Addressing Racism as a Public Health Crisis PDF

Addressing Racism as a Public Health Crisis Meagan A. Brown, PharmD, BCACP Clinical Associate Professor Director, Center for Clinical and Translational Science Setting the Stage The Invitation Participate Actively engage Facts are feelings Explore what feelings are coming up; write down Understandin...

Addressing Racism as a Public Health Crisis Meagan A. Brown, PharmD, BCACP Clinical Associate Professor Director, Center for Clinical and Translational Science Setting the Stage The Invitation Participate Actively engage Facts are feelings Explore what feelings are coming up; write down Understanding is key Objectives Define racism and its impact on health outcomes Provide a brief overview of historical accounts of medical racism and the lasting impact this has held on our communities Understand the intersectionality of racism, health and other identities that contribute to health disparities Define microagressions and explore ways to combat them in your respective communities More Explicitly… What I’m teaching Why I’m teaching it How does this relate to practice My Social Location Quick Reflection/Activity Consider your own social location How does this influence who you are? How does this influence how you interact with others? When do you feel uncomfortable around others? – Why do you think that is? Quick Activity Intersectionality Fun Fact Aaron E. Henry – Graduated from Xavier University in 1950 – Opened a pharmacy in Clarksdale – Helped organize the Clarksdale brance of NAACP in 1960 – President of the MS State Conference of NAACP – Fourth Street Drug Store 220 4th Street Clarksdale, Mississippi Racism Racism is a system of structuring opportunity and assigning value based on the social interpretation of how one looks (which is what we call "race"), that: unfairly disadvantages some individuals and communities, unfairly advantages other individuals and communities, and saps the strength of the whole society through the waste of human resources. https://www.apha.org/Topics-and-Issues/Racial-Equity Historical Perspective Phrenology: character traits could be read through differently shaped skulls – Black people were naturally submissive Spirometry – Used during American Civil War to conclude Black soldiers had inferior bodies to bc White soldiers had a higher lung capacity Tuskegee Study/Experiment Tuskegee Study – Promised people special treatment for “bad blood” – Run by the U.S. Public Health Service – Recruited 600 Black men, 399 diagnosed with syphilis and never treated; 201 in the control group – 1972; outed in the New York Times– revealing the men had deliberately been left untreated for 40 years – 1974; Congress passed the National Research Act Men who participated in the experiment, part of a collection photos in the National Archives labeled “Tuskegee Syphilis Study. 4/11/1953-1972.” Herman Shaw, one of the last survivors of the Tuskegee study, raises his arms with praise as President Bill Clinton apologizes for the Henrietta Lacks In 1951, Henrietta Lacks, a 30-yearold African American woman diagnosed with cervical cancer She was killed by the disease, but the cancer cells lived on They were cultured on a mass scale, becoming known as the “HeLa” cell line These “immortal” cells were critical to medical breakthroughs In Today’s World It still affects us today – Medical Software discrimination The computer appeared to give fewer referrals to Black people because their care costs – on average – were less over a year than for white patients (despite the Black patients being sicker) – COVID 19 – Racism has been linked to Black men having higher levels of death from suicide, disease and homicide – On average, black youth face one major discriminatory event yearly (similar if not more in other minority groups as well) – Race being used in medical calculators to determine risk https://www.weforum.org/agenda/2020/07/george-floyd-racismopportunities-life-expectancy/ It’s in The Numbers… https://www.cdc.gov/nchs/data/nvsr/nvsr68/nvsr68_07-508.pdf Disparities in Americans 25% of medical residents believed that black people have thicker skin than whites Racial Bias in Pain Nursing Textbook: Misconceptions about how each race handles pain: Latinx, Black and Native American 2012, 34% AAs less opioid prescribing than others Disparities in Americans Highest rate of maternal mortality in the developed world is in the US 3-4x higher for AA women, REGARDLESS of socioeconomic status Mostly tied to disbelief of pain levels Bias in HealthCareThe Evidence Maternal Mortality Rates Highest rate of maternal mortality in the developed world is in the US 3-4x higher for AA women, REGARDLESS of socioeconomic status Mostly tied to disbelief of pain levels Interesting Stories A 25-year-old teacher died after waiting hours at the ER. She's not the only one who saw delays. https://www.usatoday.com/story/news/nation/2020/ 02/28/milwaukee-woman-who-died-after-er-wait-de lays/4889053002/ Dr. Susan Moore: What we know about the Black doctor’s claims of racism at Carmel hospital https://www.indystar.com/story/news/local/indianapolis/2020/12/29/dr-susan-mooreindiana-what-we-know-her-life-and-death/4071090001/ Time to Chat What makes you hesitant to act- even if you still do- when you witness racism and other –isms in action? What do those hesitations look like in action? When might this come up? Rotations In the classroom In organizational meetings In patient encounters The Bystander Effect Diffusion of responsibility The more people who are present, the less likely that someone will take action during a situation Social influence Group behavior Individuals don’t want to violate the norms Intervene: Stop the harm Educational moment is good bonus Some ways to Respond Ask questions that invite discussion I