We invite scholars and antiracism activists, Drs. Rhea Boyd and Rachel Hardeman, to discuss the meaning of structural racism, the health impacts of police violence, the “say her name” movement, and the ways we can ensure our country’s current antiracist movement grows beyond a moment.
After listening to this episode learners will be able to…
- Define structural racism
- Understand how police violence is a social determinant of health
- Explore the relationship between policing and healthcare
- Explore and employ strategies to dismantle structural racism in clinical practice
- Written and produced by: Naomi Fields, Rohan Khazanchi, LaShyra Nolen, Michelle Ogunwole, MD, Chioma Onuoha, Dereck Paul, MS, and Utibe R. Essien, MD, MPH
- Hosts: Dereck Paul, MS, Utibe R. Essien, MD, MPH, Michelle Ogunwole, MD
- Show notes: LaShyra Nolen
- Written & Produced By: Michelle Ogunwole, MD, Naomi Fields, Rohan Khazanchi, LaShyra Nolen, Chioma Onuoha, Dereck Paul, MS, and Utibe R. Essien, MD, MPH
- Infographic: Creative Edge Design
- Guests: Rachel Hardeman PhD, MPH (@RRHDr) and Rhea Boyd MD, MPH (@RheaBoyd)
CPS-Anti-Racism Show Notes Episode 1
August 26, 2020
By LaShyra Nolen
01:00 Our mission and vision
01:50 Introduction to the Antiracism in Medicine team
02:55 Introduction of Dr. Boyd and Dr. Hardeman
04:30 Defining structural racism
10:30 Dr. Boyd’s Lancet piece on the history of police violence
12:00 Police violence, communities, and health outcomes
15:00 Dr. Hardeman on police brutality and a public health agenda
24:00 Understanding this moment (COVID-19 and George Floyd)
29:00 The #SayHerName campaign and police brutality’s effects on women
33:00 Emmett and Mamie Till
44:00 Policing in healthcare settings
54:00 What can we start doing tomorrow?
56:00 Conclusion and outro
“First do no harm and while you’re doing no harm, learn as much as you can.” -Dr. Rhea Boyd.
Practitioners who benefit from the racist power structures existent in America must examine the ways they benefit from or ignore racism in their workspaces and beyond. Then we must all commit to dismantling racism with tangible policy change.
We encourage trainees to reflect on the ways they have been socialized to learn and think about racism in our country. Trainees may use this foundation to question how this might impact their medical education and think about this educational legacy may be reformed through curricular and structural changes at their institutions.
Regardless of specialty or field, it is important all educators and clinicians do the work of understanding how racism is pervasive within their respective areas of expertise. This starts with self-education and a commitment to speak up when blatant examples of racism come up in the work space and beyond.
Defining Structural Racism
Structural racism is a term that acknowledges that racism is perpetuated beyond individual interactions and interpersonal racism, but is present in the systems and policies that govern our everyday lives. These policies and decisions are often rooted in a historical legacy of white supremacy that have led to the systematic disadvantage of racial minorities in our society. Public health advocate, leader, and scholar, Dr. Camara Phyllis Jones, is credited for creating the framework many healthcare professionals and researchers use to think about systemic racism’s impacts on Black health. Her definition centers the idea that Black individuals did not inherit the diseases they disparately suffer from, but they inherited a disadvantaged system that creates the stark health disparities we see today. It is important to understand this unequal system negatively impacts everyone and every aspect of our society.
Policing and health outcomes
Evidence has shown that excessive policing not only impacts the individual health of Black and brown people who’ve interacted with the police, but it also impacts the health of their communities at large. Heightened police presence in communities of color can be perceived as a threat by community members which can result in sustained increases in stress and cortisol levels. This pathologic process can lead to adverse health outcomes affecting the cardiovascular, neurological, and endocrine systems.
Police brutality should be thought of as the ways state-sanctioned violence leads to the physical, psychological, and emotional harm of its victims. It is important to understand that police brutality not only impacts individuals with direct relationships to those afflicted by this violence but also has widespread effects on the entire Black community. It impacts the health of our colleagues who constantly have to witness this injustice play on television, often without consequence. It also leads to decreased productivity in Black communities as they deal with the aftermath and ongoing challenges of police brutality.
As we continue conversations around police brutality, antiracism, and health equity, we must remember to not exclude women, children, the LGBTQ community, and the disabled community, among other communities of intersecting marginalized identities who continue to be impacted by police brutality. Social media and public response to police brutality traditionally center cis-gendered men, but people like Breonna Taylor, Tony McDade, and Tamir Rice, along with so many others, need our voices too.
Policing in Schools and Hospitals
Health care systems must actively advocate and protect their patients and that means we have to also reevaluate the presence of police in our spaces. This includes thinking about our roles as mandated reporters and police presence in emergency departments. Police presence in medical spaces can add to Black patients’ feelings of not having a “safe space” and we must consider our roles in potentially perpetuating violence in this way.
References discussed throughout episode
Hardeman RR, Karbeah J, Kozhimannil KB. Applying a critical race lens to relationship-centered care in pregnancy and childbirth: An antidote to structural racism. Birth. 2020;47(1):3-7. doi:10.1111/birt.12462
Alyasah Ali Sewell, Justin M. Feldman, Rashawn Ray, Keon L. Gilbert, Kevin A. Jefferson & Hedwig Lee (2020) Illness spillovers of lethal police violence: the significance of gendered marginalization. Ethnic and Racial Studies. 2020. doiI: 10.1080/01419870.2020.1781913
Bor J, Venkataramani AS, Williams DR, Tsai AC, Police killings and their spillover effects on the mental health of black Americans: a population-based, quasi-experimental study. Lancet. 2018. doi: 10.1016/S0140-6736(18)31130-9.
Additional references and papers as mentioned in episode
Link to the work of Dr. Rupa Marya as mentioned by Dr. Boyd: https://medium.com/@radiorupa/health-and-justice-the-path-of-liberation-through-medicine-86c4c1252fb9
Link to African-American Policy Forum #SayHerName Campaign: https://aapf.org/sayhername
Link to latest work of Dr. Rachel Hardeman: Physician-patient racial concordance and disparities in birthing mortality for newborns. Brad N. Greenwood, Rachel R. Hardeman, Laura Huang, Aaron Sojourner. Proceedings of the National Academy of Sciences Aug 2020, 201913405; DOI: 10.1073/pnas.1913405117
The hosts and guests report no relevant financial disclosures.
Boyd R, Hardeman R, Ogunwole M, Fields N, Khazanachi R, Nolen L, Onuoha C, Paul D, Essien UR. “#120 Racism, Police Violence, and Health.” The Clinical Problem Solvers Podcast. https://clinicalproblemsolving.com/episodes/ August 26, 2020.