This is a critical moment for healthcare leaders to publicly reaffirm support for antiracism in medicine, according to an article published Feb. 17 by The New England Journal of Medicine.
The article is penned by David Ansell, MD, senior vice president for community health equity at Chicago-based Rush University Medical Center and professor at Rush Medical College; Brittani James, MD, physician and co-founder of nonprofit the Institute for Antiracism in Medicine and advocacy group the Coalition to Advance Antiracism in Medicine; and Fernando De Maio, PhD, director of health equity research and data use at the American Medical Association's Center for Health Equity.
In 2020, as racial gaps in COVID-19 mortality and murders of Black people gained national attention, more than 200 healthcare organizations declared racism a public health crisis. Now, healthcare leaders need to reiterate that message and put it into organizational action, the authors wrote.
In 2021, two physicians from Boston-based Brigham and Women's Hospital — Bram Wispelwey, MD, and Michelle Morse, MD — published "An Antiracist Agenda for Medicine," which lays out a plan known as the Healing ARC for organizations to build a proactively antiracist agenda. The article detailed the historical failure of "color-blind" solutions to racial inequity in healthcare and offered a race-conscious approach.
In response, neo-Nazis marched on Brigham and Women's Hospital in January 2022, with a banner claiming the hospital "kills whites." The protest reflects broader reactionary efforts in both medicine and society to deny that racism exists or invalidate antiracism efforts as "anti-white," the NEJM authors write.
Black people, American Indians and Alaska Natives are more likely than white people to die early in life from conditions that are treatable with timely access to high-quality care, according to available U.S. data cited by the Commonwealth Fund. A large body of literature demonstrates that these gaps reflect racism, rather than genetic or biological differences, the four authors wrote, noting that even analyses that control for socioeconomic status find that Black Americans have worse health outcomes than their white counterparts.
The Massachusetts Medical Society issued a statement regarding the recent protest at Brigham and Women's, but the three NEJM authors are urging more leaders of national healthcare organizations to publicly express their support for Drs. Morse and Wispelwey and their antiracism efforts — and then put those words into actions.
The neo-Nazi march on physician colleagues and attacks on health equity interventions are "stark reminders of the obligation of physicians, particularly white physician leaders of national healthcare organizations, to denounce white supremacism and reaffirm race-conscious antiracism efforts," the three wrote.
The authors recommend healthcare leaders take three immediate actions:
1. Publicly defend Drs. Morse and Wispelwey and others who have become targets of hatred because of their antiracism work.
2. Implement and evaluate race-conscious, intersectional interventions such as the Healing ARC.
3. Publicly report progress toward achieving racial equity in health outcomes.
"Inaction in the face of white supremacism must not be an option," the authors concluded.