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Training to Build Antiracist, Equitable Health Care Systems.

Emily Cleveland Manchanda¹, Karthik Sivashanker², Steffie Kinglake³

¹Assistant professor of emergency medicine at the Boston University School of Medicine in Massachusetts.

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Summary

Health care systems often worsen inequities due to segregation, leading to unjust outcomes. Educators must address these harms, which are iatrogenic and preventable, to ensure equitable patient care.

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Area of Science:

Medical Education
Health Equity
Social Determinants of Health

Background:

Healthcare delivery systems perpetuate inequities in access and outcomes.
Clinicians face incentives that promote unequal care within segregated academic health centers.
These centers often reinforce systemic racism and white supremacy.

Purpose of the Study:

To investigate the obligations of health professions educators.
To examine the nature and scope of acknowledging harms caused by segregation in healthcare.
To understand segregation's impact as unjust, iatrogenic, and preventable.

Main Methods:

Literature review on healthcare segregation and its impact.
Analysis of systemic factors within academic health centers.
Ethical examination of educator responsibilities.

Main Results:

Healthcare segregation is a significant driver of health inequities.
Systemic structures within academic health centers contribute to iatrogenic harm.
Educators have a critical role in addressing and mitigating these harms.

Conclusions:

Health professions educators must acknowledge the widespread, unjust harms of segregation.
Addressing segregation is essential for preventing iatrogenic outcomes and promoting health equity.
Systemic change is needed to dismantle structures that reify white supremacy in healthcare.