Starting off #AAP2021 w #PEM#SOMHEI joint session to hear @DrTiffJohnson’s talk on racism and child health - can’t screenshot anything but will try to live tweet!
Strategies for confronting bias
- perspective taking
- common identities
- stereotype replacement
- individuation eg asking kids what they want to grow up to be
- cross cultural contact
- mindfulness
- talk time ratios (how much time spent listening vs talking)
- read and reflect
Working on structural/organizational bias
- equity in QI
- equity as strategic priority
- organization culture and policies (eg can pts access subspecialty care after ER visit?)
- welcoming physical environment
- metrics to measure impact over time
- community empowerment
Racism in research
- acknowledged historical context AND modern bias/exploitation
- NIH funding inequalities (even among ppl studying disparities!) ncbi.nlm.nih.gov/pmc/articles/P…
- bias among journals re: publications, editors, etc
Need to diversify applicant pool, reviewers, editorial boards, etc
- call for papers on disparities research (not just perspectives)
- call out racist statements (aka don’t do what JAMA did w their podcast)
Racism in #MedEd (at all levels!)
- how is race portrayed in clinical teaching?
- faculty development re: race and racism
- curricula incorporating anti-racism lens
Excited to hear from @YadiraCaraveo (who was @DrBenHoffman’s resident, now a #tweetiatrician and CO state rep!) #AAP2021
- Kids’ issues not always taken seriously in govt since they don’t vote so it’s OUR job to advocate for policies that #PutKids1st
#Advocacy tips
- many important decisions made at state/local levels
- maybe better to contact legislators when NOT in session to establish relationships
- join AAP lists for alerts on various issues/bills
- consider running for office eg @docsinpolitics@runforsomething #AAP2021
How to decide what to research/advocate for?
- most severe injury?
- most prevalent condition?
- issue w greatest inequity?
- influenced by a patient story?
Paraphrased: As humans we don’t want to be a burden, we want to figure things out on our own, but at the end of the day people want to help you! #AAP2021#MentalHealthMatters#SuicidePrevention
If you see something, speak up because you might be helping others too. It might be daunting, but we just need someone to believe what we say, someone to protect us 😢 #AAP2021
Why misinformation is a problem
- false beliefs ➡️ increase fear, mistrust
- expose ppl to harm
- worsen existing biases/disparities
- ppl make ineffective or harmful policies based on bad info 🙃
Kids specifically more vulnerable to misinformation 😔
Starting #AAP2021#COCM#CNACH session w @LanreFalusi on overcoming communication barriers 1) Look within: admit/ID biases, raise awareness
- don’t just ask BIPOC friends “to teach you”
- reflect on your own experiences
- intentionally diversify network
- question everything!
2) Use inclusive language
- It’s not them, it’s us: focus on collective orientation rather than labeling (shoutout @DrOmolara!)
- Strength-based language: focus on assets (vs deficits) and recognize disparities eg underserved ➡️ under-resourced
“X” was a healthy girl until ~1 yo when she became a picky eater and got extra fussy after eating. When I met her, mom had been told it was reflux, constipation, multiple viral illnesses, etc. She’d even been hospitalized elsewhere for “dehydration” then discharged 2/
Reviewing the records, I was struck by very elevated AST/ALT, which can be seen in many conditions, but these were pretty high. On exam, X was really fussy, maybe mild gross motor delay, but no focal findings like a hard belly, rash, or dysmorphic facial features 3/