Wandeth Van Grover, MPH & Julian Santino Garcia
Mar 16, 20184 min
Updated: Nov 16, 2023
The Bronx Health REACH coalition came together as a coalition of 40 different community and faith-based organization. They were able to assess the differences between races and within institutions which resulted in a separate and unequal distribution of care. In order to come to this conclusion and find solutions to these inequities, they generated a report about their research and findings studying medical apartheid in New York City. (Calman, et al., 2005). They responded to these inequities through a host of community organizing strategies. These strategies included the sponsoring of several community health and disease prevention programs, as well as community advocacy events and volunteer coordination. (Calman, et al., 2005).
Furthermore, a perspective in the New England Journal of Medicine detailed the “White Coats for Black Lives” demonstrations. This coordinated protest was done in response to the killing of an unarmed black man, but also drew attention to the institutional racism present within medical centers and academia at large. The community organizing strategy was done through a call to action posted online. This was followed up by medical students in California who coordinating thousands of medical students from 70 different schools across the United States. They protested through holding large die-ins for the administrations of these institutions to examine their bias (Ansell and McDonald, 2015).
A seminal report by the Aspen highlighted the importance of the structural racism framework for community building and health education. They support the idea of practitioners viewing the problem with a race-conscious perspective. This is an active approach that not only engages the community, but also promotes advocacy for system-level change. To that end, they highlight the need to invest in local community-building organizations, identifying key policies that need reform, and acknowledging the existing disparities (Lawrence et al., 2004).
New York City’s health commissioner, Mary Bassett, detailed her recommendations in a perspective piece published in the New England Journal of Medicine. She highlights critical research, internal reform, and public advocacy to combat institutional racism. The research aspect would highlight identifying the forms of racial and social inequality that persist within our understanding of health and health outcomes. Internal reform was described as coming from a place of direct representation and community engagement. Finally, she recommends that physicians and other healthcare professionals use their social status and credibility to amplify the demands to change health policies and call out inequities (Bassett, 2015).
An editorial piece by Ramaswamy and Kelly echoed this sentiment and identified public health nurses as being critical as teachers and advocates (Ramaswamy and Kelly, 2015). They describe the problem being perpetuated by policymakers, politicians, employers, hospital administrators, urban planners, and housing authorities. The reason why they would be great teachers and advocates is because they are uniquely situated to have firsthand experience confronting these inequities on a daily basis. Based on that experience, they would be able to speak on it to administrators who would be in a position to make the necessary changes.
Conclusion
Modern medicine may not always consider a healthcare perspective that considers the effects of race/ethnicity and social determinants of health. Ultimately, this issue is not novel in its conception, and has been an active reality for many Americans that has been glossed over in the past. Although there have been steps taken to reduce these disparities caused by race, it is important to remember the systems and institutions that serve to perpetuate these situations. Current strategies that address this topic take into account a multidisciplinary approach that considers the larger structures that allow institutional racism to persist. Through community organizing, it is possible to advocate for a more holistic and inclusive medical education for healthcare professionals.