1/ BREAKING from #AMAmtg: AMA HOD just adopted a report by the @AmerMedicalAssn's Council on Medical Education which aims to begin redressing the harms of the #FlexnerReport.

As a Councilor on CME who is invested in health justice, this is a report I am jazzed about. 🧵
2/
I learned about CME's role as a sponsor of the Flexner Report well before joining the Council, bc the downstream consequences have been huge.

The Report closed 5/7 Black medical colleges, diminishing the projected # of Black docs today by >35k 👇🏽
jamanetwork.com/journals/jaman…
3/
When CME began our report on pathway programs & workforce diversity, it was clear we needed to address our history. As we (@DrAlethaMaybank @FaithCrittenden @glass_heff_full) wrote in @Health_Affairs, this was a chance to go beyond declarative advocacy.
healthaffairs.org/do/10.1377/hbl…
4/
CME's report has a number of important recommendations:
✅Advocate for HBCU, HSI, TCU funding with goal of achieving population parity in the health workforce
✅Create a commission to guide AMA's work on truth, reconciliation, & healing in medicine + MedEd
5/
✅Recognize how systems of oppression contribute to underrepresention/exclusion/marginalization in #MedEd by race, ethnicity, sexual orientation, disability status, and gender identify
✅Recognize the harm of the Flexner Report on physicians, HBCUs, and patients
6/
✅Commission & enact a new, forward-looking, cross-continuum study of #MedEd focused on racial justice, workforce diversity, and ameliorating inequitable outcomes
✅Study interventions to improve equity in residency selection (eg, address AOA/GHHS disparity, ATLAS tool, etc.)
7/
Let's be clear: this report is not a standalone end-game.

But, by redirecting resources of AMA & others in #MedEd, I hope we can make a dent in the "wicked problems" of improving workforce diversity & mitigating health inequities.
medscape.com/viewarticle/95…

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More from @rohankhaz

16 Nov 20
1/ @AmerMedicalAssn adopted two resolutions we wrote (CC @glass_heff_full @FaithCrittenden + more).

For the first time in AMA history, we have policy to explicitly & actionably fight for #antiracism in #MedEd, health care delivery, research, & practice.

🧵 from the #AMAmtg ImageImage
2/ First, let's be clear: we passed these policies by standing on the shoulders of giants, & especially women of color.

We cited almost 100 references by scholars including @CamaraJones @DorothyERoberts @zinzinator @DrMaryTBassett @RRHDr @tsaiduck77 @AmakaEMD @IHJM_ & others. ImageImageImageImage
3/ By telling the truth & reconciling harms, and by advocating for actionable paths forward, these new policies will foster a brighter future of robust AMA advocacy for #HealthEquity and #Antiracism.

The adopted Resolved clauses (our resolutions are 005 & 010) are as follows: ImageImageImage
Read 8 tweets
27 Aug 20
1/ What do #racism & #redlining have to do with inequities in #HIV outcomes?

Our new study just published in #ClinInfectDis examines neighborhood deprivation, race/ethnicity, and HIV viral suppression. Thread 👇🏾

#MedTwitter #MedStudentTwitter #IDTwitter

doi.org/10.1093/cid/ci… ACCEPTED MANUSCRIPT "Neighborhood Deprivation and Racia
2/ #Redlining in the 1930s involved racialized federal mapping of housing "desirability" (L) --> ⬆️💰 into White/affluent areas + systematic disinvestment in "undesirable" areas.

To this day, HOLC maps of urban areas like Omaha STILL align w/deprivation & racial segregation (R). An official U.S. Home Owners Loan Corporation (HOLC) map of Area Deprivation Index (ADI) map of the Greater Omaha Area, Racial Dot Map of Greater Omaha Area, demonstrating clear pr
3/ Omaha is among the most segregated U.S. cities. Our HIV clinic serves ~50% Black and Latinx pts, who disproportionately live in deprived neighborhoods.

We assessed neighborhood disadvantage using the ADI, outlined by @amyjhkind et al. in @NEJM.

nejm.org/doi/full/10.10…
Read 8 tweets
14 May 20
1/ In @OWHnews @OWHopinion this morning, @DrJRMarcelin & I call for racial/ethnic #COVID19 data reporting in Nebraska.

We are currently the ONLY state reporting ZERO state-level demographics. Short thread about why this is a #HealthEquity nightmare 🧵👇🏾

omaha.com/opinion/midlan…
2/ @AmerMedicalAssn's Center for Health Equity has followed state demographic reporting. 46 states currently report race/ethnicity, 49 report age, and 48 report gender.

This is a map on which #GoBigRed #GBR has a less than ideal meaning for Nebraska.

ama-assn.org/delivering-car…
3/ Being a flyover state doesn't render us immune to inequity. Data from Douglas County (includes most of Omaha) shows disproportionate case incidence among Hispanic, Black, and Asian patients despite our county being ~70% non-Hispanic & White...

dogis.maps.arcgis.com/apps/opsdashbo…
Read 7 tweets
31 Oct 19
1/ So, today was a big day for @DrJRMarcelin and I. We've been developing curricula on "Structural Challenges & Inequities in Healthcare Delivery" for the @UNMCCOM M1 students as part of the Health Systems Science coil.

Thread on this #MedEd project + today's capstone 👇🏾
2/ With inspiration from @JonathanMetzl & Dr. Helena Hanson's work on #StructuralCompetency, we wanted to assemble a pilot set of experiences that would give @UNMC students a glimpse into local health inequities, from historical & community perspectives:
3/ We gave the M1s several introductory lectures & assignments focused on big-picture issues like #SDoH & disparities, creating a "structural DDx" for patients, unconscious #bias & #microaggressions, developing structural humility, and #racism in medicine...
Read 11 tweets

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