Okay, I'm about to start listening.
Thanks @AmyBaugher for bringing this podcast to my attention, and thanks @statsepi for preparing me for the offenses I'm about to hear.

And to think, this was released during #BlackHistoryMonth

🧵 live tweeting this podcast
Title: #StructuralRacism for Doctors- What is it?
1st the title is distressing. Why are we still asking what is it? Why aren't we focused on addressing it? Still defining something that is clear, noted in research, & pervasive is problematic & stalls progress.
Pressing play now
"We discussed structural racism. Going into this interview I didn't understand the concept." I'm confused, who are you? There's no introduction of the narrator. What field is he from? What work does he do? Does he interact with patients & not understand this life & death concept?
"Racism is defined as the use of race to make decisions about what people can and can't do."

Here's a problem. We have discussions about Racism in America and think you can define it in 18 words. No! Racism is a complex phenomenon interweaved in our culture since the beginning
It has levels and manifests differently based on who, what, why, when and how. To even begin to give a simple definition of this complex structure is just... wrong.

Okay, back to listening.
"The use of race for any sought of transactional activity was made patently illegal by the Civil rights legislation passed in the 1960s. Given that racism is illegal, how could it be so embedded in society that its considered structural? As a child of the 60's I didn't get it."
Okay, I'm gonna need a drink for this.
He literally just said "In today's JAMA clinical reviews podcast, we discuss structural racism for skeptics"
In next week's podcast will you discuss "Covid a pandemic or PLANdemic".
Or do you only approve podcast that gaslight experiences of minorities?
Dr. Katz starts off great. He clarifies that structural racism and racism in general aren't the same interchangeable term. It has little to do with individual opinions, but a system with policies that perpetuate inequality.
Using a built environment example of truck routes through low income neighborhoods, the impacts on the environment which leads to bad health outcomes for residents, asthma for children, missed school days, despite Civil rights laws, neighborhoods are segregated. All good points.
"In certain neighborhoods the schools are not as good... & the hospitals cannot provide the same level of care, NOT BECAUSE THEY DON'T WANT TO, not bc the drs aren't every bit of not more committed bc they are choosing to work in safetynet hospitals,...
but bc the resources aren't there"

Let's pause. Is this a true statement for all? Are some there for loan repayment programs and don't care any about the people? Are some there bc of white savior complex? Are some there bc other places don't want them? Are some there to skid by?
Let's not paint with too broad of a brush, everyone doesn't have altruistic reasons for coming into my community. Some are passing time and causing harm.
"we know that racial disparities in the US are connected to income."

Let me stop you here.
Racial disparities exist EVEN AFTER controlling for income.

Suggested reading... anything by Dr. Art James.
Life changing moment for me was learning that Black doctors have infant mortality rates higher than White high school drop outs. I learned this 20 years ago.
Miss me with the income explanation.
Host- "I think the term racism is hurting us... I grew up anti-racist"
Yall! I almost threw the computer when he defined "anti-racist"- "never ever even think about a person's race or ethnicity when you're evaluating them.
Full stop! Being color blind is not anti-racist, it's harmful!
"What you're talking about isn't so much racism as much as, that there are population, it's a socioeconomic phenomenon, that have a hard time getting our of their place bc of their environment. It isn't their race, it isn't their color, it's their SES. Is that a fair assessment?"
Yall! the response was "Yes!"
and also "you are not a racist"

I need a break.
30 seconds later, after reaffirming colorblindness and not calling it out as harmful, Dr. Katz then says
"where it goes beyond SES but still stays as a societal issue is bc of the countries past with slavery... there are biased views and society should not reinforce them"
"I do believe... whatever people's belief, they cannot necessarily prevent the idea that they may react differently to a person who looks different then they do."
okay so nearly 2 minutes later, the response is "you may treat ppl differently, but your not racist, you can't help your implicit bias"
2nd time from the host "I think using the term racism invokes feelings that are negative... then they're turned off by the whole structural racism phenomenon. Is there a better term we could use, a better word than racism? '
Dr. Katz- "there may well be... When I describe it, I always try to get people to focus on the "structural" part."
Okay, so with that, I'm quitting this podcast.
In the US all the levels of racism works together. Structural racism wouldn't work if it wasn't upheld by racist ppl.
This phrase caused me walk away from the podcast, because this is how all the "isms" in this country remain in place. When pushed, well-meaning (white?) people in power cower.
No, racism can't be taken out of the phrase. If it makes you uncomfortable, fix it. Don't ignore it.
It seems as if Dr. Katz knows better. But when pushed, opted to keep structured racism in place by not bucking the systems. Each person failing to recognize the harm, is a part of the system.
This podcast was harmful and should be removed.
The host holds a position of power, a position that allows for gatekeeping of research, his role should be reassessed.
Dr. Katz needs to reassess his role in aiding and abetting structural and interpersonal racism through being complicit and not calling out misinformation.

