Opinions 15 June 2020

Racism in the health system: when will we address it?

Anti-vaccination brigade stalking social media for recruits - Featured Image
Authored by
Jane McCredie
GEORGE Floyd is more famous in death than he ever was in life. The African American man died after a Minneapolis police officer knelt on his neck for almost 9 minutes while arresting him, sparking protests around the world.

Floyd is not the first black man to die during an interaction with the forces of the law, and sadly he will not be the last.

What does seem different this time, though, is the scale and reach of the anger and soul searching his death has prompted around the world.

Perhaps this unique moment, in the midst of a pandemic, is somehow allowing all of us to question realities we may have avoided looking at too closely in the past.

Many of us who, because of the colour of our skin, do not have to live with the persistent fear of such violence have been shaken in recent weeks by an outpouring of first-person accounts on social media.

This account by US college professor Steve Locke of being detained by police on his way to work because he “fit the description” of an alleged offender (ie, was also black) is just one of many.

People will have differing views on the advisability of large public gatherings in the current environment. There are valid arguments on both sides, and I’m not going to comment on that here.

I hope, though, that the protests will lead to real measures to address the structural racism embedded in so many of our institutions, and not just in the US.

Almost three decades after Australia’s Royal Commission into Aboriginal Deaths in Custody, Indigenous incarceration rates remain well above those of other Australians. The ABC reports new national targets to address Indigenous justice are expected in the next few weeks.

How might medical institutions respond to the calls for change?

The BMJ last week published a special issue on racism in the UK health system.

Articles in the themed issue discuss treatment shortfalls for patients from minority backgrounds, prejudice in employment and career progression for doctors, and racism in medical education.

“Research has shown differential attainment by ethnicity in the medical workforce across all measures of training and career progression,” wrote the guest editors of the special issue, Victor Adebowale of the NHS and Professor Mala Rao of Imperial College.

Doctors from minority backgrounds are more likely to face complaints, more likely to have those complaints investigated, and may face harsher sanctions after investigation. They are paid less, and are more likely to experience bullying and harassment at work.

For patients, inequalities in care have been shown in areas including genetic counselling maternal health, disparities that are all the more concerning given the higher prevalence of chronic illness in some populations.

Addressing racism in the system will benefit everybody, the editors argue, but it won’t happen by itself.

“Achieving race equality requires leaders with the courage and ability to shift the culture,” they write. “Their greatest need is for knowledge and evidence to identify the gaps, determine what works, and help orient their organisational structures and cultures towards race equality in relation to the ethnic minority population and workforce.”

All humans have unconscious biases that can undermine their ability to deal with others fairly. When somebody tells me they are without prejudice, I tend to think that means they haven’t yet begun the hard work of trying to overcome it.

We often need to have discrimination pointed out to us if we’re not experiencing it ourselves. For both institutions and individuals, the struggle against racism begins with listening, really listening, to those whose experiences differ radically from our own.

Jane McCredie is a Sydney-based health and science writer.

 

 

The statements or opinions expressed in this article reflect the views of the authors and do not represent the official policy of the AMA, the MJA or InSight+ unless so stated.
Loading comments…

Newsletters

Subscribe to the InSight+ newsletter

Immediate and free access to the latest articles

No spam, you can unsubscribe anytime you want.

By providing your information, you agree to our Access Terms and our Privacy Policy. This site is protected by reCAPTCHA and the Google Privacy Policy and Terms of Service apply.