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The American Medical Association (AMA), which is the nation’s largest association of doctors, has formally recognized racism as a public health threat. On November 16, the organization announced a new policy outlining its intention to work on alleviating the health effects of racism.
“By declaring racism as a public health threat at the AMA, we’re moving closer towards reaching health equity which we define as optimal health for all,” AMA Board Member Willarda Edwards, MD, MBA, who runs an internal medicine private practice in Baltimore, tells Verywell. “And we’re creating a path then to truth, healing, and reconciliation.”
The new policy recognizes racism as a social determinant of health and a significant contributor to health disparities and lack of access to health care for Black and other historically marginalized communities in the United States.
This is an opportunity to reconcile some of the incredible harm that we know has been inflicted on people of color, and particularly on Black folks.
— Rachel Hardeman, PhD, MPHThe announcement comes from the AMA House of Delegates—a group of more than 600 members representing every medical specialty. The group identified three forms of racism—systemic, cultural, and interpersonal—as being detrimental to the goal of providing equitable health care.
While large-scale structural problems contribute most to public health outcomes, the announcement notes that racism and unconscious bias play out in medical research and healthcare delivery as well.
The policy also urges medical professionals to support policy development for researching racism’s health risks, encourage medical schools to include stronger curricula on racism and its effects, and work to prevent influences of bias in health technology innovation.
“This is an opportunity to reconcile some of the incredible harm that we know has been inflicted on people of color, and particularly on Black folks,” Rachel Hardeman, PhD, MPH, an associate professor at the University of Minnesota School of Public Health, tells Verywell. “I think acknowledging that and understanding that, and then thinking about it with the lens of how to move forward is really important.”
Hardman explains that structural and systemic racism impact the ability of people of color to live healthy lives. Centuries of racially motivated policies and practices have led to people of color being more likely to experience limited access to affordable food, housing, and health care.
According to the AMA's policy, historically marginalized populations in the U.S. have:
During the COVID-19 pandemic, racial disparities in health care have become even more glaring. Black, Indigenous, and Latino Americans all have a death rate triple or more than White Americans, according to APM Research Lab.
We felt we needed to do more than provide statistics, which we have done for a number of years. It was time for us to take action.
— Willarda Edwards, MD, MBATo achieve this goal, the policy urges medical providers to recognize race as a social construct and not to use it as a proxy for ancestry, genetics, and biology.
“The problem lies in the fact that a lot of folks aren’t taught the fact that race is a social construct,” Hardeman says. “They’re being taught that it’s biological—that there’s a genetic difference between Black people and White people and they don’t understand that race is something we created, and we do to people.”
The policy also calls for a turn away from “racial essentialism”—the notion that race is a crucial consideration when discussing a person’s health.
“It’s important to study what is clinically relevant and not just what’s socially constructed,” Edwards says. “We can start dealing with people just for who they are and what their needs are rather than based on the implicit bias that has led us down the wrong path and created the inequities that we have.”
For example, when a doctor presents a patient and reveals that person’s racial identity, it may cause people to make assumptions about them based on their race rather than their health record and risk factors.
The policy urges healthcare providers to recognize that when a person's race is being described as a risk factor, it might be acting as a proxy for influences like structural racism rather than for genetics.
The AMA says that it will also work to eliminate the influences of racism and bias in new healthcare technologies. Edwards says that rather than creating technology based on a standard of whiteness, people must be aware of its practical uses and implications for people of all backgrounds.
In June, the organization published a statement condemning police brutality and racially motivated violence and pledged anti-racist action. The new policy goes a step further by recognizing the effect of racism in perpetuating health in society more broadly and pledging to take action.
“We felt we needed to do more than provide statistics, which we have done for a number of years,” Edwards says. “It was time for us to take action.”
The primary drivers of racial inequity are systemic and structural. However, medical professionals must also actively work to weed out unconscious bias and racism in their research and when delivering health care.
The AMA’s new anti-racist policy comes after more than a decade of reckoning with the organization’s history. In 2008, the organization apologized for excluding Black Americans from the AMA, as well as barring them from some state and local medical societies, for more than a century.
Per its statement, during that period in history, the AMA “actively reinforced or passively accepted racial inequities and the exclusion of African-American physicians."
In 2004, the AMA created a commission on health equity to raise awareness for the issue of racism’s effect on public health. The task was handed to the Minority Affairs commission. In 2017, the AMA House of Delegates named Edwards to head a task force to create a report on health equity.
The Center for Health Equity was created in 2019, and Aletha Maybank was appointed the inaugural chief health equity officer and vice president.
“The Center for Health Equity is now our crown jewel in convening others who are interested as well in trying to provide more health equity and put some teeth into our statistics and take some action,” Edwards says. "It's now not just an organization that’s part of the AMA, it’s embedded in the AMA and everything we do.”
Hardeman says that the AMA, which is a powerful organization in the world of medicine, putting out a policy on racism is a signal that people in power are stepping up to anti-racism conversations in new ways.
“Students were having these conversations and folks like me who are doing scholarship and research in this space were having these conversations, and I think now more people are paying attention and they’re paying attention in a different way,” Hardeman says. “Statements like the ones that AMA have made are important, but they’re kind of the floor. And now we need to be aiming toward the ceiling and doing the next steps in this work.”
The policy also emphasizes the need to educate the next generation of medical students on the different forms of racism and their effects on public health and medicine.
"I'm incredibly excited and proud for what the future of our healthcare force looks like," Hardeman says, expressing hope for new curricula that will emphasize the importance of understanding implicit bias, structural racism, and cultural racism to the same degree that students are expected to know physiology and anatomy.
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By Claire Bugos
Bugos is a senior news reporter at Verywell Health. She holds a bachelor's degree in journalism from Northwestern University.
