Paw'd Defiance

Racism, Medicine and the COVID-19 Vaccine

January 12, 2021 Edwin Lindo, Assistant Dean for Social & Health Justice at University of Washington School of Medicine Season 1 Episode 63
Paw'd Defiance
Racism, Medicine and the COVID-19 Vaccine
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Paw'd Defiance
Racism, Medicine and the COVID-19 Vaccine
Jan 12, 2021 Season 1 Episode 63
Edwin Lindo, Assistant Dean for Social & Health Justice at University of Washington School of Medicine

Medicine has played a key role in the development of racist ideas, policies, and practices.  Swedish scientist Carl Linnaeus developed a system of organizing plants and animals known as taxonomy. Linnaeus and other scientists used taxonomy to disseminate racist ideas about those who weren't white. In this episode, we talk about Linnaeus with University of Washington Assistant Dean Edwin Lindo. We also talk about other historical examples of medical racism and how these ideas still impact medicine and the larger society. Finally, we discuss how this history impacts the current effort to vaccinate members of Black and Brown communities against COVID-19.

Show Notes Transcript

Medicine has played a key role in the development of racist ideas, policies, and practices.  Swedish scientist Carl Linnaeus developed a system of organizing plants and animals known as taxonomy. Linnaeus and other scientists used taxonomy to disseminate racist ideas about those who weren't white. In this episode, we talk about Linnaeus with University of Washington Assistant Dean Edwin Lindo. We also talk about other historical examples of medical racism and how these ideas still impact medicine and the larger society. Finally, we discuss how this history impacts the current effort to vaccinate members of Black and Brown communities against COVID-19.

Asst Dean Edwin Lindo:

Racism affects health outcomes, but that's because of the way that society treats people of a certain race. It isn't because that race is biologically inferior.

Audio:

From UW Tacoma, this is Paw'd Defiance.

Eric Wilson-Edge:

Welcome to Paw'd Defiance, where we don't lecture, but we do educate. I'm Eric Wilson-Edge. Today on the Paw'd, the COVID-19 vaccine and the long history of racism in medicine. University of Washington Assistant Dean and Professor Edwin Lindo joins us to talk about how the medical field helped shaped racist ideas and practices. We'll also discuss how these ideas originated and how they still impact the healthcare industry and society as a whole. Finally, we talk about the impact this history has had on the effort to get people and black and brown communities vaccinated against COVID.

Eric Wilson-Edge:

University of Washington Assistant Dean and Professor Edwin Lindo, thank you for joining us today on Paw'd Defiance.

Asst Dean Edwin Lindo:

Eric, thanks for having me.

Eric Wilson-Edge:

Before we get started into the main reason I wanted to talk you today, which is talking about medicine and vaccines and sort of the racism within medicine and what means for us today, I wanted to start with you just talking a little bit about the work that you do. I know you are a critical race scholar. For folks who maybe don't know or unfamiliar with that term, I wonder if you could give us a little information on your background.

Asst Dean Edwin Lindo:

Yeah, happy to. And again, excited to be joining you. I think it is an important conversation in especially building solidarity and relationships among the three campuses. I know you all are in Tacoma, and so excited for us to partner. A little about myself, I am someone who is legally trained. And in that training, I did a lot of work focused on critical race theory, the understanding of it, the analytical approach to it, the grasping of trying to answer the questions around how does racism work, why does it exist, where did it come from, and what do we need to do address it, dismantle it, and build something that is much more equitable and justice-focused.

Asst Dean Edwin Lindo:

Some people may ask, well, how did you go from law to being a professor and assistant dean within the medical school? I get that question a lot, but it's a question that doesn't have a direct answer, and I won't bore everyone with the long story. But in short, it's realizing that to observe, to interrogate racism, you don't need an MD. You need the ability to ask critical questions, the ability to understand the way systems and mechanisms within the system operate, and then asking the questions of, why is it operating this way? How has it operated in the past? And history plays a huge part in critical race theory.

Asst Dean Edwin Lindo:

And what do we need to do moving forward if we're actually trying to address this? In a nutshell, critical race theory is really a theoretical framework that came from law in the early '70s that was used to ask the questions of the legal system, why is there disproportionate impact on black, brown, and indigenous communities from a legal perspective? And my goal has been with many scholars around the country bringing a very similar question to medical institution and the medical system and saying, "How do we interrogate racism within medicine so that we can address the health inequities that we see on a day-to-day basis?

