Stanford Medicine magazine focuses on racial inequity in medicine

What does race have to do with health? And what can the health care system do about racism? 

A special report in the new issue of Stanford Medicine magazine, “Closing the gap: Addressing racial inequity in medicine,” offers some answers and describes efforts at Stanford to counter the impact of racism on health.

What becomes clear through the stories is that race is not a biological construct but a social construct — and that the world of medicine must embrace this understanding to advance health equity. 

As Lloyd Minor, MD, dean of the Stanford University School of Medicine, explains in his letter to readers: 

“The best predictor of a person’s health is still a 58-year-old postal service innovation: the ZIP code. For example, life expectancy across Los Angeles County ranges by as much as 15 years. Plotted on a map, shorter life expectancy closely tracks with lower income, less home ownership, more pollution — and race.” 

Where you live, writes Minor, is likely to say more about your health outcomes than your doctor or your genes do.

And while our genes play a role in our health, race is not a clear indicator of our genetics, population geneticist Carlos Bustamante, PhD, explains in an article about using race as a variable in health care and biomedical research. A better, though also imperfect, way to characterize populations is to look at ancestors’ geographic origins, said Bustamante, professor of biomedical data science and of genetics.

Yet race does matter in medicine, in large part because of the harm caused by systemic racism, Minor says. The new issue of Stanford Medicine magazine includes articles about ways people at Stanford Medicine are addressing racial inequity in health through teaching, research, patient care, community outreach and efforts to support diversity at Stanford Medicine itself.  

The issue also includes:

• An exploration of projects that aim to address racial inequity and medical mistrust, from using Black barbershops as nodes of medical information for Black men to increasing the representation of nonwhite skin in dermatology research. 

• A look at Stanford-led efforts to identify how racism affects childbirth, translate science into safer care during pregnancy for women of color, and foster open dialogue between these women and their doctors.

• A video, “How considering race can sabotage health care,” in which Stanford Health Care’s chief of staff, Megan Mahoney, MD, draws on her experience as a biracial physician to discuss why clinicians should stop using racial classifications to guide care. The video accompanies a review of the implications of using race as a proxy in medicine.

• An article about the new Stanford Medicine Commission on Justice and Equity, launched to target racial inequality as an urgent health care issue and to dismantle discrimination against marginalized groups within Stanford Medicine and beyond. 

• An online-only Q&A with Italo Brown, MD, clinical assistant professor of emergency medicine, on the ways systemic racism has led to Black people’s medical mistrust and his ideas for building their confidence in doctors.

• A profile of Eric Sibley, MD, PhD, a Black physician-scientist and professor of pediatrics, who was diagnosed in the early 2000s with multiple sclerosis. As the symptoms progressed, his compassion for his patients and will to champion diversity grew stronger.

• A Q&A with author Shaka Senghor about finding redemption after 19 years in prison by keeping young people out of the criminal justice system and helping others see the humanity of incarcerated people.

• An article about a student who nearly gave up on a medical career but was inspired by stories about resilient women in her Mixtec family to persevere.

• A look at a study that compared the track record of a virtual coach, bilingual in Spanish and English, with that of real humans. (The computer program did better.) 

In this issue you’ll also find an essay by professor of medicine Karl Lorenz, MD, about how dining on barbecue woke his father from the fog of dementia and the role the senses play in cognition. And read about cancer researchers’ frustration over the ability of basal cell carcinomas to dodge a new treatment and why they’re optimistic they can stop the cells from escaping.

The new issue is online at http://stanmed.stanford.edu as well as in print. Print copies of the magazine are being sent to subscribers. Others can request a copy by sending an email to medmag@stanford.edu.