Actions Anyone Can Take to Start Addressing Structural Racism in Health Care

Racism. Antiracism. Health care. At first blush, it may not seem like those three terms fit together, but, more and more, we are starting to understand how racism and antiracism influence our health care systems and the care patients receive.

In our latest CareQuest Institute for Oral Health webinar, our expert panel from oral health and primary care explored the foundations of structural racism and how those foundations ultimately shape our care environments. Four speakers from diverse perspectives — Eleanor Fleming, PhD, DDS, MPH, associate professor at Meharry Medical College; Derek M. Griffith, PhD, founding co-director of the Racial Justice Institute at Georgetown University; Sarah E. Raskin, PhD, MPH, assistant professor at Virginia Commonwealth University; and Monica Wang, ScD, MS, associate director of Narrative at the BU Center for Antiracist Research — presented research and insights into how antiracist policies and practices influence our systems. 

You can watch the full recording of the program here.

One key theme that emerged during the webinar was that many participants (and their organizations) are at much different places on their journey. After the show, our panelists homed in on one question: What approach do you recommend for an organization that is just beginning its journey into diversity, equity, and inclusion?

Their answer:
Start with asking yourself why you care? How does having a more diverse, fair, and inclusive organization help to improve your organizational culture and bottom line? How does the status quo waste resources, hinder innovation, and limit opportunities for advancement, retention, and satisfaction of your best employees?

Also, look at your data and the ways it is collected and aggregated. See if there are differences in key factors by race, ethnicity, and other factors that matter in your context. Ask yourself why and talk to staff at all levels about why those may exist and consult the literature. Likely, you will have different explanations. See which explanations seem to fit the way your organization operates, and which explanations have received less consideration (but may in fact be more accurate) in your organization.

Toward the close of the program, Professor Wang offered several other practical ways individuals and organizations can get started on their journey to build antiracist policies and practices into their local settings:

On the individual level:

• Use terms (racism, racist) accurately and talk about them.
• Be curious about your own biases.
• Learn about different forms of racism.
• Pay attention to the language used to describe people.
• Familiarize yourself with the literature on racial/ethnic health inequities in your field.

On the interpersonal level:

• Be an active bystander/ally.
  • Focus on calling out the specific behavior
  • Diffuse the situation.
  • Discuss the situation with a group leader.
  • Mentor and be a sponsor.
• Treat patients with a health equity lens.  
  • Recognize the need to build trust.
    • Spend quality time (ask more or different questions, encourage dialogue, ask for feedback).
    • Avoid coming across as in a rush or impatient.
  • Meet patients where they are.
  • Learn more about different sub-groups and ask; don’t assume.

On the organizational level:

• Revisit and establish guidelines around work culture.
• Establish protocols to address discrimination in the work setting and accountability structures.
• Value and encourage research on health equity.
• Integrate health equity into training programs and CME.
• Establish or enhance partnerships with community organizations.
• Examine for inequities in the data.

Editor’s Note: To view the full recording of the webinar, "Building Antiracist Policies and Practices into Health Care Settings," visit the CareQuest Institute webinar library.