"Take the Microphone - It's Your Turn to Speak Up for Racial Equity in Healthcare." - Laura Schlabach, RN, BSN, MHA, CV-BC Harold Barnette ...
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“Take the Microphone – It’s Your
Turn to Speak Up for Racial Equity
in Healthcare.”
Laura Schlabach, RN, BSN, MHA, CV-BC
Harold Barnette, Co-Founder, Institute for
Family Caregiving
114th Annual Convention
Concord, NC | September 23-24, 2021
Discussions Guidelines 1. Listen actively 2. Accept one another’s reality 3. Ask compassionate questions 4. Challenge yourself 5. Place no blame on ourselves or others – hear truth in what is said 6. Assume good intentions 7. Maintain confidentiality and this safe space 8. Acknowledge that topics might be uncomfortable to talk about 9. You are already speaking out, just by being here 10. Take care of yourself so you may continue caring for others
Inequality, equality, equity and justice
Racism, Defined… Merriam-Webster defines racism as: 1. A belief that race is a fundamental determinant of human traits and capacities and that racial differences produce an inherent superiority of a particular race 2. Behavior or attitudes that reflect and foster racial discrimination or prejudice 3. The systemic oppression of a racial group to the social, economic and political advantage of another 4. A political or social system founded on racism and designed to execute its principles
“Racism is a structure,
not an event.”
- Kēhaulani Kauanui, Associate Professor of
Anthropology at Wesleyan University
Recognizing racism in medicine
• Human Genome Project
• Need for systemic change on local/national level
• Brief outline of racism in medicine
• Analyzing data trends
• Institutional racism in clinical practice:
- Lack of diversity in clinical research trials
- Role of artificial intelligence (AI) in furthering
institutional racism
• Future strategies to alleviate bias and
disparate outcomes in healthcare
services
Human Genome Project Race is a social construct, not a scientific concept.
Need for systemic equity recognized in NC “We must all stand together to stop racial injustices in North Carolina, in all areas that are important for people’s success – health care, education, economic strength, the justice system. We must confront systems that favor some and harm others and we must fix them.” • - Governor Roy Cooper
Need for national change in professional healthcare associations recently addressed • Recent examples include the American Medical Association (AMA) and the American Psychiatry Association (APA). • Consider the foundation of medicine from a historical perspective to better understand how these practices were founded on discriminatory beliefs.
Brief Timeline of Structural Racism in Medicine • 1847 – Segregated from inception • 1869 – Three Black med students tried to join AMA but were repeatedly denied. They started the National Medical Association (NMA). • 1868 – 1904 – Seven schools established for Black med students • 1910 – Publication of Flexner Report • 2003 – Publication of the Institute of Medicine’s Unequal Treatment
Underrepresented in Medicine (URM) In 2015, the American Medical Student Association reported concerning data regarding the following: • 26% of total population is ethnic • Only 6% of practicing physicians are Latino, African American or Native American • Only 4% of physicians are in US Medical school faculty members and of that, 20% are concentrated at only 6 universities
Institutional racism in clinical practice
Lack of inclusivity of ethnic groups in clinical research • Ethnic groups are less likely to be included in healthcare studies • White population is decreasing, ethnic populations are increasing • Despite the 1993 National Institutes of Health (NIH) Revitalization Act, ethnic groups continue to account for significantly less than the ideal total
Role of artificial intelligence (AI) and clinical practices in furthering institutional racism • Consider the potential of AI and other technologies to further institutionalize harmful clinical practices, obsolete criteria and racial bias in diagnostic tools, procedures, assessments, and treatment protocols. • Ex: pulse oximetry device, NFL settlement re: brain injury claims for Black players
Future strategies to alleviate bias and disparate outcomes in healthcare services • Education • Legislation • Improve data collection systemically as well as in clinical research trials • Review algorithms to determine if they could be bias • Hire more medical staff from ethnic minority groups to increase those who are underrepresented in medicine
Let’s do this…
“We need to be really focused because it’s our
responsibility to be civically engaged. Ultimately,
we choose what kind of system we want to live
with – and we don’t have to live in this type of
system anymore.”
- Megan Rapinoe, U.S. Women’s National
Soccer League Team CaptainReferences
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Changing the Game for Equal Pay and Her Break from
Soccer with Fiancée Sue Bird (harpersbazaar.com)You can also read
