This is our lane: talking with patients about racism

Diop, Michelle S.; Taylor, Christy; Murillo, Sascha; Zeidman, Jessica; James, Aisha; Burnett-Bowie, Sherri-Ann M.

doi:10.1186/s40695-021-00066-3

Cited by 19 publications

(19 citation statements)

References 73 publications

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“…In their review, Diop et al demonstrated the importance of addressing experiences of bias and racism directly with patients and the unique role healthcare providers can play. They proposed a framework of trauma-informed care, structural competency, provider bias and intersectionality when discussing patients’ experiences of racism [ 50 ]. Hardeman et al, have proposed to couple critical race theory with the previously described relationship centered care to improve the clinical experiences of Black birthing people [ 51 , 52 ].…”

Section: Discussionmentioning

confidence: 99%

Trends and inequities in severe maternal morbidity in Massachusetts: A closer look at the last two decades

Diop

Declercq

Liu³

et al. 2022

PLoS ONE

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It is estimated that 50,000–60,000 pregnant people in the United States (US) experience severe maternal morbidity (SMM). SMM includes life-threatening conditions, such as acute myocardial infarction, acute renal failure, amniotic fluid embolism, disseminated intravascular coagulation, or sepsis. Prior research has identified both rising rates through 2014 and wide racial disparities in SMM. While reducing maternal death and SMM has been a global goal for the past several decades, limited progress has been made in the US in achieving this goal. Our objectives were to examine SMM trends from 1998–2018 to identify factors contributing to the persistent and rising rates of SMM by race/ethnicity and describe the Black non-Hispanic/White non-Hispanic rate ratio for each SMM condition. We used a population-based data system that links delivery records to their corresponding hospital discharge records to identify SMM rates (excluding transfusion) per 10, 000 deliveries and examined the trends by race/ethnicity. We then conducted stratified analyses separately for Black and White birthing people. While the rates of SMM during the same periods steadily increased for all racial/ethnic groups, Black birthing people experienced the greatest absolute increase compared to any other race/ethnic group going from 69.4 in 1998–2000 to 173.7 per 10,000 deliveries in 2016–2018. In addition, we found that Black birthing people had higher rates for every individual condition compared to White birthing people, with rate ratios ranging from a low of 1.11 for heart failure during surgery to a high of 102.4 for sickle cell anemia. Obesity was not significantly associated with SMM among Black birthing people but was associated with SMM among White birthing people [aRR 1.18 (95% CI: 1.02, 1.36)]. An unbiased understanding of how SMM has affected different race/ethnicity groups is key to improving maternal health and preventing SMM and mortality among Black birthing people. SMM needs to be addressed as both a medical and public health challenge.

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Section: Discussionmentioning

confidence: 99%

Trends and inequities in severe maternal morbidity in Massachusetts: A closer look at the last two decades

Diop

Declercq

Liu³

et al. 2022

PLoS ONE

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“…Development of interview questions was informed by existing work exploring how to talk about racism and other forms of discrimination with patients. 15,16,[22][23][24] Interview questions were framed to be intentionally open, and study participants were free to share experiences of discussing racism at any levelinternalized, personally mediated, and/or institutional racism. 27 The patient interview guide was revised after the first interview, and the PCP interview guide was revised after pilot interviews with two fourth-year medical students.…”

Section: Data Collectionmentioning

confidence: 99%

Opportunities and challenges in discussing racism during primary care visits

Borowsky

Willis

Bullock

et al. 2022

Health Services Research

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Objective To understand how patients and primary care practitioners (PCPs) discuss racism and their perspectives on having these conversations during primary care visits. Data Sources/Study Setting We conducted semi‐structured interviews from September 2020–March 2021 at a Federally Qualified Health Center in the San Francisco Bay Area. Study Design We conducted an inductive qualitative descriptive pilot study using one‐on‐one, semi‐structured interviews with 5 members of a Patient Advisory Council and 10 internal medicine PCPs. Data Collection/Extraction Methods Interviews were conducted via video conferencing, recorded, and transcribed. An iterative analytic process was used to thematically assess participants' experiences and perspectives and identify key themes. Principal Findings Patients and PCPs identified benefits from engaging in conversations about racism during primary care visits and noted challenges and concerns. Patients and PCPs highlighted strategies to advance communication about racism in primary care. Conclusions Initiating conversations about racism with patients in primary care can be meaningful, but also has risks. More research is needed for deeper exploration of patients' perspectives and development of trainings. Improving how PCPs communicate with patients about racism represents an opportunity to advance antiracism in medicine and improve health outcomes for individuals who have historically been poorly served by our health care system.

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“…Higher education institutions are failing BIPOC faculty, particularly BIPOC women, as they are often overworked, overstressed, and overlooked by the operations of racist ideologies 8. The outright murder of George Floyd and the killings of Ahmaud Arbury and Breonna Taylor facilitated national conversations about the detrimental effects of racism that have expanded to health care 9…”

mentioning

confidence: 99%

“…8 The outright murder of George Floyd and the killings of Ahmaud Arbury and Breonna Taylor facilitated national conversations about the detrimental effects of racism that have expanded to health care. 9 The COVID-19 pandemic further illuminated and amplified the damaging effects of systemic racism on historically marginalized communities. 10 BIPOC and Latinx are reported to suffer the highest mortality and morbidity from COVID-19.…”

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confidence: 99%

Racism Declared a Public Health Emergency

Adeniran¹

2023

Holistic Nursing Practice

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The only thing necessary for the triumph of evil is for good men to do nothing.-Edmund Burke Vestal 1 asserted that being Black is bad for your health and the etiology of disparities in health care is pervasive racism. Disturbingly, African Americans are not the only historically marginalized group in the United States that experience racial injustice in health care. Persistent harm, poorer outcomes, and inequities are associated with the legacy of racism in health care delivery. Historically marginalized groups are socially vulnerable to external stressors due to racial oppression and discriminatory practices. And inequities, creating high socially vulnerable index communities 2,3 comprised primarily Black, Indigenous, people of color (BIPOC), and Latinx. These individuals experience harm through higher health risk exposures, unequal access to health services, and a lack of empowering resources. A body of evidence documents disparities to be rooted in racism and discriminatory health care practices and racism is embedded in structural and systemic inequities. 4,5 After accessing the health care system, BIPOC and Latinx individuals are more likely to receive substandard and/or disparate treatments due to health care providers' conscious and unconscious bias and discriminatory and culturally disconnected health care practices. 6,7

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This is our lane: talking with patients about racism

Cited by 19 publications

References 73 publications

Trends and inequities in severe maternal morbidity in Massachusetts: A closer look at the last two decades

Trends and inequities in severe maternal morbidity in Massachusetts: A closer look at the last two decades

Opportunities and challenges in discussing racism during primary care visits

Racism Declared a Public Health Emergency

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