On Racism: A New Standard For Publishing On Racial Health Inequities

Edwin Lindo, JD, is a critical race theory scholar and educator who is faculty within the Department of Family Medicine at the University of Washington School of Medicine; and associate director for equity and critical teaching in the Center for Leadership and Innovation in Medical Education.

"In short, racism kills. Whether through force, deprivation, or discrimination, it is a fundamental cause of disease and the strange but familiar root of racial health inequities.  Yet, despite racism’s alarming impact on health and the wealth of scholarship that outlines its ill effects, preeminent scholars and the journals that publish them, including Health Affairs, routinely fail to interrogate racism as a critical driver of racial health inequities." Read more in Health Affairs

Letters to the Editor

We strive to share diverse opinions of our members, who this year alone, have been lending physician voices to the New York Times, Seattle Times, and Crosscut, among other outlets. We are also welcoming feedback and opinions for publication to our general readership. All published comments are with the express consent of the authors.  

In response to Dueling Pandemics by Dr. Rajneet Lamba, KCMS President's Column:
Greetings Dr. Lamba,
I am glad to read of your resolve to hone your analytical skills.  There may be room for this, as shown by your conflation of susceptibility to epidemic respiratory disease with racism.  There is nothing new in the vulnerability of an underclass to epidemic disease.  On this subject I recommend Rats, Lice, and History, by Hans Zinsser MD.  This was written in the 1930s, before "structural racism" became fashionable.  And in America today, the medically vulnerable underclass is stratified by behavior, and is certainly not monochromatic. 

Would it not instead be logical to assert that in any era, to maximize successful outcomes, an underclass is primarily responsible for its own cultural self-improvement?

Best regards, Kent Saltonstall MD, KCMS member since 1978. 
Thanks for reading Ken. Racism, including it's structural form, was quite “fashionable” in the 1930s and continues to drive health inequality.  Similar power structures can increase or decrease inequality in areas other than race.  I am surprised that someone with your experience at the city council level would write off the importance of policy in shaping our society.  
I appreciated the letter from Raj Lamba and hope that the King County Medical Society, and many physician organizations around the country will join the global Sustainable Health Equity Movement thttps://www.sustainablehealthequity.org/ that would create a task force within the WHO that would monitor and enforce global equity in access to and distribution of medications, vaccines and supplies related to our current pandemic.   

Yours,   Elinor A. Graham MD, MPH, Associate Professor Emeritus, U. of WA
Dear Dr. Graham,

Thank you for your letter to King County Medical Society. Our medical society welcomes opportunities for its physician membership to advance for equity in healthcare for the public. As a medical society, we aim to strongly support international, national, and local efforts by clinicians and researchers to promote best scientific information for the public. As such, we are certainly interested in learning more about the Movement for Sustainable Health Equity. We appreciate the goal of the doctors with clinical, epidemiological and health policy experience around the world who have highlighted worsening structural health and socioeconomic inequities between regions and countries that are now worsening in the midst of the COVID-19 pandemic. 

I am deeply concerned by the decision on July 8, 2020 of the Trump administration to notify both the U.S. Congress and the United Nations that the United States will formally withdraw from the World Health Organization. This decision appears to have been taken against the medical advice of the president's own health advisors and certainly raises concerns about the ability of our nation to coordinate worldwide efforts to combat the pandemic. We welcome comments and thoughts on how we as a medical society can show our support for the work of the World Health Organization. (Here's a link to our vaccine equity article on KevinMD.com)

Amish J. Dave, MD, MPH
Chair, KCMS Public Health Committee

As A Doctor, Some Words Of Advice About Self-Quarantine

Thomas Green, MD

"I will start off by acknowledging that I am a very social person. This medical/social experiment of self-quarantine in order to flatten the curve of new cases of COVID-19 has been very difficult for me. It has made me consider and value my relationships with others and think about new ways to use my time while quarantined. I am learning to adjust my day to prevent boredom and social isolation..." Read more below. 
Words of Advice About Self-Quarantine

Washington DOH shares COVID-19 Morbidity and Mortality by Race, Ethnicity and Language

July 2, 2020
"Data show that communities of color are disproportionately impacted by COVID-19 in significant ways. For cases, Native Hawaiian or Other Pacific Islander people (NHOPI) and Hispanic people have age-adjusted rates nine times higher relative to White peoples. Hospitalizations are seven times higher for Hispanics and ten times higher for Native Hawaiian or Other Pacific Islanders relative to Whites. Blacks and American Indian or Alaska Native (AIAN) case and hospitalization rates are three times higher than those of Whites.  . Among COVID-19 deaths, we see a similar trend although not as extreme."
These racial health disparities should be considered in the context of racism and its impact on the social determinants of health, with attention to structural racism. There has been no biological evidence identified for racial disparities in COVID-19.
Department of Health Data

Physician Feedback for Summer Interns

This summer, King County Medical Society has taken on a great group of interns who have been researching the death investigation system in Washington state, prostate cancer and racial inequity, and homelessness. Our interns have prepared a few questions on their topics that they would like to ask physicians. Please take a few minutes to fill out this survey and provide our interns with your experiences and perspectives on these issues. 
Physician Feedback Survey

Practical Advice for Countering Patient Misinformation on Vaccines

JAMA - Practical Advice for Vaccines
Together, tackle pertinent issues such as: 

1) The impact of gender, race and socioeconomic status on healthcare disparities - Dr. Irene Blanco
2) Inclusiveness in clinical research, the obstacles and solutions - Dr. Ashira Blazer 
3) The physician as a pupil, patient, provider, and a person - Panel Discussion
4) How can we create a path to inclusivity? – Dr. Priya Reddy

Saturday, July 18, 2020  9:00 am - 2:00 pm PST  (attendance is free; registration is required)
Registration for Disparities in Healthcare Under the Spotlight of COVID-19

Racial Disparities, Covid-19 and Cancer

A roundtable with the American Cancer Society
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