Resolution: F-20-16: AMENDMENT TO H409-A/16

[Valerie Lile]

1  WHEREAS, the SOMA policy S-19-23 addresses lobbying to COCA to incorporate a more
2  specific and robust set of accreditation standards on diversity including enacting outreach and
3  recruitment efforts for underrepresented minority (URM) students and faculty as well as
4  integrating training programs in cultural humility and bias awareness for students, faculty and
5  staff; and
6  WHEREAS, medical racism is defined as prejudice and discrimination in the healthcare system
7  due to race¹ resulting in pervasive racial health disparities that harm Black, Indigenous, and People
8  of Color (BIPOC) in medical practices;² and implicit bias refers to the attitudes or stereotypes that
9  affect our understanding, actions, and decision in an unconscious manner and implicit biases have
10  been shown to contribute to BIPOC-related health disparities³; and
11  WHEREAS, health disparities have complicated roots, including White privilege, Eurocentrism,
12  medically inaccurate beliefs, explicit racism, lack of access to insurance and care, mistrust of the
13  medical system, socially sanctioned, implicitly racist ideology, and unconscious biases held by
14  doctors. Evidence-based anti-racism education early in physicians’ training is vital to improving
15  these disparities ^4,5,6,7; and
16  WHEREAS, physicians of all ethnic groups showed an implicit preference for white people
17  (even when explicit bias was denied) except for Black physicians who did not show any racial
18  preference and have better outcomes when treating black patients. Physicians with higher pro-
19  white bias have worse perceptions of their Black patients, deliver lower quality care, and make
20  medical decisions that adversely affect Black patients^5,6,7,8; and
21  WHEREAS, Black men have been shown to have better health outcomes when treated by a
22  physician of their own race, thereby underscoring the importance of educating a diverse cohort of
23  future physicians to serve marginalized and underrepresented communities⁸; and
24

25  WHEREAS, the American Heart Association recognizes that “Hospital administrators should
26  ensure that the physicians and providers caring for patients are well trained, culturally
27  competent, and adequately equipped. The current lack of diversity among staff should be
28  considered as a marker of hospital quality that must be recognized, measured, and tracked until
29  improvements are made.” This underscores the importance of anti-racism training in medical
30  education as well as the need for increasing diversity among medical students⁹; and
31  WHEREAS, the Journal of Academic Medicine recognizes the current gap in, and need for,
32  appropriate faculty training on anti-racism and health inequities in Academic Health Centers to
33  effectively deliver anti-racism education to medical trainees. Such training should include “how
34  to conduct interracial dialogues on race, racism, oppression, and the invisibility of privilege”¹⁰;
35  and
36  WHEREAS, anti-racism educational interventions are effective in changing attitudes about
37  racism and health inequities among health clinicians^4,7,11,12. Institutions recognize the need for
1  increased diversity and the implementation of anti-racist medical curricula, and the allocation of
2  faculty training resources for effective curriculum delivery^9,10,13; and
3  WHEREAS, resolution H409-A/16 is due for sunset in 2021; now, therefore be it
4  RESOLVED that SOMA and the AOA support the pursuit of medical careers among Black,
5  Indigenous, and People of Color (BIPOC) students through the use of pipeline
6  programs, scholarships, academic counseling, science intensive pre-medical preparatory
7  programs, and other appropriate interventions targeting underrepresented minority and
8  disadvantaged students at any level of academic education, to help increase ethnic minority
9  physicians in medically underserved areas; and, be it further
10  RESOLVED, that SOMA recommend that the following policy, H409-A/16 MINORITY
11  HEALTH AND OSTEOPATHIC MEDICAL EDUCATION, be REAFFIRMED as AMENDED.
12  (Old language is crossed out and new language is in CAPS)
13  H409-A/16 MINORITY HEALTH AND OSTEOPATHIC MEDICAL EDUCATION
14  The American Osteopathic Association encourages the development of internal programs THAT
15  INCREASE ANTI-RACISM AND IMPLICIT BIAS EDUCATION to address the
16  disproportionate incidence of preventable diseases in minority populations, the lack of proper
17  medical treatment for such diseases, the pervasive lack of quality healthcare in minority
18  communities, and the under representation of minority populations in osteopathic medicine; and
19  will work with the American Association of Colleges of Osteopathic Medicine (AACOM), and
20  towards eliminating such disparities within its osteopathic medical educational processes, and
21  collaborate with federal/state governments, academia, and the healthcare industry to develop
22  programs to eliminate medical and academic disparities between minority and non-minority
23  groups in the US, INCLUDING BUT NOT LIMITED TO PIPELINE
24  PROGRAMS, SCHOLARSHIPS, ACADEMIC COUNSELING, SCIENCE INTENSIVE PRE-
25  MEDICAL PREPARATORY PROGRAMS, AND OTHER APPROPRIATE
26  INTERVENTIONS TARGETING UNDERREPRESENTED MINORITY AND
27  DISADVANTAGED STUDENTS AT ANY LEVEL OF ACADEMIC EDUCATION, TO
28  HELP INCREASE ETHNIC MINORITY PHYSICIANS IN MEDICALLY UNDERSERVED
29  AREAS. 1996; 2001; modified and reaffirmed 2006; reaffirmed 2011; 2016

