Black and Blue by
Black & Blue is the first systematic description of how American doctors think about racial differences and how this kind of thinking affects the treatment of their black patients. The standard studies of medical racism examine past medical abuses of black people and do not address the racially motivated thinking and behaviors of physicians practicing medicine today. Black & Blue penetrates the physician's private sphere where racial fantasies and misinformation distort diagnoses and treatments. Doctors have always absorbed the racial stereotypes and folkloric beliefs about racial differences that permeate the general population. Within the world of medicine this racial folklore has infiltrated all of the medical sub-disciplines, from cardiology to gynecology to psychiatry. Doctors have thus imposed white or black racial identities upon every organ system of the human body, along with racial interpretations of black children, the black elderly, the black athlete, black musicality, black pain thresholds, and other aspects of black minds and bodies. The American medical establishment does not readily absorb either historical or current information about medical racism. For this reason, racial enlightenment will not reach medical schools until the current race-aversive curricula include new historical and sociological perspectives.
Breathing Race into the Machine by
How race became embedded in a medical instrument In the antebellum South, plantation physicians used a new medical device--the spirometer--to show that lung volume and therefore vital capacity were supposedly less in black slaves than in white citizens. At the end of the Civil War, a large study of racial difference employing the spirometer appeared to confirm the finding, which was then applied to argue that slaves were unfit for freedom. What is astonishing is that this example of racial thinking is anything but a historical relic. In Breathing Race into the Machine, science studies scholar Lundy Braun traces the little-known history of the spirometer to reveal the social and scientific processes by which medical instruments have worked to naturalize racial and ethnic differences, from Victorian Britain to today. Routinely a factor in clinical diagnoses, preemployment physicals, and disability estimates, spirometers are often "race corrected," typically reducing normal values for African Americans by 15 percent. An unsettling account of the pernicious effects of racial thinking that divides people along genetic lines, Breathing Race into the Machine helps us understand how race enters into science and shapes medical research and practice. Honorable Mention, 2017 Rachel Carson Prize, Society for the Social Studies of Science Winner of the 2018 Ludwik Fleck Prize from the Society for Social Studies of Science
Just Medicine by
Offers an innovative plan to eliminate inequalities in American health care and save the lives they endanger Over 84,000 black and brown lives are needlessly lost each year due to health disparities: the unfair, unjust, and avoidable differences between the quality and quantity of health care provided to Americans who are members of racial and ethnic minorities and care provided to whites. Health disparities have remained stubbornly entrenched in the American health care system--and in Just Medicine Dayna Bowen Matthew finds that they principally arise from unconscious racial and ethnic biases held by physicians, institutional providers, and their patients. Implicit bias is the single most important determinant of health and health care disparities. Because we have missed this fact, the money we spend on training providers to become culturally competent, expanding wellness education programs and community health centers, and even expanding access to health insurance will have only a modest effect on reducing health disparities. We will continue to utterly fail in the effort to eradicate health disparities unless we enact strong, evidence-based legal remedies that accurately address implicit and unintentional forms of discrimination, to replace the weak, tepid, and largely irrelevant legal remedies currently available. Our continued failure to fashion an effective response that purges the effects of implicit bias from American health care, Matthew argues, is unjust and morally untenable. In this book, she unites medical, neuroscience, psychology, and sociology research on implicit bias and health disparities with her own expertise in civil rights and constitutional law. In a time when the health of the entire nation is at risk, it is essential to confront the issues keeping the health care system from providing equal treatment to all.
Race, Ethnicity, and Language Data by
The goal of eliminating disparities in health care in the United States remains elusive. Even as quality improves on specific measures, disparities often persist. Addressing these disparities must begin with the fundamental step of bringing the nature of the disparities and the groups at risk for those disparities to light by collecting health care quality information stratified by race, ethnicity and language data. Then attention can be focused on where interventions might be best applied, and on planning and evaluating those efforts to inform the development of policy and the application of resources. A lack of standardization of categories for race, ethnicity, and language data has been suggested as one obstacle to achieving more widespread collection and utilization of these data. Race, Ethnicity, and Language Data identifies current models for collecting and coding race, ethnicity, and language data; reviews challenges involved in obtaining these data, and makes recommendations for a nationally standardized approach for use in health care quality improvement.
Strategies for Deconstructing Racism in the Health and Human Services by
Building on the successful outcomes of a five-year initiative undertaken in New York City, Alma Carten, Alan Siskind, and Mary Pender Greene bring together a national roster of leading practitioners, scholars, and advocates who draw upon extensive practice experiences and original research. Together, they offer a range of strategies with a high potential for creating the critical mass for change that is essential to transforming the nation's health and human services systems. Strategies for Deconstructing Racism in the Health and Human Services closes the gap in the literature examining the role of interpersonal bias, structural racism, and institutional racism that diminish service access and serve as the root cause for the persistence of disparate racial and ethnic outcomes observed in the nation's health and human services systems. The one-of-a-kind text is especially relevant today as population trends are dramatically changing the nation's demographic and cultural landscape, while funds for the health and human services diminish and demands for culturally relevant evidence-based interventions increase. The book is an invaluable resource for service providers and educational institutions that play a central role in the education and preparation of the health and human service workforce.
Unequal Treatment by
Racial and ethnic disparities in health care are known to reflect access to care and other issues that arise from differing socioeconomic conditions. There is, however, increasing evidence that even after such differences are accounted for, race and ethnicity remain significant predictors of the quality of health care received. In Unequal Treatment, a panel of experts documents this evidence and explores how persons of color experience the health care environment. The book examines how disparities in treatment may arise in health care systems and looks at aspects of the clinical encounter that may contribute to such disparities. Patients' and providers' attitudes, expectations, and behavior are analyzed. How to intervene? Unequal Treatment offers recommendations for improvements in medical care financing, allocation of care, availability of language translation, community-based care, and other arenas. The committee highlights the potential of cross-cultural education to improve provider-patient communication and offers a detailed look at how to integrate cross-cultural learning within the health professions. The book concludes with recommendations for data collection and research initiatives. Unequal Treatment will be vitally important to health care policymakers, administrators, providers, educators, and students as well as advocates for people of color.
Legacy by
Growing up in Brooklyn, New York, it never occurred to Uche Blackstock and her twin sister, Oni, that they would be anything but physicians. In the 1980s, their mother headed an organisation of Black women physicians, and for years the girls watched these fiercely intelligent women in white coats tend to their patients and neighbours, host community health fairs, cure ills, and save lives. What Dr. Uche Blackstock did not understand as a child - or learn about at Harvard Medical School, where she and her sister had followed in their mother's footsteps, making them the first Black mother-daughter legacies from the school - were the profound and long-standing systemic inequities that mean just 2 percent of all U.S. physicians today are Black women; the racist practices and policies that ensure Black Americans have far worse health outcomes than any other group in the country; and the flawed system that endangers the well-being of communities like theirs. As an ER physician, and later as a professor in academic medicine, Dr. Blackstock became profoundly aware of the systemic barriers that Black patients and physicians continue to face. Legacy is a journey through the critical intersection of racism and healthcare. At once a searing indictment of our healthcare system, a generational family memoir, and a call to action, Legacy is Dr. Blackstock's odyssey from child to medical student to practicing physician - to finally seizing her own power as a health equity advocate against the backdrop of the pandemic and the Black Lives Matter movement.
