20+ resources for understanding the past, acknowledging the present, and building a more equitable future

Equity is a process and practice of awareness, understanding, acknowledgement, action, accountability, and repair. In health, as in other areas, building a more equitable future will require examining both past wrongs and current inequities; it will also mean designing new systems that help us pinpoint and correct structural failures. The Luminary Labs team has curated a selection of resources to help leaders and decision-makers understand the past, acknowledge the present, and plot a path forward.

Historical context and systemic underpinnings

• 20 years ago, a landmark report spotlighted systemic racism in medicine. Why has so little changed? and The nation hasn’t made much progress on health equity. These leaders forged ahead anyway (STAT). Decades ago, a National Academies report connected the dots between racial inequity, health disparities, and the need for a more diverse physician workforce. Usha Lee McFarling’s two-part report revisits the 2002 study and looks at what has happened since.
• Medical Racism Is Very Real, and It’s Time To End It (Teen Vogue). An op-ed by LaShyra “Lash” Nolen explores the persistence of medical racism and the need for an antiracist approach to medicine.
• The Complicated Legacy of E. O. Wilson (Scientific American). UCSF professor Dr. Monica R. McLemore explains the importance of reckoning with “the complicated legacies of scientists whose works are built on racist ideas and how these ideas came to define our understanding of the world.”

Current data, events, and ideas

• Medical Debt Is Crushing Black Americans, and Hospitals Aren’t Helping (Bloomberg Businessweek). The burden of America’s $140 billion in overdue medical bills is not evenly distributed: Census data show that more Black households have medical debt than white households.
• AI gone astray: How subtle shifts in patient data send popular algorithms reeling, undermining patient safety (STAT). A joint investigation with MIT found that “subtle shifts in data fed into popular health care algorithms — used to warn caregivers of impending medical crises — can cause their accuracy to plummet over time, raising the prospect AI could do more harm than good in many hospitals.”
• Maternal Deaths Rose During the First Year of the Pandemic (New York Times). The National Center for Health Statistics found that maternal mortality increased sharply in 2020, especially for Black and Hispanic women.
• Racial Inequities in COVID-19 Hospitalizations During the Omicron Wave in NYC (NYC Department of Health and Mental Hygiene). During the latest surge, the COVID-19 hospitalization rate was more than two times greater among Black New Yorkers than among white New Yorkers. Health Commissioner Dave A. Chokshi summarized the department’s analysis and its plan to address systemic inequity.
• Take a deep breath: Asthma drug study failed to include Black and Puerto Rican children who could benefit most (STAT). Children enrolled in clinical trials for Sanofi and Regeneron’s pediatric asthma drug were “almost entirely white, even though asthma disproportionately affects Black and Puerto Rican children.”
• Access UMass (TikTok). A University of Massachusetts chapter of the Campus Access Network, run by disabled students, is bringing visibility to accessibility issues. The group’s videos highlight how even when a school is ADA-compliant, it is still nearly impossible for disabled students to get around campus.

Opportunities and forward movement

• Dr. Camara Jones explains the Cliff of Good Health (Urban Institute). Dr. Jones, the past president of the American Public Health Association and one of the foremost scholars on health equity, outlines some of the drivers of good health and opportunities to reduce health inequities.
• On Racism: A New Standard For Publishing On Racial Health Inequities (Health Affairs). Equity work often begins in response to racism; particularly in the United States, it’s the foundation of many other “isms.” Dr. Rhea Boyd, Edwin Lindo, Dr. Lachelle Weeks, and Dr. Monica McLemore explain the need for a “racism not race” framing for conversations about health equity.
• Disability and Ableism in Medicine: A Curriculum for Medical Students (Association of American Medical Colleges). Introducing medical students to important topics — ”ableism, the social model of disability, disability history and culture, and health disparities” — can influence how they provide care to patients with disabilities.
• Pathways To Equitable And Antiracist Maternal Mental Health Care: Insights From Black Women Stakeholders (Health Affairs). Researchers from the National Birth Equity Collaborative spoke with 10 Black women who support Black birthing people. They found five key pathways to address racism and inequities — and highlighted the importance of listening to underrepresented stakeholders, who often already have ideas for how to solve systemic problems.
• Improving diversity in Alzheimer’s research can help update the ‘gold standard’ for all medical research (STAT). Health equity is both the right thing to do and the smart thing to do. Conducting Alzheimer’s research in a more diverse population “will give scientists better chances of identifying new markers that predict the disease earlier and developing targeted new approaches for treating everyone, not just some.”
• Academic research award: smart ideas with real-world impact (Financial Times). After discovering large-scale racial bias in algorithms used by insurers to predict healthcare needs, researchers at The University of Chicago Booth School of Business developed a free Algorithmic Bias Playbook — “a guide for C-suite leaders, technical teams, policymakers, and regulators on how to define, measure, and mitigate bias in live algorithms.”
• Get To Know The Future Med Student Whose Illustrations Of A Black Fetus Went Viral (Essence). Aspiring pediatric neurosurgeon Chidiebere Ibe gained widespread attention for his medical illustrations depicting Black patients, which prompted a conversation about the overwhelming whiteness of existing imagery.
• Narrative Medicine: A Model for Empathy, Reflection, Profession, and Trust (JAMA). Narrative competence, “the ability to acknowledge, absorb, interpret, and act on the stories and plights of others,” is an essential tool for medical practitioners who want to develop a stronger understanding of the patient experience and build more equitable health systems.
• Beyond Declarative Advocacy: Moving Organized Medicine And Policy Makers From Position Statements To Anti-Racist Praxis (Health Affairs). Dr. Aletha Maybank, the American Medical Association’s Chief Health Equity Officer, co-authored a case study on the AMA’s historical reckoning and its recent steps toward equity and justice.

Photo by Dom J