5 Minute Moment

Dismantling racism in healthcare demands a concerted effort on many fronts because of the downstream effects on patient health and health equity. A key component is medical education that promotes racial justice. This begins with the acknowledgement and recognition that racism is embedded in healthcare, history of medicine, and modern practice.

Our 5-Minute Moment for Racial Justice curriculum teaches how racism and implicit bias affect routine care, and how we, as healthcare professionals, may unknowingly propagate health disparities. Our goal is for it to be a high-impact resource for learners and educators to normalize conversations around race and racism in medicine. We offer actionable steps for health equity.

Anti-racism in medicine takes intentionality, consistency, and effort.

We invite you on this journey with us.

Thank you for your courage.

5 Minute Moment for Racial Justice in Healthcare Series

Intro to 5-Minute Moment for Racial Justice in Healthcare

Racial Disparities in Maternal Health

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Center on Budget and Policy Priorities. (n.d.). Closing the Coverage Gap to Improve Black Maternal Health. https://www.cbpp.org/research/health/closing-the-coverage-gap-would-improve-black-maternal-health
Centers for Disease Control and Prevention. (2019, September 5). Racial and Ethnic Disparities in Pregnancy-Related Deaths. https://www.cdc.gov/media/releases/2019/p0905-racial-ethnic-disparities-pregnancy-deaths.html
Howell, E. A., Redmond, N., Winkle, G., Tinsley, M., Perron, A., Bryant, A. S., & Frates, E. P. (2020). Structural Racism and Maternal Health Among Black Women. Journal of Racial and Ethnic Health Disparities, 7(6), 1184-1195. https://journals.sagepub.com/doi/epub/10.1177/1073110520958875

Racism and Bias in Medication Prescriptions and Scientific Studies

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“Black Pills” episode from Innate: How Science Invented the Myth of Race. Distillations Podcast from Science History Institute. March 28, 2023. Accessed September 12, 2023. https://sciencehistory.org/stories/distillations-pod/black-pills/
BiDil: race medicine or race marketing? Sankar P, Kahn J. BiDil: race medicine or race marketing? Health Aff (Millwood). 2005 Jul-Dec;Suppl Web Exclusives:W5-455-63. doi: 10.1377/hlthaff.w5.455. PMID: 16219647.

Structural Racism and Disparities in Child Maltreatment Reporting

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Hyunil Kim, Christopher Wildeman, Melissa Jonson-Reid, and Brett Drake, 2017: Lifetime Prevalence of Investigating Child Maltreatment Among US Children American Journal of Public Health 107, 274_280, https://doi.org/10.2105/AJPH.2016.303545
Race and Bias in Child Maltreatment Diagnosis and Reporting Palusci VJ, Botash AS. Race and Bias in Child Maltreatment Diagnosis and Reporting. Pediatrics. 2021;148(1):e2020049625.doi:10.1542/peds.2020-049625
The Perils of Child “Protection” for Children of Color: Lessons From History Raz M, Dettlaff A, Edwards F. The Perils of Child “Protection” for Children of Color: Lessons From History. Pediatrics. 2021;148(1):e2021050237. doi:10.1542/peds.2021-050237
A Cure Worse than the Disease? The Impact of Removal on Children and Their Families Vivek Sankaran. "A Cure Worse Than the Disease? The Impact of Removal on Children and Their Families." Christopher Church and Monique Mitchell, co-authors. Marq. L. Rev. 102, no. 4 (2019): 1163-94.

