J Natl Med Assoc
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In these unprecedented times, Black medical professionals must deliver excellent medical care and uphold the highest standards of their profession while living through a devastating pandemic. They must do so in a time when the country tries to reconcile with generations of racism and injustice. The current social environment in America is particularly challenging for medical trainees such as medical students and resident physicians who must focus on their educational requirements and careers in settings that are often averse to addressing topics such as racism. This plight is not new for Black medical trainees, as they have been fighting for centuries to obtain an equitable seat at the table of medical education. Throughout the 19th century and early 20th century, Black physicians were repeatedly disenfranchised from the predominantly white medical societies, most notably the American Medical Association (AMA), which was established in 1847. Racially integrated medical organizations such as the National Medical Society of Washington D.C. (NMS), which was founded in 1870, were developed to challenge discriminatory practices of the American Medical Association against Black practitioners. The inception of the National Medical Association (NMA) in 1895 allowed Black doctors to advocate for disadvantaged patient populations and focus efforts on health issues pertinent to the underserved. ⋯ To improve these matriculation statistics, it is critical that institutions integrate innovative measures such as robust recruitment pipelines to expose underrepresented high school and college students to the medical field, as well as seek diversity actively in administration to dismantle the ingrained ideologies of systemic racism rooted in healthcare and medical education. To combat the institutionalized racism that has plagued medical education throughout its existence, collaboration as a unified front is essential to achieving the equity and social justice in healthcare that patients deserve.
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There has been a recent focus on the impact of race on health equity, which has revealed unsettling results. Multiple studies have shown that the underrepresentation of minorities in medical education such as course slides, pre-clinical lecture material, case studies, and textbooks impedes racial equity in the practice of medicine. ⋯ Unfortunately, these results suggest that there is an underlying implicit racial bias in published images from medical literature with an underrepresentation of minorities compared to the general population, which could also contribute to inequities in health care. It is critical that health care providers, educators, and trainees promote cultural competency and work to understand the multifaceted influence of race and culture on the daily experience of patients in the modern healthcare system. We hope this study will encourage authors to critically evaluate their medical images for implicit bias so that documented photography in scientific literature may better reflect the populations we serve.
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Outcome differences driven by variation in Blacks' biologic response to treatment may contribute to persistent racial disparities in asthma morbidity and mortality. This review assessed systematic variation in β2 agonist treatment outcomes among Blacks compared to other groups. ⋯ Evidence suggests the potential for differences in β2 agonist outcomes among Blacks compared with other groups. This literature, however, remains small and significantly underpowered for substantive conclusions. There are notable opportunities for adequately-powered investigations exploring safety and efficacy of β2 agonists among Blacks, including pharmacogenomic modifiers of response.
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The objective of the study was to examine racial/ethnic differences in medical expenditures (prescription, office-based, in-patient, out-patient, emergency room, total) over time, overall and by type of expenditure, in a nationally representative sample of adults with diabetes. ⋯ Minority groups with type 2 diabetes were found to have significantly less total expenditures, with the exception of total expenditures for NHB compared to NHW. These findings indicate minorities with type 2 diabetes may be receiving less care than NHW, which has implications for the known disparities in health outcomes and complications in individuals with diabetes.
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Medical students often have limited exposure to providing care to physically and cognitively disabled patients. To address this gap, Involvement with Disability Education and Advancement (IDEA) was started in 2015 at Rutgers New Jersey Medical School (NJMS). The organization provides NJMS students the opportunity to visit a school dedicated to disabled students and lead educational sessions on health topics. ⋯ IDEA members may have increased comfort interacting with cognitively impaired individuals due to their regular experience and lower levels of comfort providing medical attention to physically disabled patients due to awareness of complex problems specific to the population. The current results warrant continued data collection and further evaluation.