Racial Bias Isn't Just a Problem at Starbucks
A video of two black men getting arrested at a Starbucks in Philadelphia has sparked widespread outrage directed at both Starbucks and the police. In response, Starbucks announced that it will close 8,000 stores in May so employees can engage in racial bias training. "While this is not limited to Starbucks, we're committed to being a part of the solution," said CEO Kevin Johnson. The problem certainly isn't limited to one company, or one industry, or one region of the country. There are any number of examples of white Americans calling the police on black Americans without real justification. Deeply ingrained and unconscious racial bias routinely leads to instant, often fear-based judgements about people that can have dire consequences. The question is, what can we do to break this cycle?
From the article:
Starbucks will do what it needs to do to protect its brand. But what is America doing to protect its own citizens of color? Who will train Americans to stop calling the cops on their unarmed black neighbors? Who will train school officials not to use police force on black kids just for being kids? Who will train the convenience-store managers? The mom-and-pop restaurants? And how can we up the social and legal costs for people who make life-threatening decisions by calling the police on peaceful black people?
Calling the Police on Black People isn’t a Starbucks Problem. It’s an America Problem., from The Washington Post
Black Maternal Mortality Examined In Depth
The New York Times published a long investigation of the crisis in black maternal and infant mortality. The piece follows a young black mother who delivered two healthy boys, and then had a stillborn daughter. During her pregnancy with her daughter, the mother had several concerns that were dismissed by her medical team. She nearly died during the c-section delivery of her stillborn baby. When she becomes pregnant again, she is afraid that she will lose this baby too. Her pregnancy and birth don't go perfectly, but this time she receives pro-bono doula services from an organization called Birthmark. The article makes a strong case for the work of doulas in pregnancy and childbirth, particularly for women of color who are dealing with added stress and "weatherization" from lifetime exposure to racism. It also provides a comprehensive survey of research done in the area of black maternal and infant mortality.
From the article:
The reasons for the black-white divide in both infant and maternal mortality have been debated by researchers and doctors for more than two decades. But recently there has been growing acceptance of what has largely been, for the medical establishment, a shocking idea: For black women in America, an inescapable atmosphere of societal and systemic racism can create a kind of toxic physiological stress, resulting in conditions — including hypertension and pre-eclampsia — that lead directly to higher rates of infant and maternal death. And that societal racism is further expressed in a pervasive, longstanding racial bias in health care — including the dismissal of legitimate concerns and symptoms — that can help explain poor birth outcomes even in the case of black women with the most advantages....
In 2016, a study by researchers at the University of Virginia examined why African-American patients receive inadequate treatment for pain not only compared with white patients but also relative to World Health Organization guidelines. The study found that white medical students and residents often believed incorrect and sometimes “fantastical” biological fallacies about racial differences in patients. For example, many thought, falsely, that blacks have less-sensitive nerve endings than whites, that black people’s blood coagulates more quickly and that black skin is thicker than white. For these assumptions, researchers blamed not individual prejudice but deeply ingrained unconscious stereotypes about people of color, as well as physicians’ difficulty in empathizing with patients whose experiences differ from their own. In specific research regarding childbirth, the Listening to Mothers Survey III found that one in five black and Hispanic women reported poor treatment from hospital staff because of race, ethnicity, cultural background or language, compared with 8 percent of white mothers.
ACP Issues Recommendations to Improve Health Equity
The American College of Physicians (ACP) released 9 recommendations designed to address social determinants of health (SODH) in order to improve health equity and patient outcomes. SODH include income, social status, education, environmental safety, and access to healthcare. Among the recommendations, the ACP called for increased training on how to communicate with patients whose health may be impacted by SODH.
From the recommendations:
The American College of Physicians recommends that social determinants of health and the underlying individual, community, and systemic issues related to health inequities be integrated into medical education at all levels. Health care professionals should be knowledgeable about screening and identifying social determinants of health and approaches to treating patients whose health is affected by social determinants throughout their training and medical career.
Addressing Social Determinants to Improve Patient Care and Promote Health Equity: An American College of Physicians Position Paper, from Annals of Internal Medicine
Improve Interpreter Services to Reduce Health DisparitiesWhen Minnesota released its annual Adverse Health Events report, which lists serious yet preventable clinical events, communication problems were responsible for 20% of all reported events. English-language proficiency is not included in the data, so it's impossible to know how many of those events were due to poor interpreter services. But it's safe to assume that patients with limited English proficiency (LEP) are at a greater risk for receiving suboptimal care, and that high-quality interpretation could do a lot to improve doctor-patient communication. Unlike other healthcare professions, medical interpreters are not well regulated, and it is often up to healthcare organizations to set the standard for their staff interpreters. Ensuring that interpreters are highly qualified, and medical staff are trained to work with them, can improve health equity and patient outcomes.
From the article:
Linguistic diversity has become ingrained in the fabric of U.S. health care. The lack of oversight of the quality of care our taxpayer money pays for, and the risk of human harm are too large to ignore. Minnesota already has some of the largest disparities in health quality. If we are to eliminate them we need to begin closing the health gaps one by one, including the language gap for Limited English Proficient speakers. It is in the best interest of every Minnesotan to have a healthy state, and health begins with good communication and equitable access to quality and safe care for all.