GLMS EVENTS
RACIAL INEQUALITY IN MEDICINE : IMPLICIT BIAS AND COMMUNICATION
AUTHOR Kathryn Vance
Starting in January , GLMS hosted a three-part series entitled Racial Inequality in Medicine , co-sponsored by the Lexington Medical Society and the Health Enterprises Network . The second session in the series took place on Feb . 11 and focused on implicit bias in medicine with speaker Dr . Stephanie White .
Stephanie White , MD , MS , FAAP is an associate professor of pediatrics and is the Associate Dean for Diversity and Inclusion at the University of Kentucky College of Medicine .
There have been three diversity paradigms described in academic medicine over the last six decades . The first emerged as a need to right past wrongs and provide fairness and access to women and minorities . The second promoted cultural competency as a means of understanding differences and focused on the retention of women and minority students , staff and faculty . In the third and current paradigm , we continue to rely heavily on the need to recruit and retain these demographics . But it needs to be more than keeping a tally of how many people fit these groups , Dr . White said .
“ Diversity work must be seen as more than just solving the problem of inadequate representation and alleviating barriers faced by disadvantaged and marginalized populations ,” she said . “ Promoting diversity must be tightly coupled with developing a culture of inclusion and one that fully appreciates the difference of perspectives .”
Diversity can often be thought of as just race or skin color , but Dr . White said it is much more than that . It is the “ richness of human differences ” and can refer not only to race , but also socioeconomic status , language , disability , sexual orientation and more . Inclusion is how those differences interact and communicate . Where these two collide is where organizations can improve and thrive .
Racism can be defined as “ phenomena that maintain or exacerbate avoidable or unfair inequalities in power , resources , or opportunities across racial , cultural , ethnic or religious groups ” and it can be expressed through beliefs , emotions , behaviors and practices .
“ If we want to make progress , we need to get over the stigma associated with the word racism ,” she said . “ If we ’ re so afraid to even say the word or talk about its impact , how are we going to be able to create the inclusive and equitable environments that we strive for ?”
Racism has a major impact on health care for both the patient and the practitioner . There are documented relationships between racism and heightened cortisol , blood pressure and heart rate responses , which have been linked to the development of hypertension and cardiovascular disease . Literature shows a link between racism and smoking and substance use . Subjecting people to racist environments reduces their use of preventive services like cholesterol testing or mammography . Coupled with COVID-19 , we have seen in 2020 historically and worrisomely low participation in primary preventive services from Black and Latinx communities , including for childhood immunizations .
Racism affects the delivery of health care from the physician . The impaired patient-provider relationship undermines efforts to promote healthy behaviors . Research has shown that physicians make differential estimates of risk for disease and spend less time planning and collaborating with individuals from some racial groups . Perceived racism causes an increased rate of emotional and physical stress and increased anxiety and depression .
20 LOUISVILLE MEDICINE