Problem: Dismantling structural racism is essential to achieving health equity, but there is little guidance for medical educators who wish to teach learners to recognize and confront structural racism.
Approach: Critical consciousness provides a framework to identify and dismantle structural racism. Using a critical consciousness approach, the authors developed a novel 5-day travel experience to the American South for medical residents and faculty to explore the history and legacy of structural racism and the Civil Rights Movement. The purpose of the travel was to examine the connection between structural racism, especially anti-Black racism, and health disparities to better address health inequities within the participants' own home environment. Throughout the trip, faculty leaders applied principles of cultural humility and techniques from critical pedagogy, including recognizing the value of everyone in the room, creating cognitive disequilibrium, and promoting authentic dialogue.
Outcomes: End-of-week surveys revealed that the trip was well received. Organizers learned important lessons related to faculty and resident dynamics, race-based affinity group meetings, and the respectful use of stories as a tool for learning. Post-trip surveys at 1, 6, and 12 months revealed 3 major themes: participants experienced (1) transformed understanding of systemic racism, (2) increased motivation and bravery to act when witnessing interpersonal and structural racism, and (3) increased practice of cultural humility.
Next Steps: Cultural humility and critical pedagogy can be used with travel to support learners in recognizing and confronting structural racism. The application of such techniques should be explored in local learning environments to foster commitment and action toward dismantling structural racism. In teaching structural racism, medical educators must be willing to consider new ways of teaching and learning.
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http://dx.doi.org/10.1097/ACM.0000000000004126 | DOI Listing |
Can J Nurs Res
January 2025
School of Nursing, Toronto Metropolitan University, Toronto, ON, Canada.
Although race is socially constructed, racism and racialization are social determinants of health. Over four centuries of colonial genocide and structural violence against Indigenous and Black peoples in Canada have resulted in intergeneration traumas and health disparities among Indigenous and Black people, sustained by ongoing social, political, and economic inequities. Evidence indicates the impact of contemporary and historical forms of racism on health outcomes.
View Article and Find Full Text PDFAm J Prev Med
January 2025
The Ubuntu Center on Racism, Global Movements, and Population Health Equity, Drexel University Dornsife School of Public Health, Philadelphia, Pennsylvania.
Introduction Cash bail reforms that end pretrial detention due to the inability to afford bail have been highly debated across the US. A major concern cited by bail reform opponents is that reducing pretrial detention will increase community violence, particularly violence against women. The objective of this study was to assess if New Jersey's cash bail reform was associated with changes in rates of fatal violence against women.
View Article and Find Full Text PDFHosp Pediatr
January 2025
Department of Pediatrics, New York-Presbyterian Morgan Stanley Children's Hospital/Columbia University Irving Medical Center, New York, New York.
Noah, an 18-month-old infant with trisomy 21, was brought to the emergency department for adenovirus bronchiolitis. He was found to meet criteria for severe malnutrition, and his medical team called Child Protective Services (CPS) with concern for neglect. He remained hospitalized for 1 month while a safe discharge was coordinated by the medical and CPS teams.
View Article and Find Full Text PDFAnnu Rev Public Health
January 2025
3Department of Sociology, Florida State University, Tallahassee, Florida, USA.
This article provides a guide for rigorous, theory-driven measurement approaches, proposing best practices for the scientific study of systemic racism in health research. We argue that the analytical crux of measuring systemic racism-a complex, interconnected, and dynamic system-lies in operationalizing the collective logics, properties, and mechanisms that undergird racial inequities. Misalignment between measurement tools and these foundational features undermines research validity, as incongruent measures distort findings and obscure systemic racism's true impacts.
View Article and Find Full Text PDFBackground: Formerly incarcerated individuals (FIIs) encounter difficulties with covering the cost of dental and medical care, adhering to medication regimens, and receiving fair treatment from health care providers. Yet, no published research has examined modifiable pathways to increase FIIs' health literacy (HL), which is essential for addressing the health needs of this vulnerable population.
Objective: The aim of this article is to examine neighborhood characteristics (neighborhood deprivation, racial and economic polarization, and residential segregation) and public assistance program enrollment as structural determinants of limited health literacy (LHL) among FIIs.
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