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Racism is killing Americans. As healthcare professionals, we see the ways systemic racism, and specifically anti-Black racism, harm our patients. People of color bear the burden of structural inequities in housing, education, employment, and access to healthy food and green spaces, all of which impact health outcomes. Due to a long history of segregation, redlining, and environmental racism, Black Americans are 75% more likely to live near a polluting facility than the average American, which contributes to Black children having a 60% higher prevalence of asthma. Inequities in access to healthcare exacerbate this disparity, as Black children have a 500% higher death rate from asthma than White children. The impacts of structural racism are compounded by the ways racism itself damages health. Discrimination causes changes that can be measured at the cellular level. This has been linked to heart disease, diabetes, and depression, among others. Perhaps most tragically, evidence suggests that the racism experienced by Black mothers partially explains the high Black maternal and infant mortality rates in America.

The most recent murders of Breonna Taylor, Ahmaud Arbery, George Floyd, Tony McDade, and Rayshard Brooks are heartbreaking and we grieve their lost lives. In our profession, we see daily evidence that police violence disproportionately harms Black and Brown bodies. Black Americans are nearly three times more likely to die because of police violence than white Americans, and one in every one thousand Black men and boys can expect to be killed by police in this country. These devastating numbers make it clear that police violence and racism are public health crises.

Despite decades of clear evidence, our medical institutions have only recently begun to acknowledge the destructive nature of structural racism. The COVID-19 pandemic has laid bare undeniable health disparities inherent in healthcare. Black and Indigenous Americans are dying at inordinate rates across our country. Unless we take urgent and aggressive steps to dismantle racism at the social, economic, political, legal, educational, and health care levels, this centuries old, deadly pandemic will persist long after COVID-19 is gone.

In our training, we are taught to do no harm. And yet, medicine has a profoundly racist history that includes experimentation without consent, withholding treatment, and removal of children from their mothers. As providers, we must reckon with our past and present investment in racism. We call on our healthcare institutions to implement these anti-racist steps outlined by prominent scholars Drs. Hardemen, Medina and Boyd:

1. Divest from racial health inequities (which are byproducts of health care systems functioning as intended) and support a more equitable business and care delivery model.

2. Desegregate the healthcare workforce at all levels, from student and staff to CEO.

3. Make “mastering the health effects of structural racism” a professional medical competency so that all health professionals are better equipped to address racism and its health effects.

4. Mandate and measure equitable outcomes in the same way that institutions have to meet safety and quality standards.

5. Protect and serve all of our patients by defending the interests of patients impacted by state sanctioned violence, taking a clear stand to end police brutality, and advocating for policies that promote health.

Last Saturday, we gathered for Black Lives and now the real work continues. We are Idaho healthcare providers and we commit ourselves to using our voice, privilege, and power to dismantle the institutional racism that affects every single person. We commit ourselves to the never-ending process of becoming more anti-racist. We commit ourselves to holding healthcare accountable and following Black and Brown community organizers working for justice and anti-racism. To remain silent is to be complicit.

Jessie Duvall is a pediatrician. Andrea Christopher is an internal medicine physician. Caroline Beyer is a doctor working in family medicine. Sara Swoboda is a pediatrician. Alicia Carrasco is a doctor. Brittany Blockman is a pediatrician. Jessica Maddox is a pediatrician. Gabrielle Davis is a respiratory therapist/counselor. Lonnie Shumsky is a doctor working in internal medicine. Maritza Lorenzana is a clinical social worker. Kelly Stanley is a family medicine chief resident. Sarah Staller is a doctor working in family medicine for Terry Reilly Health Services. Jessica Evert is a doctor working in hospital medicine/family medicine for Child Family Health International. Stephanie Long is a family medicine doctor for Planned Parenthood of the Great Northwest and Hawaiian Islands. Sarah Gerrish is a doctor working in family medicine. Vishnu Iyer is a third-year medical student at the University of Washington.

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