Pulse Oximetry

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Sjoding, M. W., Dickson, R. P., Iwashyna, T. J., Gay, S. E., & Valley, T. S. (2020). Racial bias in pulse oximetry measurement. New England Journal of Medicine, 383(25), 2477-2478. doi:10.1056/NEJMc2029240
Moran-Thomas, A. (2020, August 2). How a popular medical device encodes racial bias. Boston Review. Retrieved from https://bostonreview.net/articles/amy-moran-thomas-pulse-oximeter/
FDA Safety Communication. (n.d.). Pulse Oximeter Accuracy and Limitations. Retrieved from https://www.fda.gov/medical-devices/safety-communications/pulse-oximeter-accuracy-and-limitations-fda-safety-communication?utm_medium=email&utm_source=govdelivery
Sjoding, M. W., Dickson, R. P., Iwashyna, T. J., Gay, S. E., & Valley, T. S. (2020, December 17). Occult Hypoxemia in Adult ICU Patients. Racial Bias in Pulse Oximetry Measurement. New England Journal of Medicine, 383(25), 2477-2478. doi:10.1056/NEJMc2029240. PMID: 33326721; PMCID: PMC7808260

Racism and Medical Mistrust in Health Care

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Cooper, L. A., Callender, C. O., & Roter, D. L. (2021). Beyond Tuskegee: Vaccine Distrust and Everyday Racism. New England Journal of Medicine, 384(19), e74. doi: 10.1056/NEJMpv2035827. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMpv2035827?query=race_and_medicine
Beach, M. C., Roter, D. L., & Saha, S. (2019). Practices to Foster Physician Presence and Connection with Patients. JAMA, 322(3), 216-217. doi: 10.1001/jama.2019.7529. Retrieved from https://jamanetwork.com/journals/jama/article-abstract/2758456
Wells, A. A., Lindsay, M. D., & Battle-Lindsay, S. (2020). A Legacy of Mistrust: African Americans and the US Healthcare System. Proceedings of UCLA Health, 24, 1-4. Retrieved from https://proceedings.med.ucla.edu/wp-content/uploads/2020/06/Wells-A200421LW-rko-Wells-Lindsay-M.D.-BLM-formatted.pdf
Penner, L. A., Blair, I. V., Albrecht, T. L., & Dovidio, J. F. (2014). Reducing Healthcare Disparities: A Social Psychological Analysis. Policy Insights from the Behavioral and Brain Sciences, 1(1), 204-212. doi: 10.1177/2372732214548430. Retrieved from https://journals.sagepub.com/doi/full/10.1177/2372732214548430

Racial Disparities in Pain Management

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EGoyal MK, Johnson TJ, Chamberlain JM, et al. Racial and Ethnic Differences in Emergency Department Pain Management of Children With Fractures. Pediatrics. 2020;145(5):e20193370. doi:10.1542/peds.2019-3370
Guillory JD. The pro-slavery arguments of Dr. Samuel A. Cartwright. La Hist. 1968;9:209-227.
Waytz A, Hoffman KM, Trawalter S. A Superhumanization Bias in Whites’ Perceptions of Blacks. Soc Psychol Personal Sci. 2015;6(3):352-359. doi:10.1177/1948550614553642
Hoffman KM, Trawalter S, Axt JR, Oliver MN. Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites. Proc Natl Acad Sci. 2016;113(16):4296-4301. doi:10.1073/pnas.1516047113
Rasooly IR, Mullins PM, Mazer-Amirshahi M, van den Anker J, Pines JM. The Impact of Race on Analgesia Use among Pediatric Emergency Department Patients. J Pediatr. 2014;165(3):618-621. doi:10.1016/j.jpeds.2014.04.059

Diagnosis and Treatment of Kidney Disease in Black Patients

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Eneanya, N.D., Boulware, L.E., Tsai, J. et al. Health inequities and the inappropriate use of race in nephrology. Nat Rev Nephrol 18, 84–94 (2022). https://doi.org/10.1038/s41581-021-00501-8
Tsai JW, Cerdeña JP, Goedel WC, Asch WS, Grubbs V, Mendu ML, Kaufman JS. Evaluating the Impact and Rationale of Race-Specific Estimations of Kidney Function: Estimations from U.S. NHANES, 2015-2018. EClinicalMedicine. 2021 Nov 19;42:101197. doi: 10.1016/j.eclinm.2021.101197. PMID: 34849475; PMCID: PMC8608882.
Ahmed, S., Nutt, C.T., Eneanya, N.D. et al. Examining the Potential Impact of Race Multiplier Utilization in Estimated Glomerular Filtration Rate Calculation on African-American Care Outcomes. J GEN INTERN MED 36, 464–471 (2021). https://doi.org/10.1007/s11606-020-06280-5
NKF-ASN Task Force on Reassessing the Inclusion of Race in Diagnosing Kidney Diseases: https://www.ajkd.org/article/S0272-63862100828-3/fulltext

