Nurse Hannah Brooks

Who Is Still Afraid to Talk About Racism in Healthcare?

By and large, people can deal with anything they can talk about. But if they can’t talk about it, they can’t deal with it. Talking through a problem is the first step to solving it. Until now, though, racism in healthcare has been a problem that no one wants to talk about. Writing in the Washington Post, Ron Wyatt explains:

“When I write about health policy or speak with medical colleagues about barriers to care, there is one word – and one word only – that evokes a wide range of responses. Some respond with silence; others with avoidance. Some respond with anger and defensiveness.

“The word appeared at the top of a paper I submitted to the Journal of the American Medical Association in 2015 with David R. Williams, a professor of public health and African American studies at Harvard University. The title: ‘Racism in Health and Healthcare: Challenges and Opportunities.’

“The editor of the journal at that time, Howard Bauchner, advised us that the word could not be published and that ‘racial bias’ would be substituted into the title before publication. Using ‘racism,’ he said, would result in ‘losing readers.’ As authors and scientists, we compromised. We agreed to the change, and the article was published.”

Recently, the AMA suspended Bauchner from his job as editor for JAMA because of a podcast that seemingly denied racism is a problem in medicine.

Naming the Problem

This week, at long last, the CDC found belated courage to name the problem. CDC Director Rochelle Walensky said it plainly:

“What we know is this: racism is a serious public health threat that directly affects the well-being of millions of Americans. As a result, it affects the health of our entire nation. Racism is not just the discrimination against one group based on the color of their skin or their race or ethnicity, but the structural barriers that impact racial and ethnic groups differently to influence where a person lives, where they work, where their children play, and where they worship and gather in community.”

This comes almost a year after CDC employees called out this problem to the center’s leadership:

“We, as dedicated public health professionals, can no longer stay silent to the widespread acts of racism and discrimination within CDC that are, in fact, undermining the agency’s core mission.”

No Offense

It is easy for people to take offense when this subject arises. Privilege protects itself instinctively. We’ve heard a few people in a mostly White church take offense at calls to “do justice, love mercy, walk humbly, and end racism.” They labeled it blasphemy. This illustrates what is meant by white fragility.

But the fact is that racism is killing people. Not just because of racist policing practices. But also because of separate and unequal healthcare for racial and ethnic minorities. Among other things, racism contributes to disparities in obesity, which in turn contributes to disparities in health and lifespans.

The only thing offensive about the glaring problem of racism in healthcare is our failure to deal with it – to let it hide in plain sight. Are we still afraid to talk about it? The time has come to overcome that fear and get to work on solving the problem.

Click here for Wyatt’s commentary in the Washington Post.

Nurse Hannah Brooks, photograph © Florida Keys Public Libraries / flickr

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April 11, 2021