Relevant Existing Policies:

SOMA Policy: S-19-23

AOA Policy: H429-A/14, H409-A/16

References

1. .” Encyclopedia of Race and Racism. Encyclopedia.com. 11 Aug. 2020 . Encyclopedia.com. https://encyclopedia.com/social-sciences/encyclopedias-almanacs-transcripts-and-maps/medical-racism. Published September 12, 2020. Accessed September 12, 2020.
2. Samantha Artiga Follow @SArtiga2 on Twitter KOF@_KOon T. Disparities in Health and Health Care: Five Key Questions and Answers. KFF. https://www.kff.org/disparities-policy/issue-brief/disparities-in-health-and-health-care-five-key-questions-and-answers/. Published April 1, 2020. Accessed September 12, 2020.

3. Devine, P. G., et al. (2012). “Long-term reduction in implicit race bias: A prejudice habit- breaking intervention.” J Exp Soc Psychol 48(6): 1267-1278.
4. Institute of Medicine (US) Committee on Understanding and Eliminating Racial and Ethnic Disparities in Health Care. Introduction and Literature Review. Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care. https://www.ncbi.nlm.nih.gov/books/NBK220344/. Published January 1, 1970. Accessed September 13,
5. Chapman EN, Kaatz A, Carnes M. Physicians and Implicit Bias: How Doctors May Unwittingly Perpetuate Health Care Disparities. Journal of General Internal 2013;28(11):1504-1510. doi:10.1007/s11606-013-2441-1
6. Understanding and Addressing Racial Disparities in Health Care. https://www.cms.gov/Research-Statistics-Data-and-Systems/Research/HealthCareFinancingReview/downloads/00summerpg75.pdf. Accessed September 13, 2020.
7. Geiger HJ. Race and health care–an American dilemma?. N Engl J Med. 1996;335(11):815-816. doi:10.1056/NEJM199609123351110
8. Torres N. Research: Having a Black Doctor Led Black Men to Receive More-Effective Care. Harvard Business Review. https://hbr.org/2018/08/research-having-a-black-doctor-led-black-men-to-receive-more-effective-care. Published August 10, 2018. Accessed September 13,
9. Johnson MD A, Johnson A, Amber Johnson University of Pittsburgh School of Medicine, Johnson Cto: A, Popescu I. Understanding Why Black Patients Have Worse Coronary Heart Disease Outcomes: Does the Answer Lie in Knowing Where Patients Seek Care? Journal of the American Heart Association. https://www.ahajournals.org/doi/full/10.1161/JAHA.119.014706. Published November 30, 2019. Accessed September 13,
10. Acosta is associate vice chancellor. Breaking the Silence: Time to Talk About Race and Racism : Academic Medicine. LWW. https://journals.lww.com/academicmedicine/Fulltext/2017/03000/Breaking_the_Silence__Time_to_Talk_About_Race_and.15.aspx. Accessed September 13, 2020.

11. Black patients less likely to receive statins. Healio. https://www.heacom/news/cardiology/20180613/black-patients-less-likely-to-receive-statins. Accessed September 13, 2020.
12. White-Davis T;Edgoose J;Brown Speights JS;Fraser K;Ring JM;Guh J;Saba GW; Addressing Racism in Medical Education An Interactive Training Module. Family medicine. https://pubmed.ncbi.nlm.nih.gov/29762795/?from_term=educational interventions that reduce racism among health providers&from_pos=1. Accessed September 13,
13. Smith WR, University FVC, Betancourt JR, et al. Recommendations for Teaching about Racial and Ethnic Disparities in Health and Health Care. Annals of Internal Medicine. https://www.acorg/doi/10.7326/0003-4819-147-9-200711060-00010. Accessed September 13, 2020.

Submitted by:

Azaria Lewis, OMSII, WesternU College of Osteopathic Medicine of the Pacific
Toni Davis, OMSII, WesternU College of Osteopathic Medicine of the Pacific
Mary Unanyan, OMSII, WesternU College of Osteopathic Medicine of the Pacific
Chardonnay Ward, OMSII, WesternU College of Osteopathic Medicine of the Pacific
Christelle Salomon, OMSII, WesternU College of Osteopathic Medicine of the Pacific
Suria Markus, OMSII, WesternU College of Osteopathic Medicine of the Pacific Emerald Chiang, OMSII, WesternU College of Osteopathic Medicine of the Pacific
Edie Waskel, OMSIV, WesternU College of Osteopathic Medicine of the Pacific
Gilbert Hernandez, OMSIII, WesternU College of Osteopathic Medicine of the Pacific
Brian Diep, OMSIII, WesternU College of Osteopathic Medicine of the Pacific

Action Taken:
Date:
Effective Time Period: Ongoing

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