Diagnosing Skin Findings in Patients with Darker Skin

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Mind the gap (clinical handbook of signs and symptoms in black and brown skin) https://www.blackandbrownskin.co.uk/mindthegap
Skin deep: (open-access, searachable image database of medical conditions across skintones) https://dftbskindeep.com/
Brown Skin Matters: (community-sourced image database of medical conditions on non-white skin) https://brownskinmatters.com/
Taylor and Kelly's dermatology for skin of color: Kelly A, & Taylor S. C., & Lim H.W., & SerranoA (Eds.), (2016). Taylor and Kelly's Dermatology for Skin of Color, 2e. McGraw Hill.
St George's, University of London. (2020, August 12). Mind the gap: A handbook of clinical signs in black and Brown Skin. figshare. Retrieved November 9, 2022, from https://sgul.figshare.com/articles/online_resource/Mind_the_Gap_A_handbook_of_clinical_signs_in_Black_and_Brown_skin/12769988

Race Correction in Pediatric UTI Guidelines

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K Roberts. “Urinary Tract Infection: Clinical Practice Guideline for the Diagnosis and Management of the Initial UTI in Febrile Infants and Children 2 to 24 Months.” Pediatrics. 2011. 128 (3): 595 - 610.
RH Kowalsky. “The Case for Removing Race from the American Academy of Pediatrics Clinical Practice Guideline for Urinary Tract Infection in Infants and Young Children with Fever.” JAMA viewpoint Jan 2020.
Ramgopal S, Tidwell N, Shaikh N, Shope TR, Macy ML. “Racial Differences in Urine Testing of Febrile Young Children Presenting to Pediatric Hospitals. J Racial Ethn Health Disparities.” Nov 2021. doi: 10.1007/s40615-021-01182-6. Epub ahead of print. PMID: 34780020.
American Academy of Pediatrics Board of Directors and Executive Committee. AAP Perspective: Race-Based Medicine. Pediatrics. 2021;148(4):e2021053829. doi: 10.1542/peds.2021-053829
Shaikh N, Hoberman A, Hum SW, et al. Development and Validation of a Calculator for Estimating the Probability of Urinary Tract Infection in Young Febrile Children. JAMA Pediatr. 2018; 172(6):550. doi: 10.1001/jamapediatrics.2018.0217
J Madhusoodanan. “How scientists are subtracting race from medical risk calculators.” Science. Jul 2021. http://www.science.org/content/article/how-scientists-are-subtracting-race-medical-risk-calculators
Race neutral pediatric UTI risk calculator calc, https://uticalc.pitt.edu/

Health Disparities in Patients with Limited English Proficiency

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Provider FAQs from National Council on Healthcare Interpretation - https://www.ncihc.org/faq-healthcare-professionals
AMA Journal of Ethics: Language-Based Inequity in Health Care: Who Is the “Poor Historian”? - https://journalofethics.ama-assn.org/article/language-based-inequity-health-care-who-poor-historian/2017-03- "Ultimately, to achieve linguistic equity will require creating effective systems for medical interpretation and a major culture shift not unlike what has happened in patient safety".
Stanford SOM Video on Working Effectively with Interpreters - https://www.youtube.com/watch?v=Uhzcl2JDi48&t=55s
Examining the telehealth digital divide for patients with limited English proficiency - https://www.youtube.com/watch?v=atUonTaPBNU