13
views
0
recommends
+1 Recommend
0 collections
    0
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      The REPAIR Project: A Prospectus for Change Toward Racial Justice in Medical Education and Health Sciences Research: REPAIR Project Steering Committee

      article-commentary
      REPAIR Project Steering Committee
      , PhD (Collab), , PhD (Collab), , PhD (Collab), , MSc, PhD (Collab), , MPH, PhD (Collab), , PhD, MD, MPH (Collab), , PhD (Collab), (Collab), (Collab), , MFA (Collab), , MA (Collab), , PhD (Collab), , PhD (Collab), , PhD (Collab)
      Academic Medicine
      Lippincott Williams & Wilkins

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          Amidst ongoing efforts to address racial injustice, U.S. medical institutions are grappling with the structural roots of anti-Black racism. The REPAIR (REParations and Anti-Institutional Racism) Project is a 3-year strategic initiative at the University of California, San Francisco aiming to address anti-Black racism and augment the presence and voices of people of color in science, medicine, and health care. The REPAIR Project was designed in response to an unmet need for critical dialogue, cross-disciplinary research, and curriculum development addressing structural racism. It offers a framework for thinking and acting to achieve repair in relation to racial injustice and is anchored by 3 concepts—reparations, abolition, and decolonization—which have been deployed as annual themes in academic years 2020–2021, 2021–2022, and 2022–2023, respectively.

          The theme of medical reparations builds on the longstanding call for slavery reparations and the paying of debts owed to Black Americans for the harms of slavery. The REPAIR Project focuses on the specific debts owed to Black Americans for racial harm in health care settings. The theme of medical abolition examines the intersections of incarceration, policing, and surveillance in health care and the role of clinicians in furthering or stopping oppressive practices that bind patterns of Black incarceration to health and health care. The theme of decolonizing the health sciences targets “othering” practices entrenched in scientific methodologies that have arisen from colonial-era beliefs and practices around imperialism, including how the colonial-era concept of race contributes to ongoing racial harm.

          In this article, the authors describe the REPAIR Project, preliminary outcomes from its first year, and potential future lines of inquiry for medical educators and health sciences researchers. The authors argue that the full damage from slavery and its legacies cannot be undone, but everyone can work in new ways that reduce or eliminate harm.

          Related collections

          Most cited references63

          • Record: found
          • Abstract: found
          • Article: not found

          Racial bias in pain assessment and treatment recommendations, and false beliefs about biological differences between blacks and whites.

          Black Americans are systematically undertreated for pain relative to white Americans. We examine whether this racial bias is related to false beliefs about biological differences between blacks and whites (e.g., "black people's skin is thicker than white people's skin"). Study 1 documented these beliefs among white laypersons and revealed that participants who more strongly endorsed false beliefs about biological differences reported lower pain ratings for a black (vs. white) target. Study 2 extended these findings to the medical context and found that half of a sample of white medical students and residents endorsed these beliefs. Moreover, participants who endorsed these beliefs rated the black (vs. white) patient's pain as lower and made less accurate treatment recommendations. Participants who did not endorse these beliefs rated the black (vs. white) patient's pain as higher, but showed no bias in treatment recommendations. These findings suggest that individuals with at least some medical training hold and may use false beliefs about biological differences between blacks and whites to inform medical judgments, which may contribute to racial disparities in pain assessment and treatment.
            Bookmark
            • Record: found
            • Abstract: not found
            • Article: not found

            Hidden in Plain Sight — Reconsidering the Use of Race Correction in Clinical Algorithms

              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Epigenetic mechanisms that underpin metabolic and cardiovascular diseases.

              Cellular commitment to a specific lineage is controlled by differential silencing of genes, which in turn depends on epigenetic processes such as DNA methylation and histone modification. During early embryogenesis, the mammalian genome is 'wiped clean' of most epigenetic modifications, which are progressively re-established during embryonic development. Thus, the epigenome of each mature cellular lineage carries the record of its developmental history. The subsequent trajectory and pattern of development are also responsive to environmental influences, and such plasticity is likely to have an epigenetic basis. Epigenetic marks may be transmitted across generations, either directly by persisting through meiosis or indirectly through replication in the next generation of the conditions in which the epigenetic change occurred. Developmental plasticity evolved to match an organism to its environment, and a mismatch between the phenotypic outcome of adaptive plasticity and the current environment increases the risk of metabolic and cardiovascular disease. These considerations point to epigenetic processes as a key mechanism that underpins the developmental origins of chronic noncommunicable disease. Here, we review the evidence that environmental influences during mammalian development lead to stable changes in the epigenome that alter the individual's susceptibility to chronic metabolic and cardiovascular disease, and discuss the clinical implications.
                Bookmark

                Author and article information

                Contributors
                Journal
                Acad Med
                Acad Med
                ACM
                Academic Medicine
                Lippincott Williams & Wilkins (Hagerstown, MD )
                1040-2446
                1938-808X
                12 July 2022
                December 2022
                : 97
                : 12
                : 1753-1759
                Affiliations
                University of California, San Francisco
                University of California, San Francisco
                University of California, San Francisco
                University of California, Berkeley and Stanford Medical School
                University of California, San Francisco
                University of California, San Francisco
                University of California, San Francisco
                University of California, Berkeley
                University of California, San Francisco
                University of California, San Francisco
                University of California, San Francisco
                University of California, San Francisco
                University of California, San Francisco
                University of California, San Francisco
                Author notes
                Correspondence should be addressed to Kara Zamora, Department of Humanities and Social Sciences, University of California San Francisco, 490 Illinois St., 7th Floor, San Francisco, CA 94143-0850; telephone: (510) 912-7324; email: Kara.Zamora@ 123456ucsf.edu .
                Article
                00014
                10.1097/ACM.0000000000004831
                9698077
                35830260
                0abe7eb5-f7a5-4567-abf7-b95454079d21
                Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the Association of American Medical Colleges.

                This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal.

                History
                Categories
                Scholarly Perspectives
                Custom metadata
                TRUE

                Comments

                Comment on this article