Asst Dean Edwin Lindo:

So at the end of the day, our patients are healthier, our trainees are learning valid science, science that will truly help their patients, and that we move towards a more equitable and just medical system." We'll talk more about this, but we are in a middle one of those questions of how do we make sure equity is at the center of this conversation around vaccines in COVID-19.

Eric Wilson-Edge:

Like I mentioned earlier, I wanted to talk with you about racism and medicine and where those intersect and what that means for us right now. We are, I guess, about a year into when the pandemic started, but there are some good news it feels. There are currently vaccines that are approved and are being dispersed. But with that, I have been reading a lot of stories lately in different media outlets about distrust within black and brown communities about vaccines and getting the vaccine. I want to spend some time with you today talking about where this mistrust comes from and, I guess, if there was a beginning to this.

Eric Wilson-Edge:

I wonder if we could go back and talk about people like Carl Linnaeus, Samuel Morton, and Samuel Cartwright. I'm wondering if you could tell us who these men were and why they're important to the conversation we're having today.

Asst Dean Edwin Lindo:

Yeah, it's a great question. Let me start with the basic notion of mistrust versus untrustworthiness. There's amazing black scholars that speak to this specifically, so I encourage folks to go and do a bit of research. But what we should be doing and the way we should frame it is that this isn't actually about the mistrust of any particular community, because mistrust only exists because of the untrustworthiness of an individual, of a group, or in this case, the institution and society. But by exclaiming that there is mistrust, it now puts an ownness and a responsibility on the community that was actually harmed by the untrustworthy system.

Asst Dean Edwin Lindo:

I'm going to ask us, for those that are listening, to transfer that burden and that ownness and actually put it on the system itself and say, "What has the system done that has made itself not viable of trust?" In other words, what has it done to become untrustworthy? Because when we reframe that question, then we start focusing on the real issue. But when we focus on mistrust, we start asking really strange questions of, well, what do these communities need to do so that they can start to trust the system? And I keep thinking to myself, wait, why do they have to change when it's the system that did the harm?

Asst Dean Edwin Lindo:

I think it's important that we recalibrate and start focusing on the perpetrator of the untrustworthiness. To get to the beginning of it, like you mentioned, you have folks like Carl Linnaeus, Samuel Morton, Samuel Cartwright and the list goes on and on, but we're talking about early to mid... Actually all of the 1800s, this generation of physicians and bio medical researchers and scientists that created biological myths. And it wasn't an accident. And when I say myths, I don't mean storytelling and it was a bedtime story. I mean, intentional fabrications of physiology.

Asst Dean Edwin Lindo:

They knew they were lying, but they continued to perpetuate these myths for the purposes, and the list is long, for the purposes of maintaining racial hierarchy, for the purposes of maintaining chattel slavery, for the purposes of maintaining economic power. Well, how did they do that? It starts from early beginnings of chattel slavery through reconstruction, the black code, Jim Crow, to today. And it takes different forms, but in the early parts of this, it was suggesting that black folks, folks who weren't European, white European, were less than human, were subhuman, were physiologically inferior, intellectually inferior.

Asst Dean Edwin Lindo:

And I'm not being hyperbolic. They say this in the papers that they say they "researched" and that they published in peer-reviewed journals and peer-reviewed articles. And when you look back at it, it is this continuous indoctrination and conditional of society to allow for and maintain the type of inequities socially, interpersonally, medically that we see today. It's not an accident. It isn't just a few people who are terrible people and they despise people who were different colors and who didn't look like them. No. It was a systematic act of maintaining racial power. They created this racial caste and they said, "Europeans are of the most enlightened."

Asst Dean Edwin Lindo:

They said things to the effect of, "We may believe in evolution, but still, Europeans are exponentially more evolved than black or Native Americans." If you were to do the research, you can't prove that. That's not a thing. It's not real. You have folks like Carl Linnaeus who literally created the racial taxonomy, who "observed" that Native Americans were governed by beliefs, that Asian folks were governed by caprice, that black folks were governed customs. I'm not looking at the language at the moment, but it was everyone who wasn't European had a negative connotation to their body, to their behavior, to their customs, to their government.

Asst Dean Edwin Lindo:

But you looked at European and it was the most positive. They were saying that they were governed laws and covered with cloth vestments. That somehow being clothed made you more intelligent. But these stereotypes still exist today and they evolved and they found their way into our clinical and medical practices, from Samuel Cartwright in 1850s, who had his hand in racialized medicine. From the beginning, he created the spirometer. The spirometer measures lung capacity and lung function.