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More from @Theresa_Chapple

3 Mar
Logistics matter when planning a vaccine clinic, especially for high risk populations. Today, one of "my seniors" that I've been helping secure vaccination spots, drove over an hour for an appointment. They waited in line at the drive through vaccinated site.
Here's the problem-
Older people often have to use the bathroom frequently. That was the case here. However, this person was not allowed to get out of the car. They were terrified to break the rules because of the police presence & didn't want to leave because it took months to get a appointment.
This elderly person wet themselves all while waiting to get vaccinated.

Yesterday I was told about a disabled elderly person at a walk up clinic who left instead of getting vaccinated because their health condition didn't allow for them to wait hours in the cold.
Read 4 tweets
26 Feb
@Epi_D_Nique and I collaborated to provide a user-friendly review of the CDC’s study on #Covid_19 spread in elementary #schools in one Georgia district. This study is important because of its focus on young children and community spread. Happy🧵reading! cdc.gov/mmwr/volumes/7…
Data were collected over 24 school days (Dec 1-Jan 22, 2021) on Covid-19 spread in and outside of elementary schools, from Cobb County, GA. What’s interesting about this study? It focuses solely on elementary schools. Why is that important?
These schools serve the youngest group of school age kids, and some believe their contribution to Covid spread is negligible. We know that young kids have less extreme symptoms and lower risk of death compared to older children and adults.
Read 26 tweets
20 Feb
my concern about the CDC operational report on reopening schools
new classification of low, moderate, substantial, and high.
Low is 0-9 cases per 100,000 with a test positivity rate of less than 5%.
moderate combined 2 previous levels and includes up to 8% + rates
I get that the thought is younger children are less likely to contract the virus, but at the same time we believe that pregnant ppl are at increased risk of contracting the virus. It is not a leap to believe elementary age children may live with a pregnant parent.
This is actually highly common for the 40% of families with 3 or more children. Yet, in moderate/low areas, there's no recommendation for virtual school for elementary age kids.
This is a concern for anyone that has any health condition making in-person school particularly risky
Read 20 tweets
17 Feb
3rd grade homework assignment was to discuss with the family why we live where we live. I tried to broadly answer, but my daughter kept probing. Qualitative researcher in the making?
The conversation I didn't want to have, that I ended up having, was about the racism we endured.
I tried to focus on us moving from ATL to MD because of my job. But she's old enough to remember that this is not our 1st home in MD.
Why did we move from our 1st MD home, she askes?
Crap, truth or lie? Think quick. Truth won out.
Our neighbors kept calling the police on us.
She wanted details, why? which ones? how often? was she happy or scared to see the police? She had all the probes.
I explained, everytime we'd enter the home through the front door instead of the garage, the neighbors would report a burglary in progress.
Read 6 tweets
7 Feb
#BlackHistoryMonth Yesterday's letter was E for excellence.
I was tired last night & just wanted the children to go to sleep, but they came to me asking, "who's our example of Black Excellence mom?"
So, I mustered all the energy I could to enthusiasticly discuss @MichelleObama
Mrs. Obama, are 44th First Lady is the epitome of Black Excellence, and became this was as a result of hard work, parents love, community support, quest for knowledge.

My children were impressed to learn that her mother, Mrs. Robinson stayed home with the children and taught
them so much during their early years, that both Mrs. Obama and her brother skipped 2nd grade. We talked about Mrs. O early academic achievements that led her to one of the top high schools in Chicago. How she traveled by bus 1 hour each way to obtain a good education.
Read 13 tweets
6 Feb
Great article on the 8 different ways to sign up for the vaccine in MoCo, MD. "Montgomery County vaccine registration, confusing, time consuming |

wusa9.com" wusa9.com/amp/article/ne…
Philly people can call this number for the vaccine
"Eligible Philadelphians who lack internet access can call a hotline at 215-685-5488 for help making appointments."
"Philadelphia to open mass COVID-19 vaccination clinics, pharmacies to get doses" inquirer.com/news/coronavir…..
New Jersey
"People who are currently eligible for vaccination in New Jersey will be allowed to book appointments as early as Feb. 9. Patients must register in advance at CVS.com. People without online access can contact CVS customer service at 800-746-7287."
Read 5 tweets

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