You will find here links to scholarly articles and videos for healthcare providers and professionals.
While geared towards members of the healthcare field, access to this information for everyone is important. They will help you better understand the systemic causes of health inequities, and tenets of cultural humility which improves health outcomes when practiced by people at levels of healthcare.
By Melanie Tervalon, MD, MPH, Jann Murray-García, MD, MPH
Abstract
Researchers and program developers in medical education presently face the challenge of implementing and evaluating curricula that teach medical students and house staff how to effectively and respectfully deliver health care to the increasingly diverse populations of the
United States. Inherent in this challenge is clearly defining educational and training outcomes consistent with this imperative. The traditional notion of competence in clinical training as a detached mastery of a theoretically finite body of knowledge may not be appropriate for this area of physician education. Cultural humility is proposed as a more suitable goal in multicultural medical education. Cultural humility incorporates a lifelong commitment to self-evaluation and self-critique, to redressing the power imbalances in the patient-physician dynamic, and to developing mutually beneficial and nonpaternalistic clinical and advocacy partnerships with communities on behalf of individuals and defined populations.
Video: Cultural Humility: People, Principles, and Practices
“Cultural Humility: People, Principles and Practices,” is a new 30-minute documentary by Vivian Chávez with Melanie Tervalon and Jann Murray-García, that mixes poetry with music, interviews, archival footage, images of community, nature and dance to explain what is “Cultural Humility” and why we need it.
By Daniel Solchanyka, Odera Ekeha, Lise Saffranb, Inger E. Burnett-Zeiglerc and Ashti Doobay-Persauda
Abstract
Issue: The framework of cultural humility, which emphasizes curiosity and self-reflection over
mastery, was identified over 20 years ago as a way to address implicit bias in health care, an important factor in health disparities. Despite growing interest from researchers and educators, as well as the urgent call to adopt these values, the foundational elements of cultural humility remain challenging to teach in medical education and have not yet been widely adopted. Evidence: Health disparities persist throughout the United States among a growing population of diverse patients. The cultural humility framework undermines power imbalances by encouraging the clinician to view their patient as an expert of their own experience. This approach strengthens relationships within the community, illuminates racial and historical injustices, and contributes to equitable care. However, recent reviews have shown that humility-based principles have yet to be widely integrated into cultural curricula. Based on available evidence, this article introduces the foundational concepts of cultural humility with the aim of helping medical educators better understand and implement the principles of cultural humility into undergraduate medical education. Implications: Cultural humility is a powerful and feasible adjunct to help student physicians cultivate effective tools to provide the best patient
care possible to an increasingly diverse patient population. However, there is little known about how best to implement the principles of cultural humility into existing undergraduate medical education curricula. The analyses and strategies presented provide educators with the background, instructional and curricular methods to enable learners to cultivate cultural humility. Future systematic research will need to focus on investigating design, implementation and impact.
By Ruqaiijah Yearby, Brietta Clark, and José F. Figueroa
Abstract
The COVID-19 pandemic has illuminated and amplified the harsh reality of health inequities experienced by racial and ethnic minority groups in the United States. Members of these groups have disproportionately been infected and died from COVID-19, yet they still lack equitable access to treatment and vaccines. Lack of equitable access to high-quality health care is in large part a result of structural racism in US health care policy, which structures the health care system to advantage the White population and disadvantage racial and ethnic minority populations. This article provides historical context and a detailed account of modern structural racism in health care policy, highlighting its role in health care coverage, financing, and quality.