Asst Dean Edwin Lindo:

And what he did was he created this tool on slaves that he owned, experimented on them, and then suggested, "Oh, black people have lower lung function compared to European. Therefore, they have a lower likelihood of longevity and life. And therefore, they're inferior to white people." Well, that then led... During reconstruction when the emancipation was signed, you had hundreds of thousands of black folks that were trying to establish themselves.

Asst Dean Edwin Lindo:

And what was now a free world and a few years before it wasn't, and you had life insurance companies saying, "Well, we're not going to give you life insurance because the medicine, the data tells us that you're going to die sooner because you have a lower lung function." That's not an accident. Again, it seeps into the practices. And guess what? We still use the spirometer today. But doctors don't have to have the belief, it's now baked into the equation that's used in the computer and the machine that you see in the hospital.

Asst Dean Edwin Lindo:

You have the EGFR, the estimated glomerular filtration rate, which measures kidney function, and there was an artificial inflation for black folks. Why? They suggested that on average, black folks have greater muscle mass, and that muscle mass determines your kidney function. And if you dig into the data and look at the research, there isn't sufficient evidence to suggest that to be true. But because there is a necessity to say that these bodies are different, it was believed wholesale. It was taken. And for the past 30 days, we've used the EGFR equation with a racial exponent. And it isn't until this past year that we've got ridden of it in some hospitals.

Asst Dean Edwin Lindo:

Here at UW, we got rid of it. UCSF has gotten rid of it. Brigham Young I believe has gotten rid of it. There's a handful of hospitals that are now saying, "We can't allow for racialized medicine to exist in our practice." When I say racialized medicine, I want to be clear, I mean the suggestion that race is a biological determinant. That's different than suggesting that there are different outcomes for different racial groups. The latter is dependent on racism. Racism affects health outcomes, but that's because of the way that society treats people of a certain race. It isn't because that race is biologically inferior.

Eric Wilson-Edge:

If you're enjoying this conversation with Professor Lindo, I'd encourage you to listen to his podcast, The Praxis, which explores the effects of racism and other forms of marginalization in the U.S. healthcare system. I'll include a link to the show in the episode description. You can also read Professor Lindo's thoughts on these issues in The Seattle Times and The Conversation.

Eric Wilson-Edge:

You talked about stereotypes a little bit there, and I wonder how large of a role in your mind do you think that medicine has played in sort of cultivating these stereotypes into racist ideas?

Asst Dean Edwin Lindo:

In my calculation, medicine is the architect for the segregationist era of this country. They are able to segregate communities based on race because they believed, or at least the science told them, that this group is physically and intellectually inferior to them. And therefore, having separation was in their mind a logical step. Were it not for medicine and really the sciences being proponents of those hideous ideas, I think there'd be a greater resistance and fight against these protocols, but that just didn't exist because they were one and the same.

Asst Dean Edwin Lindo:

Racism was seeped into the medical practice and society borrowed from that and said, "Well, the science tells us that we're different. Why would we coexist?" If we were to think about how it continues, we then see that medicine plays a role that it believes is apolitical. Apolitical positions don't exist. Medicine has never been apolitical. It actually has been the complete opposite based on the history that I just mentioned. It was political in its purposes in creating a racial hierarchy. It was political in the way that we choose our research questions. It's political in a way that it decides how we provide access to healthcare.

Asst Dean Edwin Lindo:

There is a number of different questions that are asked that require a political connotation, but we try to say, "Well, we're apolitical. I'm not political. That's taboo." And when I say political, I don't mean red or blue or Democrat or Republican. What I mean is what are the values upon which we sit upon? And in those values, how is it affecting the outcomes of our communities? The value of medicine was let's maintain this racial caste and this racial hierarchy. And they did and they did it well.

Asst Dean Edwin Lindo:

There's many people who are listening or my colleagues who have told me, "Well, Edwin, you just can't put the blame on medicine. What about the economy? What about education? What about politics?" And again, I go back to the beginning. Where did they get it from? They aren't the medical experts. The medical experts are the ones that suggested that people of different melanin were biologically different. You had Samuel Morton and Samuel Cartwright who are polygenesists. They believed and there are some who still believe today...

Asst Dean Edwin Lindo:

I haven't met any in the medical system that I work in, but I'm sure there are people today who believed or held the belief early on that people of different races came from different origins, that they are not of the same origins, that they are of a different species. That is a wild thought, but yet it sat at the center of medical research practice and implementation of care for nearly a century.

