Addressing and Dismantling the Legacy of Race and Racism in Academic Medicine: A Socioecological Framework.
Addressing and Dismantling the Legacy of Race and Racism in Academic Medicine: A Socioecological Framework.
复制标题
DOI：
10.3122/jabfm.2022.220050r2
复制
发表时间：
2022-12-23
影响因子：
2.9
通讯作者：
Rodriguez, Jose E.
中科院分区：
文献类型：
--
作者：
Edgoose, Jennifer Y. C.;Carvajal, Diana N.;Reavis, Kristin M. P.;Yogendran, Lashika;Echiverri, Angela T.;Rodriguez, Jose E.
在过去几年里，在临床和学术医学中，似乎越来越多的人一致认为，种族/民族健康不平等是由健康的社会、经济和政治决定因素造成的，而不是由不存在的种族生物标志造成的。简单地说，种族主义是不平等的根源，而不是种族。然而，教学和行医的方法并没有跟上这一真理的步伐，许多学习者和从业者继续推断种族的生物学基础。为了实现系统性变革，使我们走向种族/民族公平的健康结果，医学学术界必须实施明确要求我们负责的政策，以保持对种族作为一种社会政治结构的清晰理解，以便我们能够进行研究，传播学术工作，教学和临床实践更清楚地了解种族和种族主义。这篇简短的评论提议使用社会生态框架来帮助个人、领导团队和机构考虑实施人际、社区层面和广泛的机构政策变革的各种策略。这一拟议的模式包括如何在不同领域解决学术医学中的种族和种族主义问题的例子，但也提请注意这些层面之间复杂的相互作用。这一模式并不是指令性的，而是鼓励根据现有的体制差异进行调整。该模型可以作为一种工具，用于更新学术医学如何解决种族问题，更重要的是，在所有框架层面上使关于种族主义和公平的对话正常化。
Over the past several years, in both clinical and academic medicine, there seems to be a growing consensus that racial/ethnic health inequities result from social, economic and political determinants of health rather than from nonexistent biological markers of race. Simply put, racism is the root cause of inequity, not race. Yet, methods of teaching and practicing medicine have not kept pace with this truth, and many learners and practitioners continue to extrapolate a biological underpinning for race. To achieve systemic change that moves us toward racially/ethnically equitable health outcomes, it is imperative that medical academia implement policies that explicitly hold us accountable to maintain a clear understanding of race as a socio-political construct so that we can conduct research, disseminate scholarly work, teach, and practice clinically with more clarity about race and racism. This short commentary proposes the use of a socioecological framework to help individuals, leadership teams, and institutions consider the implementation of various strategies for interpersonal, community-level, and broad institutional policy changes. This proposed model includes examples of how to address race and racism in academic medicine across different spheres, but also draws attention to the complex interplay across these levels. The model is not intended to be prescriptive, but rather encourages adaptation according to existing institutional differences. This model can be used as a tool to refresh how academic medicine addresses race and, more importantly, normalizes conversations about racism and equity across all framework levels.