Discussion – Medical Racism

Discussion – Medical Racism

Medical racism is a major barrier to the achievement of equitable and universal healthcare (American Medical Association, 2021). Medical racism is a risk to the health and well-being of everyone (Yearby, 2020). However, it significantly and directly shapes the lives of individuals experiencing it and negatively impacts their health outcomes. Experiencing medical racism contributes to the development of trust issues and fear in the healthcare system. Distrust and mistrust in healthcare in racially diverse settings is the leading cause of delayed utilization or avoidance of utilization of healthcare services such as vaccines (Madorsky et al., 2021). This further has a significant impact on the health outcomes of such people. Delayed, limited access, avoided care, or consumption of care services leads to notable health disparities. It is evident that, due to medical racism, racial and ethnic minorities are majorly affected by diseases and experience worse health than white people (Butler et al., 2020; Kahkoska et al., 2022). Therefore, medical racism is the reason behind the high prevalence of chronic diseases such as diabetes, cancer, and CVD and high rates of maternal mortality under presentation in the medical workforce among racial minorities in the U.S.

The Flexner Report of 1910, published by Abraham Flexner, aimed to improve the quality and standardization of medical education. The report recommended the consolidation of medical schools, standardization, and a centralized medical education system, citing a high number of schools and graduating medical professionals (Duffy, 2011). However, it contributed to barriers to black medical professionals. The call for the consolidation of medical schools and education led to the shutting down of historically Black medical schools. The two that were not closed lost autonomy and were subjected to discriminative healthcare education. Black healthcare professionals also experienced racial segregation in medical education and had limited learning and practice opportunities (Laws, 2021). The Flexner Report thus reduced the number of Black medical students with a long-term impact on Black healthcare professionals and their supply; thus, the report significantly contributed to the legacy of medical racism in the U.S.

References

American Medical Association. (2021, June 15). AMA adopts guidelines that confront systemic racism in medicine. AMA. https://www.ama-assn.org/press-center/press-releases/ama-adopts-guidelines-confront-systemic-racism-medicine

Butler, S. S., Winkfield, K. M., Ahn, C., Song, Z., Dee, E. C., Mahal, B. A., & Sanford, N. N. (2020). Racial Disparities in Patient-Reported Measures of Physician Cultural Competency Among Cancer Survivors in the United States. JAMA Oncology, 6(1), 152. https://doi.org/10.1001/JAMAONCOL.2019.4720

Duffy, T. P. (2011). The Flexner Report ― 100 Years Later. The Yale Journal of Biology and Medicine, 84(3), 269. https://doi.org/10.5116/ijme.4cb4.85c8

Kahkoska, A. R., Pokaprakarn, T., Rumay Alexander, G., Crume, T. L., Dabelea, D., Divers, J., Dolan, L. M., Jensen, E. T., Lawrence, J. M., Marcovina, S., Mottl, A. K., Pihoker, C., Saydah, S. H., Kosorok, M. R., & Mayer-Davis, E. J. (2022). The Impact of Racial and Ethnic Health Disparities in Diabetes Management on Clinical Outcomes: A Reinforcement Learning Analysis of Health Inequity Among Youth and Young Adults in the SEARCH for Diabetes in Youth Study. Diabetes Care, 45(1), 108–118. https://doi.org/10.2337/DC21-0496

Laws, T. (2021). How should we respond to racist legacies in health professions education originating in the flexner report? AMA Journal of Ethics, 23(3), 271–275. https://doi.org/10.1001/AMAJETHICS.2021.271

Madorsky, T. Z., Adebayo, N. A., Post, S. L., O’Brian, C. A., & Simon, M. A. (2021). Vaccine Distrust: A Predictable Response to Structural Racism and an Inadequate Public Health Infrastructure. In American Journal of Public Health (Vol. 111). https://doi.org/10.2105/AJPH.2021.306411

Yearby, R. (2020). Race-Based Medicine, Colorblind Disease: How Racism in Medicine Harms Us All. The American Journal of Bioethics, 21(2), 19–27. https://doi.org/10.1080/15265161.2020.1851811

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Discussion Prompt:
What are your thoughts on how medical racism shapes the lives of individuals experiencing it and their health outcomes?
Discuss the Flexnor Report and how it contributed to barriers to Black medical professionals.