Eric Wilson-Edge:

We've got the development of these practices and ideas. I want to move it forward in history up until present day, but I feel like we need to talk about things like Tuskegee Syphilis Study and folks like Henrietta Lacks. There is a disturbing number of these incidents. Those are just a couple and probably folks have probably heard from. But I wonder if we could talk about those for a little bit, and then that is a segue into, well, how do these ideas and practices... What do they look like today and what impact do they have?

Asst Dean Edwin Lindo:

Tuskegee, Henrietta Lacks, the support and allowing of torture in Guantanamo Bay, medical professionals had a role in all of this. But those are the most obvious ones. And yes, they sit front of mind for many folks in the community. But the more resonating ones I would suggest are the everyday encounters that our communities have when they walk into the hospitals. The untrustworthiness most definitely comes from those practices that were acts of genocide in many instances like Tuskegee, where black men who had syphilis were being studied.

Asst Dean Edwin Lindo:

The cure was known a decade or two later and was never given or offered to them, and they were told they were being treated for "bad blood." That's not an accident. That's an intentional act of letting folks die when you could save their lives. Folks don't forget that. That is severe. That is traumatic. But I don't want us to forget the daily encounters with providers, with hospitals, with the healthcare system, where it's a reenforcement of these institutions don't value the bodies that are melanated in this country. A prime example is Dr. Susan Moore.

Asst Dean Edwin Lindo:

Dr. Susan Moore, a black female physician, who declared publicly on Facebook that she was being mistreated because she was a black woman, was not getting the care that she deserved. This is someone who has the knowledge. This is someone who is fully aware of what should have been done and knew that it wasn't happening. But this is happening to communities, to individuals, black, brown, indigenous, on a daily basis and those stories come back home. Those stories get shared with the uncles and aunts and the nephews and the nieces and the grandchildren. And some may say, "Well, that's just anecdotal. You can't just share that one story and say I mistrust this institution."

Asst Dean Edwin Lindo:

And we say, "Well, we have no other data point. It's actually the most accurate representation they have, because it is the experience that they had." And when we compile them, we see that it's not in isolation and it is not just anecdotal. The data overwhelmingly tells us that certain communities, marginalized, melanated communities, do not receive the same level of care. And we look at the outcomes. The outcomes are disproportionate. Knowing that, what are we as institutions going to do to gain the trustworthiness of these communities? Because that's going to be the work.

Asst Dean Edwin Lindo:

It can't just start today. It should have started decades ago, but we're here now and we can't just belabor and hammer over the head, "Well, you need to take the vaccine because. I can't believe you won't do that." And a response that is very valid is, "I can't believe you still want me to go an institution that doesn't even treat me as a human being." We have to sit in the discomfort that were part of institutions that have created so much harm that folks no longer trust it.

Eric Wilson-Edge:

You were talking about that doctor, and I feel that's a perfect segue to talking about we are in a pandemic. I'm talking about the disproportionate impacts COVID has had on marginalized communities. And I wonder, will you talk about that and healthcare bias and how these ideas of medical racism play into these issues?

Asst Dean Edwin Lindo:

That's a broad question for sure. I'll take the first part around COVID and the disproportionate impact on our marginalized communities. There are amazing folks that I've spoken into these at length. I talked about it in my podcast. But in short, it is no surprise that during a pandemic, it is black, brown, indigenous, and poor people that are harmed the most, that have the highest rates of mortality, the highest rates of transmission. And some say, "Well, what do you mean, Edwin, that it's not a surprise?" It's not a surprise because if you look at the communities where racism and systemic oppression is the greater inflictor and we look at a pandemic...

Asst Dean Edwin Lindo:

If we were to have a hypothetical... And someone will say, "Well, there's going to be a pandemic that runs through the country," who do we think is going to hit the hardest? It's going to be the working class. It's going to be poor folks. It's going to be folks in the urban centers that live in close proximity. It's going to be people who have to go to work even when the city is shut down. It's going to be people who don't have access to healthcare. It's going to be people who live in public housing.

Asst Dean Edwin Lindo:

And because social economics status is wholly tied to race, not because people of a certain race don't have the potential to be in higher socioeconomic status, but because our system has calculated and ensure that certain people, certain racial groups are sitting in poverty. And we can explain more how that took place from chattel slavery. We knew this was going to happen, which that is we still didn't jump ahead of it. It's continually getting worse. And now we have a vaccine and...

