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Clinical Framework for Dismantling Antiblack Racism in the Clinic Room
Rachel Herbst1,2, Alexandra M S Corley2,3, Emily McTate4,5
1Division of Behavioral Medicine and Clinical Psychology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH, USA.
Insights
Black and multiracial children face more adverse childhood experiences, increasing health risks. Addressing racism in healthcare is crucial for improving outcomes and building patient trust.
Area of Science:
- Public Health
- Health Disparities
- Clinical Practice
Background:
- Black and multiracial children experience higher rates of adverse childhood experiences (ACEs).
- ACEs are linked to increased risks for poor mental and physical health outcomes.
- Racism is increasingly recognized as an ACE, prompting major health organizations to declare it a public health crisis.
Purpose of the Study:
- To equip healthcare providers with knowledge and skills to address anti-Black racism.
- To sensitize providers to the historical and contextual factors influencing health disparities.
- To offer strategies for discussing racism and promoting culturally humble care.
Main Methods:
- Review of historical and contextual factors contributing to anti-Black racism and health disparities.
- Development of strategies for clinicians to address racism in patient care.
- Emphasis on communication skills, cultural humility, and bias recognition.
Main Results:
- Providers need awareness of racism's role in health disparities for high-quality care.
- Clinicians require skills to discuss racism with patients, families, and colleagues.
- Informed conversations about race can build essential trust between providers and patients.
Conclusions:
- Addressing anti-Black racism is vital for reducing health disparities.
- Clinicians must develop competence in discussing race and racism.
- Allyship and advocacy are essential components of equitable healthcare delivery.
Abstract:
Children who identify as Black or multiracial report significantly higher exposure to adverse childhood experiences, which places them at greater risk for poor mental and physical health outcomes. These disparities and increasing awareness of racism as an adverse childhood experience has resulted in the American Academy of Pediatrics, American Psychological Association, and other groups declaring racism a public health crisis. To provide high-quality care, providers who engage with patients and families impacted by systemic racism must be aware of its role in health disparities. This requires clinicians to have the knowledge and skills to discuss racism with colleagues, patients, and families. To promote clinicians' competence to engage in these discussions, this article 1) sensitizes providers to historical and contextual factors that inform experiences with anti-Black racism and health disparities and 2) offers strategies to address anti-Black racism in clinical care.Embracing the process of brave, informed conversations about race represents a pathway for building trust between providers and patients, a key component of various health outcomes. Additionally, these foundational skills of reflection, cultural humility, and bias recognition will be needed to engage in allyship and advocacy both within and beyond the exam room.
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