By Rachel Zellars
In her new award-winning book, Medical Bondage: Race, Gender, and the Origins of American Gynecology, historian Deirdre Cooper Owens describes the experimental work of early American gynecologists, including Dr. James Marion Sims, “the father of modern gynecology.” Beginning in 1844, Sims famously performed his experiments on enslaved women in Alabama, including Anarcha, Lucy, and Betsy, who he leased for the purpose of gynecological experimentation. Repeatedly performing his crude experiments without any form of anesthesia as he attempted to be the first to repair vesico-vaginal fistulae, Owens writes that, “After five years of medical experimentation, Sims performed his thirtieth surgery on Anarcha and successfully repaired her fistula” (38). “Thanks in large part to his experimentation on enslaved black women,” she adds, “Sims had established himself as one of the country’s preeminent gynecological surgeons less than a decade after he began his gynecological career” (39). Due to these experimental procedures on enslaved Black women and the subsequent rapid advancements in the field of gynecology, Sims eventually served as the president of the American Medical Association in 1875 and the American Gynecological Society in 1879.
By Leonard E. Egede, MD MS, Rebekah J. Walker, PhD,Jennifer A. Campbell, PhD, MPH, Sebastian Linde, PhD, Laura C. Hawks, MD, MPH, and Kaylin M. Burgess, MA
Abstract
There is emerging evidence that structural racism is a major contributor to poor health outcomes for ethnic minorities. Structural racism captures upstream historic racist events (such as slavery, black code, and Jim Crow laws) and more recent state-sanctioned racist laws in the form of redlining. Redlining refers to the practice of systematically denying various services (e.g., credit access) to residents of specifc neighborhoods, often based on race/ethnicity and primarily within urban communities. Historical redlining is linked to increased risk of diabetes, hypertension, and early mortality due to heart disease with evidence suggesting it impacts health through suppressing economic opportunity and human capital, or the knowledge, skills, and value one contributes to society. Addressing structural racism has been a rallying call for change in recent years—drawing attention to the racialized impact of historical policies in the USA. Unfortunately, the enormous scope of work has also left people feeling incapable of efecting the very change they seek. This paper highlights a path forward by briefy discussing the origins of historical redlining, highlighting the modernday consequences both on health and at the societal level, and suggest promising initiatives to address the impact.
Felicia Hill-Briggs,corresponding author, Patti L. Ephraim, Elizabeth A. Vrany, Karina W. Davidson, Renee Pekmezaris, Debbie Salas-Lopez, Catherine M. Alfano, and Tiffany L. Gary-Webb
Abstract
Purpose of Review
To summarize evidence of impact of social determinants of health (SDOH) on diabetes risk, morbidity, and mortality and to illustrate this impact in a population context.
Recent Findings Key fndings from the American Diabetes Association’s scientifc review of fve SDOH domains (socioeconomic status, neighborhood and physical environment, food environment, health care, social context) are highlighted. Population-based data on Black/African American adults illustrate persisting diabetes disparities and inequities in the SDOH conditions in which this population is born, grows, lives, and ages, with historical contributors. SDOH recommendations from US national committees largely address a health sector response, including health professional education, SDOH measurement, and patient referral to services for social needs. Fewer recommendations address solutions for systemic racism and socioeconomic discrimination as root causes.
Summary
SDOH are systemic, population-based, cyclical, and intergenerational, requiring extension beyond health care solutions to multi-sector and multi-policy approaches to achieve future population health improvement.
By David R. Williams (Public health sociologist)
Why does race matter so profoundly for health? David R. Williams developed a scale (The Everyday Discrimination Scale) to measure the impact of discrimination on well-being, going beyond traditional measures like income and education to reveal how factors like implicit bias, residential segregation and negative stereotypes create and sustain inequality. In this eye-opening talk, Williams presents evidence for how racism is producing a rigged system — and offers hopeful examples of programs across the US that are working to dismantle discrimination.
By Mark Rastetter, MD
Scientific evidence shows that significant disparities in health and in health care are based on socioeconomic factors of an individual’s life.
We call these factors — the conditions in which people are born, grow, live, work and age — the “social determinants of health.” They account for as much as 80% of a person’s health outcomes.
Comparisons of cultural value systems are not meant to stereotype individuals or cultures; rather, they are meant to provide generalizations, observations about a group of people, from which we can discuss cultural difference and likely areas of miscommunication.
Adapted from Elliott, C. E. (1999)
Cross-Cultural Communication Styles, pre-publication Masters thesis