Racism in Medicine

When people think about racism, they often think about Jim Crow laws, red lining, the time of the Civil Rights movement, and, currently, many are also thinking about police brutality and the criminal justice system. We tend to place the blame of racism on those we think condone it; your neighbor who voted for Trump, or some police officers, the government, or anyone in power. But the general public often misses one arena where race still plays a significant role through which it can be associated with significant mortality: medicine.

The community looks to doctors as people who can heal and can help. And while that may be true, time and again research has demonstrated that Black people have worse outcomes than White people when it comes to their diseases, pain management, pregnancy, and so on. Is this because most doctors are racist? Is it because pharmaceutical companies are racist?

It is tempting to look for individuals to blame, but the fault is found within the system of structural racism. Race, to be clear, is not a biological construct. It has been used throughout history to justify oppression and slavery, and this justification was often aided and abetted by doctors. These doctors made false claims that Black people were biologically different, that the way nature made them made it so that they were made to be enslaved. Combine this with the political justifications of racism, and you create a society that profits off of the subjugation of Black people.

 The effects of structural racism in our country have created environments that continue to create worse living conditions for Black people, Indigenous people, and People of Color. Our nation’s history has led to segregated communities that suffer from less access to healthy food, to quality education, to stable jobs, to healthcare, and to community programs that can offer support and resources. What does this mean? It means that the combination of these factors causes people of color to be more likely to not have access to adequate medical care for diseases that are direct consequences of structural racism.

This all leads to one crucial point: race is a social determinant of health. Black women are twice as likely to die of breast cancer than white women, they are four times as likely to die after childbirth, Black children are less likely to be given pain medications, Black people with kidney disease suffer worse outcomes than their white counterparts. The list goes on. So how can doctors combat racism in medicine?

This is a more difficult question to answer. On the one hand, change comes at an individual level. Having uncomfortable discussions with friends and colleagues ensures we call out problematic behavior when we see it, and also makes us more likely to recognize our own biases. But how do we promote change at the institutional level? At the national level? Medical students, doctors, and other health professionals must begin to actively engage in local government and politics, as well as politics at the national level, to advocate for the dismantling of the structures built on racism. We must amplify the voices of our Black patients and other patients of color.

Urooj Khalid, MS4

Drexel University College of Medicine