Roadmap for Anti-Racism in Health Care and the Health Sciences
The health of populations of color has been strongly impacted by racism in ways that are multidimensional. Black and other communities of color have higher death rates, shorter life spans, poorer outcomes from common diseases, inadequate access to health care services, and discrimination-based differences in quality of care. For persons of color, health disadvantage appears at early ages and persists across their lifespans. These differences are found at every level of income and education; thus, for citizens of color, education and income do not diminish the health impact of racism.
Columbia University Irving Medical Center (CUIMC) has a longstanding commitment to diversity in the health sciences and to principles of equity, inclusion and excellence in health care. However, the COVID-19 pandemic, with its horrific burden of illness and death concentrated in communities of color, concomitant with ongoing, highly visible brutality directed toward Black citizens, has catalyzed a more nuanced understanding of diversity. It is very clear that promotion of diversity or even the presence of diversity is insufficient to counter deeply embedded anti-Black racism. Unfortunately, anti-Black racism has continued from the birth of our nation to the present, and it continues to drive social injustice, as well as inequities in health and well-being for communities of color. Furthermore, it is a highly permissive roadmap for other expressions of racism, intolerance and discrimination directed well beyond the Black community.
CUIMC has the potential to shape every aspect of health by research that spans molecular mechanisms to population health, by innovative education, and by providing extraordinary health care options to patients and populations. Our self-reflection and actions at this time must be focused on the elimination of racism in all aspects of our work. We need to rethink how we eliminate disparities in health outcomes, to consider whether current health care educational paradigms adequately disseminate anti-racism and to assess how to broaden our research to discover and implement solutions to health inequities.
To that end, in early July 2020, the four CUIMC deans, after initial meetings and reflection, appointed a large, CUIMC-wide, broadly representative Task Force to consider ways to assess and eliminate racism from all aspects of our work. The Task Force was charged with identifying and making recommendations to reduce the impact of racism in six important health-related domains. Recommendations were to be specific, actionable, durable and with measurable anti-racist outcomes in the themes listed below:
- Faculty recruitment, retention, advancement and leadership
- Education, training and curricular change
- Health care disparities, social justice and solutions research
- Clinical care
- Community and public service
- Civility and professionalism
Drs. Rafael A. Lantigua, Anne L. Taylor, and Olajide A. Williams co-chaired the Task Force of more than 100 individuals. The Task Force worked through the months of July, August and September, delivering a preliminary report, as a prelude to feedback and finalization from our leadership and constituencies. The overall recommendations noted here provide a compelling foundation for us to make substantial, impactful and durable progress. History has taught us that change is inevitable; history has also taught us that we must be champions of change.