“I often heard as a child that Mexicans were lazy and dirty. As a Mexican-American, I did not wear shorts for years because I thought my knees looked dirty. Now I fully embrace my identity. However, as a medical student, I still feel the pressure to disprove these stereotypes.” -- Camila Hurtado, JMP2 at UCSF-UC Berkeley Joint Medical Program
“Growing up in the barrio my white classmates would tease and bully the brown Latino kids constantly. I was called a wet-back, brownie and illegal alien. I was scared, stressed, and worried I would get bullied if I spoke up. Now as a medical student, I am determined to speak up for myself and my community” --Yesenia Salazar, OMS2 at A.T. Still University School of Osteopathic Medicine in Arizona
The recent events inciting conversations around racism have provoked familiar memories for the Latinx community. We first witnessed the disproportionate amount of Black and brown communities affected by COVID-19 at outstandingly high rates, which was then compounded by the deaths of Black people due to police brutality. As medical professionals, we have a duty to provide equal treatment to all. As Latinx medical students, it is imperative to advocate for the health of all people of color, especially our fellow Black and brown brothers and sisters. To do so, we must address the center of the issue: systemic racism in medicine.
Discriminatory practices based on race are widely recognized to be unethical and unconstitutional. However, subtle racism operates at various levels within systems such as housing, healthcare, and employment that ultimately affects the health of marginalized communities. Healthcare is not exempt from such systems, and in fact, has a long history of perpetuating these oppressive systems.
In healthcare, one example of how racism is perpetuated is through race-based science. Race and individual behavioral practices are often used to explain worse health outcomes among communities of color. For instance, doctors routinely interpret GFR based on the assumption that Black Americans have more muscle mass despite a lack of evidence. The GFR algorithm disproportionally affects and contributes to more severe rates of GFR decline and End Stage Renal Disease (ESRD) mortality in Black Americans. In turn, Black Americans lack timely dialysis treatment and are systematically prioritized to a lesser degree for a kidney transplant than white Americans.
In addition to the racism seen in race-based science, systemic racism continues to be the root of the social determinants of health. For example, the Black, Indigenous, and people of color (BIPOC) more frequently experience the effects of not having easy access to healthcare, not having stable housing, living in food deserts, and language barriers. All of these social constructs are preventable and often lead to disproportionate health outcomes in our communities.
As a medical community, we must declare racism as a public health crisis. We must use a holistic lens that acknowledges racist principles underpinning our medical community and
moves forward in creating a new anti-racist system that addresses the social determinants of health in our communities. We encourage our medical community to:
Study the medical community’s exploitative history of people of color to recognize the failings of our system, reflect on our current practices, and change our policies to prevent further harm.
Incorporate an antiracist framework into medical curriculum led by qualified experts in the field to teach that racism, not race, leads to disproportionate health outcomes.
Create a new system for academic medicine by investing in:
(a) research focusing on interventions to address racism on a systemic level
(b) underrepresented medical and premedical students
(c) the hiring and promoting of faculty of color
Antiracism requires action-oriented work and calls us to ask, how will we work to become antiracist? How will we change our institutional culture and systems to become antiracist? As Latina medical students, we have seen and experienced racism in many aspects of society and have felt the need to change our institutional culture. If we act now, we will foster physician leaders adequately equipped to address health disparities. We are calling on other Latinx people, other non-Black people, and allies in medicine to go beyond these protests and commit to the journey of anti-racism and health equity for all.
About the authors:
Yesenia Salazar is a third year Osteopathic Medical Student at A.T. Still University School of Osteopathic Medicine in Arizona (ATSU-SOMA). She holds the position of Health Policy Co-Chair for LMSA National. In 2019, she reactivated the LMSA chapter on her campus ATSU-SOMA. Since then, Yesenia has been actively involved in health policy and advocacy by contributing to different advocacy projects on a regional and national level such as Street Medicine, Voting & Health, and Reproductive Rights. She has represented the Latinx community by publishing an opinion piece on systemic racism, encouraging LMSA to support policies that disseminate race in medicine, participating in resolution writing, and organizing educational workshops. Yesenia is interested in Internal Medicine and Family Medicine. On her free time, she likes to go hiking, spend time with family, travel and explore new areas.
Camila Hurtado, MS is a medical and graduate student of the UCSF-UC Berkeley Joint Medical Program and PRIME-US program. She works with the California Initiative for Health Equity & Action (Cal-IHEA) to develop policy solutions to improve insulin affordability for low-income populations across California. Camila also serves as the National Policy Chair of the Latino Medical Student Association and is a founding member and grant writer of the White Coats for Black Lives chapter at UC Berkeley. She became dedicated to working towards equity through health administration and policy after working at a Federally Qualified Health Center and earning an MS from UCSF in Global Health Sciences. Her interests include addressing structural racism and its subsequent social determinants of health through medicine, health administration, and health policy. Camila’s motivations and values stem from her Mexican-American family in Southern California.