Resources for Taking Action to Reduce Bias, Racism, and Inequities

Read the FAER Board of Directors Statement on Racism and Inequity here.

There is a body of literature revealing disparities in medical care based on race/ethnicity. In anesthesiology the work has often focused on disparities in pain management, management of pregnancy and labor, and preoperative care, but the disparities clearly reach beyond those areas. In addition, there are institutional barriers within hospitals; for example, Black patients and their visitors are more likely to have security called on them than whites. These disparities appear to have multiple sources, including Implicit, explicit, conscious, and unconscious biases; systemic inequities; health care worker and patient behaviors and attitudes; and patient factors.

It is especially important to center research into healthcare disparities in the communities that are affected, by supporting, amplifying, and developing physician-scientists from underrepresented groups and consulting with the communities in designing, carrying out, and disseminating the research. We recognize that these goals require the inclusion of diverse populations more broadly in anesthesiology research. We also recognize the long history of unethical treatment of African American individuals in medical research.

Many systemic and structural issues continue to prevent and discourage members of underrepresented groups from training in anesthesiology and, specifically, pursuing careers in academic anesthesiology and as physician-scientists. These issues also lead to missed opportunities for promotion, funding, and leadership roles for those who have persevered and are in academic anesthesiology. Finally, there is a higher rate of attrition from academic anesthesiology throughout training and academic careers.

The links below include individual articles and webpages, recommendations, and resources from larger organizations that include links to a wealth of articles. They focus both on existing inequities and effective responses and approaches. The National Institutes of Health (NIH), Association of American Medical Colleges, and National Academies of Science, Engineering ,and Medicine have excellent resources describing inequities and barriers, as well as successful, unsuccessful, and potential measures to address them.

Disparities and Inequities in Healthcare

https://linkinghub.elsevier.com/retrieve/pii/S1932-2275(20)30001-X
https://www.sciencedirect.com/science/article/abs/pii/S0027968417301645?via%3Dihub
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2594273/pdf/jnma00325-0024.pdf
https://www.annualreviews.org/doi/full/10.1146/annurev-publhealth-040218-043750
https://pediatrics.aappublications.org/content/141/2/e20172221
https://www.anesthesiology.theclinics.com/article/S1932-2275(20)30001-X/pdf
https://www.anesthesiology.theclinics.com/article/S1932-2275(20)30011-2/pdf
https://linkinghub.elsevier.com/retrieve/pii/S1932-2275(20)30011-2
https://www.sciencedirect.com/science/article/abs/pii/S0146000517300484
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4724639/

Disparities and Inequities in Medical Research

https://diversity.nih.gov/science-diversity
https://www.pnas.org/content/112/40/12240
https://loop.nigms.nih.gov/2020/06/what-can-we-do-to-combat-anti-black-racism-in-the-biomedical-research-enterprise/
https://diversity.nih.gov/sociocultural-factors/implicit-bias
https://diversity.nih.gov/building-evidence/racial-disparities-nih-funding
https://diversity.nih.gov/building-evidence/mentoring-matters
https://diversity.nih.gov/sustaining-diversity
https://pubmed.ncbi.nlm.nih.gov/24233704/
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(19)33147-2/fulltext
https://pubmed.ncbi.nlm.nih.gov/31430386/
https://pediatrics.aappublications.org/content/144/5/e20192149
https://pubmed.ncbi.nlm.nih.gov/27306969/
https://pubmed.ncbi.nlm.nih.gov/23018334/
https://pubmed.ncbi.nlm.nih.gov/21852498/
https://pubmed.ncbi.nlm.nih.gov/27249058/
https://peerj.com/articles/8247/
https://www.nber.org/papers/w19905.pdf
https://www.youtube.com/watch?v=Pt38C2l-o2o
https://loop.nigms.nih.gov/2020/06/what-can-we-do-to-combat-anti-black-racism-in-the-biomedical-research-enterprise/
https://science.sciencemag.org/content/333/6045/1015.full
https://www.csr.nih.gov/reviewmatters/2020/06/12/race-peer-review/
https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2018.0501

Barriers and Inequities in Medical Education and Medicine

https://www.aamc.org/news-insights/achieving-excellence-through-equity-diversity-and-inclusion
https://www.nap.edu/catalog/25585/promising-practices-for-addressing-the-underrepresentation-of-women-in-science-engineering-and-medicine
https://www.nap.edu/catalog/25130/an-american-crisis-the-growing-absence-of-black-men-in
https://www.nature.com/articles/d41586-018-05203-z
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5909952/
https://www.aamc.org/what-we-do/mission-areas/diversity-inclusion/learning/webinar-black-men-in-medicine
http://csahq.org/news/blog/detail/csa-online-first/2020/01/17/invisible-doctor-black-men-in-medicine
https://www.nature.com/articles/d41586-018-05203-z
https://www.nap.edu/catalog/25257/minority-serving-institutions-americas-underutilized-resource-for-strengthening-the-stem
https://www.forbes.com/sites/jessicagold/2020/06/12/i-am-tired-what-black-doctors-need-you-to-know-right-now/#7957199d4ad7