• Int J Equity Health · Oct 2020

    Letter

    Addressing the caste system in U.S. healthcare in the era of COVID-19.

    • Karthik Sivashanker, Cheri Couillard, Jennifer Goldsmith, Normella Walker, and Sunil Eappen.
    • Department of Quality and Safety, Brigham and Women's Hospital, Boston, USA. ksivashanker@bwh.harvard.edu.
    • Int J Equity Health. 2020 Oct 19; 19 (1): 184.

    AbstractIn healthcare, we find an industry that typifies the unique blend of racism, classism, and other forms of structural discrimination that comprise the U.S. caste system-the artificially-constructed and legally-reinforced social hierarchy for assigning worth and determining opportunity for individuals based on race, class, and other factors. Despite myths of meritocracy, healthcare is actually a casteocracy; and conversations about racism in healthcare largely occupy an echo chamber among the privileged upper caste of hospital professionals. To address racism in healthcare, we must consider the history that brought us here and understand how we effectively perpetuate an employee caste system within our own walls.

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