don’t understand. Is that supposed to be a joke? Can you explain to me why it’s supposed to be funny? What do you mean when you say that? Do you know what that word actually means? (Bc I didn’t either) Can you explain your thought process to me? I want to be sure I understand how we reached such different conclusions. State that you are uncomfortable “That kind of language makes me uncomfortable, could you please not use that around me? Create a conversation speedbump I’m not sure how I feel about that Ouch! Whoa! Seriously! I’m not an expert but my understanding is that language is outdated. Does anyone else know what might be better ay to phrase that? Some Ways to Respond Create a conversation speedbump I’m not sure how I feel about that Ouch! Whoa! Seriously! I’m not an expert but my understanding is that language is outdated. Does anyone else know what might be better ay to phrase that? Use direct communication This is unacceptable That’s not okay. Remind people of personal and or institutional values I know you want to be an ally, and that's exactly why I want to check in about that lcomment you made Intentions and Outcomes These often come out as microaggressions “What kind of Asian are you?” “Your English is really good.” ”I bet you did really well on that math test” “You are so articulate!” (Google what kind of Asian are you? You tube video) Tips and Tricks in Navigating Bias Don’t rely on your BIPOC colleagues and friends to teach you. Do the work! If they want to share, they will. Speak up even if you don’t have the right words, the goal is: do not cause harm KNOW better so you can DO better Tips and Tricks in Navigating Bias Don’t rely on your BIPOC colleagues and friends to teach you. Do the work! If they want to share, they will. Speak up even if you don’t have the right words, the goal is: do not cause harm KNOW better so you can DO better University Resources/BERT The Division of Community Engagement The Office of Diversity and Inclusion (UMMC) Bias Education Reporting System Bert.olemiss.edu Again, Why This Matters…. Implicit bias harms everyone. Racial Equity Racial equity is what would exist if our society no longer assigned advantages and disadvantages, through society’s institutions, policies, practices and cultural beliefs, based on a person’s skin color. Racial equity looks at the root causes of inequities, not just the manifestation of the inequities itself, and focuses on the restructuring of institutional policies and practices and cultural beliefs. In this way, racial equity is central to health equity and achieving the healthiest nation. Intersectionality https://www.mathematica.org/blogs/intersectionality-amplifying-impacts-on-health-equity#:~:text=Intersectionality %20is%20a%20framework%20to,and%20sexual%20orientation%2C%20respectively). Community-Based Strategies to Address Racism Local government declarations Community-based initiatives Non-health community partners Additional Possible Solutions Be explicit Engage people of color in equity initiatives Health in all policies approach Measure and evaluate progress in reducing health disparities Protect moms and babies of color Accountable protection in communities https://endingracism.apha.org/ The Work that Still has to be Done… Belongs to us all – Oath of a Pharmacist "I promise to devote myself to a lifetime of service to others through the profession of pharmacy. In fulfilling this vow: I will consider the welfare of humanity and relief of suffering my primary concerns. I will promote inclusion, embrace diversity, and advocate for justice to advance health equity. I will apply my knowledge, experience, and skills to the best of my ability to assure optimal outcomes for all patients. I will respect and protect all personal and health information entrusted to me. I will accept the responsibility to improve my professional knowledge, expertise, and selfawareness. I will hold myself and my colleagues to the highest principles of our profession’s moral, ethical and legal conduct. I will embrace and advocate changes that improve patient care. I will utilize my knowledge, skills, experiences, and values to prepare the next generation of pharmacists. I take these vows voluntarily with the full realization of the responsibility with which I am entrusted by the public.” Activity JEDI Scavenger Hunt Food for Thought Developing of Your Projects – Purposely think about the community and those who are of marginalized identities that may want to access your services or can benefit from your project Questions, Comments, Concerns? “Be the reason someone feels loved, seen, welcomed, heard, valued, appreciated, respected.” Dr. Dawn Bennett-Alexander Resources Inclusive Teaching: Isms in the Classroom, Mx. Lena Tenney If you're interested in learning more about practical strategies for speaking up when bias happens (particularly in the classroom, but general principles apply in other spaces) feel free to use this resource: https://www.youtube.com/watch?v=eH7lUYCyKDM&feature=youtu.be The Doll Test https://www.youtube.com/watch?v=tkpUyB2xgTM&feature=youtu.be Kirwan Institute: Implicit Bias Module Series http://kirwaninstitute.osu.edu/implicit-bias-training/ Understanding Race: https://www.understandingrace.org/GameofLifeExperience https://www.practicaldiversity.com/heart-work-resources TED Talk on Implicit Bias (Marvin Ferguson): https://youtu.be/96vJpf0bIs8 PNAS Pain study: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4843483/pdf/pnas.201516047.pdf So, You’ve Been Told You Need to “check your Priveleges”. Now what? Tuskegee Experiment Article https://sociologyinfocus.com/so-youve-been-told-you-need-to-check-your-privilege-now-what-2/ https://www.washingtonpost.com/news/retropolis/wp/2017/05/16/youve-got-bad-blood-the-horror-of-the-tuskegee-syphilis-experiment/