The "standard story" of anti-Maori talk in Pae Ora (Healthy Futures) Bill submissions.

AIM: To review some common patterns of race talk in a sample of submissions made to the Pae Ora (Healthy Futures) Bill. This bill proposed a structural reform of the health system in Aotearoa New Zealand to address long-standing health inequities experienced by Maori, the Indigenous peoples, and other priority populations. METHOD: In a sample of 3,000 individual submissions made in late 2021, we found 2,536 explicit references to race. Utilising the "standard story" frame of Pakeha/non-Maori race talk, five longer submissions that inferred that the Pae Ora bill was "racist" were analysed in detail. RESULTS: Many "standard story" race discourses were identified in the Pae Ora submissions. Three derived discourses included in this paper are: Pakeha as norm (monoculturalism or not seeing Pakeha as a culture), equality and the "Treaty" (equality for all to access healthcare), and one people (we are all New Zealanders). Sources such as the Waitangi Tribunal Wai 2575 Hauora report were drawn on to provide alternative discourses. CONCLUSION: Identifying Pakeha standard story discourses enables learning about language patterns systems draw on, and the development of tools and procedures to improve equity for Maori and eliminate institutional racism.

Diversity Is Not Enough: Advancing a Framework for Antiracism in Medical Education.

Medical students, residents, and faculty have begun to examine and grapple with the legacy and persistence of structural racism in academic medicine in the United States. Until recently, the discourse and solutions have largely focused on augmenting diversity across the medical education continuum through increased numbers of learners from groups underrepresented in medicine (UIM). Despite deliberate measures implemented by medical schools, residency programs, academic institutions, and national organizations, meaningful growth in diversity has not been attained. To the contrary, the UIM representation among medical trainees has declined or remained below the representation in the general population. Inequities continue to be observed in multiple domains of medical education, including grading, admission to honor societies, and extracurricular obligations. These inequities, alongside learners' experiences and calls for action, led the authors to conclude that augmenting diversity is necessary but insufficient to achieve equity in the learning environment. In this article, the authors advance a 4-step framework, built on established principles and practices of antiracism, to dismantle structural racism in medical education. They ground each step of the framework in the concepts and skills familiar to medical educators. By drawing parallels with clinical reasoning, medical error, continuous quality improvement, the growth mindset, and adaptive expertise, the authors show how learners, faculty, and academic leaders can implement the framework's 4 steps-see, name, understand, and act-to shift the paradigm from a goal of diversity to a stance of antiracism in medical education.

Developing a Database of Structural Racism-Related State Laws for Health Equity Research and Practice in the United States.

OBJECTIVES: Although US state laws shape population health and health equity, few studies have examined how state laws affect the health of marginalized racial/ethnic groups (eg, Black, Indigenous, and Latinx populations) and racial/ethnic health inequities. A team of public health researchers and legal scholars with expertise in racial equity used systematic policy surveillance methods to develop a comprehensive database of state laws that are explicitly or implicitly related to structural racism, with the goal of evaluating their effect on health outcomes among marginalized racial/ethnic groups. METHODS: Legal scholars used primary and secondary sources to identify state laws related to structural racism pertaining to 10 legal domains and developed a coding scheme that assigned a numeric code representing a mutually exclusive category for each salient feature of each law using a subset of randomly selected states. Legal scholars systematically applied this coding scheme to laws in all 50 US states and the District of Columbia from 2010 through 2013. RESULTS: We identified 843 state laws linked to structural racism. Most states had in place laws that disproportionately discriminate against marginalized racial/ethnic groups and had not enacted laws that prevent the unjust treatment of individuals from marginalized racial/ethnic populations from 2010 to 2013. CONCLUSIONS: By providing comprehensive, detailed data on structural racism-related state laws in all 50 states and the District of Columbia over time, our database will provide public health researchers, social scientists, policy makers, and advocates with rigorous evidence to assess states' racial equity climates and evaluate and address their effect on racial/ethnic health inequities in the United States.

