As the University of Minnesota Medical School grapples with the aftermath of a current fourth year student defacing the George Floyd memorial square, it is clear that medical and public health institutions must look to move beyond their public statements condemning racism and police brutality; they must look inward and examine the values underlying their own institutional policies and practices. Objectivity, paternalism and power hoarding are insidious elements that underlie current policies and practices within healthcare systems in Minnesota and elsewhere. With the addition of the COVID-19 pandemic, Black, Indigenous and people of color (BIPOC) need now more than ever anti-racist and equitable responses to close longstanding racial and ethnic gaps in health outcomes.
Objectivity
Rather than encouraging clinicians and physicians to embrace their unique cultural perspectives, the legacies of white supremacy – specifically the myth of objectivity in academic culture promotes the suppression of personal experiences and emotion. Dr. Kafui Dzirasa described the “emotional and intellectual toll” of objectivity on black scientists.This makes discussing microaggressions and structural racism that BIPOC people experience difficult. In response to the death of George Floyd, University of Minnesota Black alumni created an Instagram page for BIPOC students to anonymously express their experiences of marginalization. Healthcare Institutions must also create space within their departmental cultures to actively listen to the full experiences of BIPOC community members.
Paternalism and Power Hoarding
Before and after the Black Lives Matter movement was accepted in dominant culture, it was easy to observe the traditions of paternalism and power hoarding in COVID-19 community responses. Rather than establishing funds directly for minority serving organizations or increasing mobile testing to improve access within their neighborhoods, institutions have created programming that has failed BIPOC communities due continuing the legacies of white supremacy. There are several community-driven efforts that healthcare institutions may wish to draw upon and model their efforts in fighting the COVID-19 pandemic. Mask Up North Minneapolis, a community led effort, has distributed 10,000 masks in North Minneapolis. Progressive Street Baptist Church and M Health Fairview have partnered to increase COVID-19 testing. Both of these initiatives demonstrate the wealth of expertise and knowledge within BIPOC communities that is underutilized or worst ignored. Institutions must be willing to share resources and power with these groups to effectively address COVID-19 racial/ethnic disparities.
What else can healthcare institutions do?
In response to the demands of the Minnesota Doctors for Health Equity, the Minnesota House recently passed legislation to declare racism a public health crisis. As they pledge to apply a racial equity lens to their practice, medical and public health institutions must also make this commitment. Such a commitment is an important first step in changing current policies and practices embedded in white supremacy. These are the reparations that racial/ethnic minorities deserve now.
This letter to the editor has been lightly edited for style and clarity.
This letter was submitted by Dominique Earland, a student at the University of Minnesota Medical School.
