Anti-Racism Resources for Students and Professionals in Healthcare
For health providers, “not being racist” is simply not enough to counter the history of mistreatment and discrimination in healthcare that has disadvantaged communities of color for centuries. Taking daily, concrete steps to eliminate racial disparities in healthcare is critical—in their communities and nationally. Through the following resources, health professionals and students can learn more about anti-racism and equip themselves to eliminate inequities wherever they see them.
Racism is a system of structures, policies, practices and norms that attribute value and opportunities based on skin color or appearance. In a racist society, some groups of people are advantaged, while other groups are severely disadvantaged.
Anti-racism has roots in abolition and the civil rights activism of Black Americans, over decades and centuries. The work of acclaimed scholar and author Ibram X. Kendi and others has brought the ideology to the forefront in recent years, emphasizing the need for structural changes such as ending medical discrimination.
In practice, anti-racism combines awareness and action. Someone who is anti-racist is actively seeking to understand how racism functions in their society and takes steps to end racial inequities, such as racism in healthcare.
To better understand the need for anti-racism efforts, author and psychologist Beverly Daniel Tatum asked readers to picture a moving walkway at an airport. Active racist behavior is equivalent to walking quickly down the walkway, and passive racist behavior is standing still. Both are caught in the cycle of racism.
“But unless they are walking actively in the opposite direction at a speed faster than the conveyor belt, unless they are actively anti-racist, they will find themselves carried along with the others,” wrote Tatum in Why Are All the Black Kids Sitting Together in the Cafeteria?
ACTIVE RACIST BEHAVIOR:
walking faster on the walkway
PASSIVE RACIST BEHAVIOR:
standing still on the walkway
walking backward on the walkway
The moving walkway carries everyone on it automatically toward a more racist and inequitable society. Active racist behavior is equivalent to walking quickly with the motion of the walkway, whereas active antiracist behavior is walking backward against the walkway. Even though the person demonstrating passive racist behavior is motionless on the walkway, they still get swept along with racism.
In other words, no one is neutral, said Kendi, who founded the Center for Antiracist Research at Boston University. “There is no in-between safe space of ‘not racist.’ The claim of ‘not racist’ neutrality is a mask for racism.”
For health professionals, practicing anti-racism in healthcare starts with understanding their position in a racist society and in a system with a history of medical discrimination.
Going further, anti-racism entails “taking stock of and eradicating policies that are racist, that have racist outcomes, and making sure that ultimately, we’re working toward a much more egalitarian, emancipatory society,” as scholar and professor Malini Ranganathan put it in a 2020 Vox article that breaks down anti-racism.
Racism influences an individual’s housing, education, wealth and employment status—often called social determinants of health. In turn, these conditions drive health inequities between white and non-white groups of people.
Racial Disparities in Healthcare: COVID-19 Case Study
The disproportionate impact of COVID-19 on communities of color helps illustrate the overall racial disparities in healthcare.
FOR EVERY 100,000 PEOPLE, HOW MANY PEOPLE WERE HOSPITALIZED FOR COVID-19 BY RACE GROUP (ADJUSTING FOR AGE)?
For every 100,000 live births, the most recent CDC pregnancy mortality data from November 2020 reports 41.7 deaths for non-Hispanic Black women and 28.3 deaths for non-Hispanic American Indian or Alaska Native women. By comparison, the mortality rate fell between 11 and 13 deaths for Hispanic or Latina women and non-Hispanic White and Asian or Pacific Islander women.
“Many times, institutional practices have been so ingrained in the tradition and fabric of our organizations that it is extremely challenging to see the problems that are, and have been, right in front of us,” as described in a 2020 Nursing Outlook article on institutional racism.
The following list of anti-racism resources for healthcare professionals can help individuals combat racial bias within themselves and in their interactions with others, as well as recognizing discrimination in nursing and other fields. Fighting racism at the systems level often requires a group, as well as institutional support and investment. The following action steps are guideposts that health leaders may consider.
How to Introduce and Implement Anti-Racism Efforts in Nursing and Healthcare
FIRST, LAY THE FOUNDATION
Activists in health organizations can start combating institutional racism by laying a foundation. Consider the following action steps:
Define the problem(s), and set clear goals.
Incorporate shared anti-racist language in daily communications.
Establish support from leadership.
Dedicate funding and resources.
Bring in expertise where needed.
Create ongoing, meaningful partnerships in the community.
NEXT, BEGIN A MULTI-LEVEL AND LONG-TERM APPROACH
With this foundation, health professionals can build a culture of anti-racism and begin (or continue) meaningful anti-racist work in their communities. Action steps for health organizations may include:
Learn about the legacy of slavery in the American health system.
Create a network of leaders to oversee anti-racism work and give them support.
Provide training and education focused on anti-racism in healthcare.
Re-evaluate policies through an anti-racist lens and implement changes as necessary.
Develop an accountability structure for reporting racism, giving feedback and intervening.
Use the health system’s resources to address structural barriers to care, such as transportation or finances.
Update the selection process for boards of trustees to prioritize inclusivity.
Back scientific research that focuses on addressing and eradicating racism.
Heavy: An American Memoir Author: Kiese Laymon Coming-of-age memoir of a Black boy in Jackson, Mississippi, that explores class, race, weight, eating disorders and sexual violence to highlight national, systemic failures.
The Immortal Life of Henrietta Lacks Author: Rebecca Skloot Nonfiction, bioethics narrative about Henrietta Lacks, whose anonymized cells became an extremely lucrative human biological material, and her descendants, who never received any profits.
The Science of Health Disparities Research Editors: Irene Dankwa-Mullan, Eliseo J. Pérez-Stable, Kevin L. Gardner, Xinzhi Zhang, and Adelaida M. Rosario Textbook that presents policies for addressing the diseases, disorders and poor health outcomes that more often affect minority population groups and individuals from socially disadvantaged communities.
How were COVID-19 deaths distributed across race groups (adjusting for age)?
The following section contains tabular data from the graphics in this post.
Distribution of COVID-19 Deaths (%)
Percentage of the Population
Non-Hispanic American Indian or Alaska Native
Non-Hispanic Native Hawaiian or Other Pacific Islander
Source: <a href=”https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/racial-ethnic-disparities/disparities-deaths.html” target=”_blank” rel=”noreferrer noopener”>“Disparities in Deaths from COVID-19,” CDC</a>, December 10, 2020. Accessed August 6, 2021.