Asst Dean Edwin Lindo:

I am grateful that here at UW, for example, we have an equity vaccination task force where we are constantly asking the question, is this the most equitable way to roll out this vaccine? And the biggest equity is, is it going to be accessible? Is it available? Who gets it? We're focusing the questions and the answers on, who are the most vulnerable populations in our communities? If we're actually trying to stop the spread of COVID, then we have to provide what has been said a solution or at least a stop cap to help stop the spread of COVID.

Asst Dean Edwin Lindo:

It has to be provided to those who need it most, to those who have to go to work, to those who are in poverty, to those who are hopping on the bus because it's their only mode of transportation. That's who has to get it first, but that isn't always the way that we're seeing it pan out, and it's not the questions that are being asked I think throughout the country.

Eric Wilson-Edge:

I was listening to you talk on a podcast. I don't remember the name of it. You said something really interesting and I think it was the way you put it that struck me. It's basically talking about the idea that if you went into a different part of the world or different parts of the world, the race you would be thought of would be different, right? It would be maybe evaluated differently.

Asst Dean Edwin Lindo:

I give that point because people try to essentialize race as the biological determining factor. "Oh, this is your race, therefore." It acts as though there is a causal relationship, and it's not true. One, if that were true, then that means that race would be a constant. That no matter where you go in this world, it is the same. That's not accurate. That is true for folks' genetics. It doesn't matter what country you go to. You still have the same genetic makeup. But race isn't genetics. And how do we know that? Because if we ask any geneticist and we give them our genome and say, "Please tell me what race I am," they will tell you, "I can't because there is no race gene."

Asst Dean Edwin Lindo:

They maybe able to triangulate perhaps what part of the world you're from, but that doesn't tell you what race you are. And some people say, "Well, your genes tell you what region, and therefore, we have a better idea of what race you are." I think your synopsis of it is accurate in that I usually say, "Well, then that means when I go to South Africa, my race will be the same as it is here in the United States." In the United States, I'm considered Latino. Brown in many circles. If you go to South Africa, I'm considered colored. Period. If I go to different parts of Central America or South America, it ranges from between Mestizo to Latino to Indio.

Asst Dean Edwin Lindo:

That's four different racial categories. And if we're depending on those racial categories for medical care and diagnostic care or diagnostic tools for care, then we're not actually being accurate, because we're not measuring for something that can be held constant. That being said, on the flip side is if... I tell folks quite a bit. If we put any other racial group in the exact same environment and history as black folks or indigenous folks, the medical outcomes, the comorbidities that we see among these communities would be the same, but that was not the experiences of white people. They didn't have to live in slavery.

Asst Dean Edwin Lindo:

They didn't have to live in camps. They didn't have to have their land stolen from them that they grew fruit on on this continent. But if were to change the script, we would see the same thing. It doesn't what race you are. It matters what was the experience that that community had. And those experiences do change the physiology and the biology over generations, but we have to be clear that, again, it's not because of their race, but it's because of the experiences that they've had in this country that alters how they're living their life.

Eric Wilson-Edge:

I forget the exact number, but a large percentage of folks in the U.S. have to get vaccinated to reach herd immunity, which the way I understand it, makes it much harder for the virus to move about. It sounds like it's never going to fully go away, but it can be kind of kept in check, I guess, from what I understand. Knowing this, how does medicine, the medical community, how does it go about repairing the damage the profession has done to black and brown communities over the years, with the idea being that we kind of need a lot of folks to get vaccinated?

Eric Wilson-Edge:

It's sort of like a greater good, but totally understanding the hesitancy from those communities to get vaccinated when you look at the history that continues until this day. What can the medical community do?

Asst Dean Edwin Lindo:

That's a good question. I'll start with analyzing and extrapolating from that. It is the continual work of black and brown communities to save this country. It took black folks to build this country. The land of indigenous, the workers of Latino folks picking our food to make this country run. And we still are requiring them to do more. What do I mean by that? And some will say, "Well, this is their obligation. They need to do this." In any other situation, if there is a person who's untrustworthy who came to you and said, "Hey, I need you to do this thing. I really don't care if it's for you or not, but you need to do it because it's better for us."

Asst Dean Edwin Lindo:

Everyone's like, "That sounds like a setup." What we have to ask is, at what point is this country going to reckon with the reality of its history and start talking about reparations, start talking about making people whole, start talking about providing care that is rooted in justice? Because if not, then it feels like a fraud. It feels like, well, I'm asking you to do this thing, but I may not actually return the favor. And some people will say, "Well, the favor is you get a vaccine that protects you."

