Academic Health Centers' Antiracism Strategies Must Extend to Their Business Practices
Authors: Shawn F. Johnson, Ayotomiwa Ojo, Haider J. Warraich
Journal: Annals of Internal Medicine (2020)

Ideas and OpinionsFebruary 2021Academic Health Centers' Antiracism Strategies Must Extend to Their Business PracticesShawn F. Johnson, BS*, Ayotomiwa Ojo, BS*, and Haider J. Warraich, MDShawn F. Johnson, BS*Harvard Medical School, Boston, Massachusetts (S.F.J., A.O.)Search for more papers by this author, Ayotomiwa Ojo, BS*Harvard Medical School, Boston, Massachusetts (S.F.J., A.O.)Search for more papers by this author, and Haider J. Warraich, MDHarvard Medical School, Brigham and Women's Hospital, and Veterans Affairs Boston Healthcare System, Boston, Massachusetts (H.J.W.).Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/M20-6203 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail Civil rights activists Kwame Ture and Charles Hamilton originated the term institutional racism in their 1967 work, Black Power: The Politics of Liberation. They described institutional racism as the “exploitative slumlords, merchants, loan sharks and discriminatory real estate agents” that coordinated to suppress Black communities in generational poverty. Although the United States had become increasingly willing to condemn interpersonal racism, Ture and Hamilton decried America's unwillingness to address institutional racism, stating, “Society either pretends it does not know of [institutional racism], or is in fact incapable of doing anything meaningful about it.”The words of Ture and Hamilton hold true ...References1. Jha AK, Orav EJ, Li Z, et al. Concentration and quality of hospitals that care for elderly black patients. Arch Intern Med. 2007;167:1177-82. [PMID: 17563027] CrossrefMedlineGoogle Scholar2. Kowalczyk L. Color line persists in sickness as in health. The Spotlight Team. Boston Globe. 12 December 2017. Accessed at https://apps.bostonglobe.com/spotlight/boston-racism-image-reality/series/hospitals on 29 October 2020. Google Scholar3. Somashekhar S, Cha A. Insurers restricting choice of doctors and hospitals to keep costs down. Washington Post. 20 November 2013. Accessed at www.washingtonpost.com/national/health-science/insurers-restricting-choice-of-doctors-and-hospitals-to-keep-costs-down/2013/11/20/98c84e20-4bb4-11e3-ac54-aa84301ced81_story.html on 29 October 2020. Google Scholar4. Himmelstein KEW, Venkataramani AS. Economic vulnerability among US female health care workers: potential impact of a $15-per-hour minimum wage. Am J Public Health. 2019;109:198-205. [PMID: 30571300] doi:10.2105/AJPH.2018.304801 CrossrefMedlineGoogle Scholar5. Rubin DB, Singh SR, Young GJ. Tax-exempt hospitals and community benefit: new directions in policy and practice. Annu Rev Public Health. 2015;36:545-57. [PMID: 25785895] doi:10.1146/annurev-publhealth-031914-122357 CrossrefMedlineGoogle Scholar6. Bai G, Yehia F, Anderson GF. Charity care provision by US nonprofit hospitals. JAMA Intern Med. 2020;180:606-7. [PMID: 32065599] doi:10.1001/jamainternmed.2019.7415 CrossrefMedlineGoogle Scholar7. Illinois Health Facilities and Services Review Board. 2018 hospital profiles. Facility profiles and summary sheets. Accessed at www2.illinois.gov/sites/hfsrb/InventoriesData/FacilityProfiles/Documents/2018%20Hospital%20Profiles.pdf on 29 October 2020. Google Scholar8. Young GJ, Chou CH, Alexander J, et al. Provision of community benefits by tax-exempt U.S. hospitals. N Engl J Med. 2013;368:1519-27. [PMID: 23594004] doi:10.1056/NEJMsa1210239 CrossrefMedlineGoogle Scholar9. Serchen J, Doherty R, Atiq O, et al. Racism and health in the United States: a policy statement from the American College of Physicians. Ann Intern Med. 2020;173:556-7. doi:10.7326/M20-4195 LinkGoogle Scholar10. Sharfstein JM, Kinzer D, Colmers JM. An update on Maryland's all-payer approach to reforming the delivery of health care. JAMA Intern Med. 2015;175:1083-4. [PMID: 25961577] doi: 10.1001/jamainternmed.2015.1616 CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAffiliations: Harvard Medical School, Boston, Massachusetts (S.F.J., A.O.)Harvard Medical School, Brigham and Women's Hospital, and Veterans Affairs Boston Healthcare System, Boston, Massachusetts (H.J.W.).Disclosures: Authors have disclosed no conflicts of interest. Forms can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M20-6203.Corresponding Author: Haider J. Warraich, MD, 4B-132, 1400 VFW Parkway, VA Boston Healthcare System, Boston, MA 02132; e-mail, [email protected]org.Current Author Addresses: Mr. Johnson and Ms. Ojo: 25 Shattuck Street, Boston, MA 02115.Dr. Warraich: 4B-132, 1400 VFW Parkway, VA Boston Healthcare System, Boston, MA 02132.Author Contributions: Conception and design: S.F. Johnson, A. Ojo, H.J. Warraich.Analysis and interpretation of the data: S.F. Johnson, H.J. Warraich.Drafting of the article: S.F. Johnson, A. Ojo, H.J. Warraich.Critical revision for important intellectual content: S.F. Johnson, A. Ojo, H.J. Warraich.Final approval of the article: S.F. Johnson, A. Ojo, H.J. Warraich.Administrative, technical, or logistic support: A. Ojo, H.J. Warraich.Collection and assembly of data: S.F. Johnson, H.J. Warraich.This article was published at Annals.org on 8 December 2020.* Mr. Johnson and Ms. Ojo contributed equally to this work. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetails Metrics Cited byNormalizing Service Learning in Medical Education to Sustain Medical Student-Led InitiativesDiversity Is Not Enough: Advancing a Framework for Antiracism in Medical Education February 2021Volume 174, Issue 2Page: 254-255KeywordsAcademic medicineHealth careHealth care providersHealth economicsHealth insurancePatient Protection and Affordable Care ActPatientsPrevention, policy, and public healthStructural racismTaxes ePublished: 8 December 2020 Issue Published: February 2021 Copyright & PermissionsCopyright © 2020 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...