal Treatment document. AMA’s House of Delegates (HOD), the legislative and policy-making body of the organization, takes the new policy deeper. AMA also acknowledges the health consequences of violent police interactions and denounces racism as an urgent threat to public health, pledging action to confront systemic racism, racial injustice, and police brutality.

“The AMA recognizes that racism negatively impacts and exacerbates health inequities among historically marginalized communities. Without systemic and structural-level change, health inequities will continue to exist, and the overall health of the nation will suffer,” said AMA’s Edwards, a past chairwoman of the NMA which represents African American physicians.

Contributing to the recent AMA policy deliberations were medical students from every state and medical specialty. According to Edwards, the AMA’s Medical Student Section (MSS) along with other AMA Sections and Councils, helps to generate reports and resolutions that are voted upon by the AMA’s House of Delegates.

“Collectively, medical students, residents, fellows, and physicians all help give voice to and advocate for change that helps influence health policy, ultimately shaping medical education and the practice of medicine,” said Edwards, a Baltimore, Md.-based internal medicine physician. “Addressing inequities in health care and in society is a priority for the AMA. Along with this new generation of physicians-to-be, we acknowledge that health is created beyond the walls of hospitals and doctor’s offices.”

Tracking the implementation of best practice in health care fairness, will be one of the responsibilities of the Center for Health Equity created by AMA. The mission of the Center is to ensure that health equity becomes part of the practice, process, action, innovation, and organizational performance and outcomes. Aletha Maybank, M.D., M.P.H., has been named AMA’s chief health equity officer to head the Center. Maybank joined the AMA after serving as deputy commissioner and founding director of the Center for Health Equity within New York City’s public health department. She is a pediatrician and preventive medicine/public health physician.

“Threading health equity into the fabric of the AMA requires urgency, patience, and perseverance. This work starts by looking inward to unearth how our own institutional practices and policies may have exacerbated inequities. The path recognizes that we must do more as institutions to protect people,” Maybank continued. “Although the AMA and physicians cannot control all conditions that need to change to achieve health equity, the AMA has a role to identify their importance and to urge those who can have a direct role to act.”

Edwards led the AMA Task Force on Health Equity, which established the AMA’s Center for Health Equity.

“Our call is to center equity in all aspects of the health system and to dismantle racism in all its forms,” Edwards said. “Some of the next steps will include challenging ourselves and others to push upstream toward racial healing and transformation. Officially naming racism as a public health threat was key in moving us toward finding meaningful solutions to advance equity.”

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