Asst Dean Edwin Lindo:

Yes, it does and they're going to still have to live in existence in a world where they know this system will not protect them outside of this vaccine, or at least it hasn't proven to do so. If that's true, the question I then ask is, when will these communities be able to cash the check of justice and say, "We deserve to be treated with the full humanity that we walk on this earth with." And I don't think this country has ever shown that it would do that. We should be on our hands and knees begging folks to take this vaccine, because they have all the right in the world not to. And most of them will.

Asst Dean Edwin Lindo:

I just want to know at what point will we do the right thing so that if something happens in the future. There has been a process of rebuilding, of becoming trustworthy, so that this conversation will be a different one. And it's not about untrustworthiness, but it's about we are ecstatic that black and brown folks are getting it first, that equity is a priority of the institution and systems, and that we're focused on providing it to the most marginalized in this country. That isn't where we are at the moment.

Eric Wilson-Edge:

I really appreciate the way you put that, talking about get it for you, but it's really for us. If I try to think about what that would look like, that would really irritate me if someone was asking me to get vaccinated not for my own necessarily well-being. Sure, I might get that. And like you're saying, you only the benefits of that shot, but you don't get these other things that you need, right? This person is essentially asking you to get it so that they will be okay or other people will be okay, which is a really strange way to think about it. Yeah, I try to imagine that. That wouldn't sit well with me I think. I'd have to think about that.

Asst Dean Edwin Lindo:

Yeah. I mean, it's highly transactional and the transaction is actually unduly forced without mutual benefit. I think it's now time that we fully transform the way that we practice research, have our medical system... These communities should be at the table having this discussion. When we talk about research, they should be on the papers. When we talk about care...

Asst Dean Edwin Lindo:

And we're doing it here at UW, working and actually building community advisory board, for folks who are interested, please feel free to reach out, to help inform the equity decisions, it'll be out of the office of healthcare equity led Dr. Polly Houston, to inform the decisions that are happening here at UW Medicine, but that needs to happen across the country.

Eric Wilson-Edge:

I think you co-wrote a piece in the conversation about adding more diversity in the medical field, whether that's doctors, researchers, nurses. And then I also think, listening to your last answer, thinking about I think one of the first people in the U.S. to get a vaccine, and they made a very public display I think, I think was a black man. I think he was a nurse, and I maybe wrong about that, but I think remember reading a story about that. I wonder if this...

Asst Dean Edwin Lindo:

It was a black woman.

Eric Wilson-Edge:

Black woman. There we go. Thank you. Two parts of the same question, I guess. From my understanding of the paper, it sounds like there might be better health outcomes if you are say a black man and black woman or maybe you don't identify by gender, but if you see someone who looks like you, that may actually be a benefit to your health outcomes. You're thinking about that, and then also that public effort to say, "Okay. Here is this black woman getting a vaccine." In your mind, do you think that's an effective strategy, or do people kind of see right through that?

Asst Dean Edwin Lindo:

Well, actually to the second part because it's much easier, I do not adhere or not work for any marketing scheme if the goal of an image is to say this helps build trust because there's two black woman, and it was a black nurse that received it and she was receiving it from a black nurse. I don't know the history behind it. I haven't researched into it, but the goal always is it must be authentic. It must be real. If it is a marketing campaign, then I wholly detest it.

Asst Dean Edwin Lindo:

As far as the question of having diversity in the medical workforce and the healthcare workforce, it's absolutely necessary because, and you hit it on the head from the paper, we see that patients that have racial concordance with their providers end up having more trust, end up getting better care, and it's because there is an understanding. It's not because black physicians are wholly giving better care than white physicians. It's because white physicians have shown throughout history that the embedded cultural racism forces white physicians to look at these patients differently and not in a positive way.

Asst Dean Edwin Lindo:

It is now the work to deconstruct this learning and conditioning to ensure that that type of care doesn't take place. But in that interim, it means that we need more black and brown and indigenous providers because we know that the care and we know that the outcomes will be more positive. There are many people who dispute this, who push back and say, "You're just going to back to segregationist ideology, and you're saying that black patients should be able to choose their provider." No, I'm saying black patients shouldn't have to get worst care. White folks already get the choice whether they want it or not because it is overwhelmingly white workforce.

Asst Dean Edwin Lindo:

I'm sure if the opposite was true, there would be discussion of white patients saying, "Well, maybe I want to see a white doctor." But the opposite isn't true because in the same paper that you cited, we also found through our research that white patients, however, do not... Well, I'll rephrase this. White patients get the same level of care regardless if it's a white or black provider. The opposite is not true when it comes to a black patient or a patient of color and a non-racial concordant provider.

Audio:

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