As the coronavirus pandemic continues to threaten hard-hit minority communities, the nation’s largest association of doctors has passed a policy that recognizes racism as a public health threat.
The new policy recognizes racism as a social determinant of health, and highlights the health disparities and lack of access to health care that have significantly hindered good health in Black and other historically marginalized communities in the U.S.
The American Medical Association’s House of Delegates – which includes 600-plus members from every medical specialty – released a statement last week that describes three tiers of racism detailed in the policy: systemic, cultural and interpersonal. Each poses specific barriers to quality medical care and good health and hinders the advancement of health equity, the group wrote.
The AMA also implored its medical professionals to identify strategies to mitigate racism’s health impacts, teach future doctors about racism in medical school curricula and support policy development for researching the issue.
Racism is a declared public health issue in 145 cities and counties across 27 states. Now what happens?
Baltimore-based board member Dr. Willarda Edwards chaired the AMA Task Force on Health Equity and lobbied for action that led to the creation of the AMA Center on Health Equity last year. She said the AMA's new policy is a continuation of those efforts – and the result of a confluence of racial unrest amid protests against police brutality and the pandemic.
“Essentially, with COVID, the Band-Aid was ripped off our health care system,” said Dr. Edwards, an internist. “And the disparities were so blatant as we see more Black and brown and Native American communities hard-hit by COVID. And we just said, ‘This has got to stop.’ We’ve got to be able to do something more than just talk about the stats.”
She’s referring to the disproportionate impact certain illnesses like heart disease and diabetes have on Black and Hispanic communities. But she's also talking about unconscious bias that has influenced medical treatment for minority patients.
“We have found that there has been a real evidence of disparity with respect to the way people of color are treated in the medical world,” she said, citing C-sections performed on minority women more than white women, and less pain medication prescribed for young minority men and women.
Last week, the AMA also officially recognized race as a social construct rather than a biological one, nodding to a vast net of socioeconomic factors that come along with it and impact health and well-being.
Dr. Otis Brawley, a renowned oncologist and professor of oncology and epidemiology at Johns Hopkins University, has been studying health disparities and treatments in Black people and minorities for three decades.
Perceiving race as a mere biological factor diminishes its far-reaching implications, he said.
“It takes the emphasis away from the fact that a substantial number of those people have poor outcomes because they either don’t get treatment or they have poor quality treatment,” Brawley said.