The CROWN act and dermatology: Taking a stand against race-based hair discrimination.

Race-based hair discrimination continues to disadvantage people of color who have been sent home from school or dismissed from their jobs on the premise that certain hairstyles, such as dreadlocks and knots, do not meet standards of professionalism. The Create a Respectful and Open World for Natural Hair (CROWN) Act, which was recently passed by several states and the House of Representatives, prohibits such discrimination based on a person's hair texture or hairstyle associated with race. Dermatologists serve a vital role in advocating for the skin and hair needs of all patients, spanning from the personal or clinical encounters level to population-level policy legislation. The act represents a critical opportunity for dermatologists to coalesce and support this important piece of legislation that defends skin of color and the fundamental human right to nondiscrimination.

Structural Racism and Health Disparities: Reconfiguring the Social Determinants of Health Framework to Include the Root Cause.

The government recognizes that social factors cause racial inequalities in access to resources and opportunities that result in racial health disparities. However, this recognition fails to acknowledge the root cause of these racial inequalities: structural racism. As a result, racial health disparities persist.

Ten simple rules for building an antiracist lab.

Demographics of the science, technology, engineering, and mathematics (STEM) workforce and student body in the US and Europe continue to show severe underrepresentation of Black, Indigenous, and people of color (BIPOC). Among the documented causes of the persistent lack of diversity in STEM are bias, discrimination, and harassment of members of underrepresented minority groups (URMs). These issues persist due to continued marginalization, power imbalances, and lack of adequate policies against misconduct in academic and other scientific institutions. All scientists can play important roles in reversing this trend by shifting the culture of academic workplaces to intentionally implement equitable and inclusive policies, set norms for acceptable workplace conduct, and provide opportunities for mentorship and networking. As scientists are increasingly acknowledging the lack of racial and ethnic diversity in science, there is a need for clear direction on how to take antiracist action. Here we present 10 rules to help labs develop antiracists policies and action in an effort to promote racial and ethnic diversity, equity, and inclusion in science.

Anti-black Attitudes Are a Threat to Health Equity in the United States.

OBJECTIVES: To assess the extent to which persistent racism shapes perspectives on public health policies aimed at improving health equity in the United States. Specifically we evaluate the relationship between implicit and explicit anti-black attitudes and support for the ACA at the beginning of the Trump administration. METHODS: We use bivariate statistics to examine views toward the ACA, anti-black attitudes, and demographic variables. Using logistic regression, we examine how anti-black attitudes and demographic variables relate to participants stating that the ACA has worsened the quality of health care services in the United States. SURVEY POPULATION: Data for this study come from the American National Election Studies 2016 Time Series Study, which targets US citizens age 18 and older currently living in the United States (N = 3245). RESULTS: Implicit anti-black attitudes, particularly among whites, are strongly associated with negative feelings toward the ACA. A measure of explicit racial prejudice has the opposite relationship among whites. These results suggest that whites are most critical of the ACA when they hold positive attitudes toward blacks but hold negative stereotypes about blacks' work ethic and reject policies to eliminate racial inequalities. CONCLUSIONS: Anti-black racial attitudes are a critical barrier to enacting health policies that stand to improve health equity in the United States. Public health practitioners and policymakers should consider racism as an essential barrier to overcome in the push for greater health equity in the United States.

Hispanics, Mental Health, and Discriminating Policies: Brief Report.

Hispanics, the largest minority group in the United States, are a heterogeneous group that contains a large portion of immigrants from Latin America. Recently, anti-immigrant policies and anti-Hispanic discriminatory practices have heightened at state and national levels. These policies and practices serve to endanger the mental health of Hispanics and play a major role in health care disparities. Positive correlations have been found between chronic discrimination and depression as well as other comorbid conditions, such as anxiety and substance use, and physical disorders. This report provides an overview of the changes in law/policy in recent history that negatively affect the well-being of Hispanics. Recommendations for health care professionals, educators, and researchers are presented.