Academic Medical Centers Urged To Establish Framework To Tackle Structural Racism

COLUMBUS, Ohio – Racially-charged police brutality in the United States, and the ensuing protests, have catalyzed a global call to end structural racism. Academic medical centers have a unique opportunity to lead the way in addressing this social determinant of health that leads to poor health outcomes for patients and hostile environments for faculty, learners and staff of color.

In the paper, “How academia should respond to racism,” published in Nature Reviews Gastroenterology and Hepatology, faculty and staff at The Ohio State University College of Medicine and The Ohio State University Wexner Medical Center propose a framework that academic medical centers can use to combat racism. It focuses on reforms in education and engagement, funding, policies and practices.

“The time is now for academic medical centers to cultivate and sustain healthier environments for their patients, staff, faculty and learners by approaching all facets of these vital anchor institutions with an anti-racist lens,” said Dr. Darrell Gray II, lead author, associate professor in the College of Medicine and chair of the Health Equity Steering Committee at The Ohio State Wexner Medical Center. “This includes policies and practices for recruitment, education, training, grading, retention, promotion, funding, and community and vendor partnerships.”

The framework suggests academic medical centers adopt and implement key practices across multiple domains such as:

  • Recruitment and retention: Examine and improve recruitment, hiring, promotion and retention processes across the institution with an end goal of greater inclusiveness. Institute term limits on leadership positions to provide opportunities for advancement. Mentor and equip diverse faculty for leadership roles.
  • ‘Stop the line’ for racism: Like the safety and quality practices in manufacturing and health care where anyone who notices a problem can speak up and halt a process until it is corrected, academic medical centers need to adopt and incentivize a stop the line for racism culture in which patients, students, trainees, staff and faculty are empowered to identify and work towards ending racist behavior, policies and practices.
  • Community advisory council: Form and utilize a local community advisory council to review institutional health equity initiatives, advise senior leadership on anti-racism strategies and provide feedback. This council should include residents from the local community in which the academic medical center is anchored and those from racial or ethnic minority groups.

“The effect and reach of academic medical center initiatives to combat structural racism and discrimination are dependent on a sustained financial commitment that is substantial enough to support clinical, education and research goals around anti-racism action,” said co-author Dr. J. Nwando Olayiwola, chair and professor of the Department of Family and Community Medicine. “Anti-racism initiatives can reduce costs and increase value-based care model incentives by improving care and addressing analytical bias.”

Additionally, it is important for all stakeholders at academic medical centers to ‘center at the margins’ in recalibrating their focus in clinical care and research to include the viewpoints of, and engagement with, those in marginalized groups. This approach includes supporting and incentivizing community-based research and engagement in the promotion and tenure process.

“At Ohio State, we denounce racism of all forms as it is damaging to our community, patients, faculty, staff and students,” said Dr. Hal Paz, executive vice president and chancellor for Health Affairs at The Ohio State University and CEO of the Ohio State Wexner Medical Center. “This is a defining moment and only when we directly address the real issues of racism will we be able to develop sustainable solutions to transform the health of our communities and truly support students, staff and faculty in doing so.”

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