Looking forward to #AAP2020 #Peds21 on Advancing Child Health Equity with @RheaBoydMD @DrTiffJohnson @JyothiMarbin @MariaTrent5
"Every generation has to make a dent in the wall of injustice" - Dr. Mary Frances Berry, PhD

For further reading on Dr. Berry's work: https://africana.sas.upenn.edu/people/mary-frances-berry
Levels of racism (really any -ism)
- Institutional (structural), eg Jim Crow, Indian Removal Act, Mexican Repatriation, internment of Japanese Americans
- personally mediated
- internalized
Raising Resister strategy (Dr. Janie Ward, The Skin We're In)
- Read it (caution that specific situation might not always be racism)
- Name it
- Oppose it
- Replace it

Will need to work at multiple levels to prevent and mitigate effects of racism: pediatric practices, schools, communities, etc.
- COVID 19 has uncovered/exacerbated flaws in US public health policy and SDOH (as Dr. Fauci also said earlier)😔

Thanks @MariaTrent5! #AAP2020
Now on to @DrTiffJohnson "A is for Anti-Racist"
Doesn't just affect BIPOC: "Racism saps the strength through the whole society through the waste of human resources" @CamaraJones
Many examples of overt racism and explicit bias, sadly...including starting in medical school (which is probably not surprising to most of #MedTwitter)

Implicit bias comes out more when we have other high cognitive load (eg after a busy ED shift), also has association with burnout symptoms
@DrTiffJohnson's 2016 study: https://doi.org/10.1111/acem.12901

@dyrbye's 2019 study https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2739043
Re: anticipatory guidance; don't want to foster mistrust, also some strategies work better for teens

Need to confront personal biases too, eg taking others' perspectives, focusing on common identities, individuation, using counter-stereotypical examples
Things to consider:
- What policies may inadvertently perpetuate care inequities, eg late policy?
- What organizational culture aspects may negatively affect relationships w pts/family eg hospital policing?
- What can we do to improve equity? (should be integral part of QI)
Decolonizing the medical curriculum
- community grand rounds
- disparities journal clubs
- city tour with community liaison
- training on trauma-informed care
- addressing hidden curriculum
- #MedEd portal has anti-racism collection
On to @JyothiMarbin discussing workforce diversity
- more innovative, more creative, better at problem-solving
- better patient care, educational experience for students
- fundamentally just the right thing to do!
The system was set up to perpetuate white supremacy, so we need to disrupt "business as usual" -> radical inclusion
- prioritize diversity
- eliminate vague hiring assessment eg "fit"
- diversity among leadership matters (consider term limits for higher-up positions)
Not all of us can take a group trip (especially nowadays w COVID) but another idea is race based affinity groups: space to process and reflect by self-ID racial group
- now offering quarterly for all residents/fellows at UCSF
Break time, will probably need a new thread for @RheaBoydMD😋

Thanks @drjoanjeung for moderating and also shoutout to whoever is doing the #AAP2020 closed-captioning in real time! #AccessibilityMatters
You can follow @DrJenChen4kids.
Tip: mention @twtextapp on a Twitter thread with the keyword “unroll” to get a link to it.

Latest Threads Unrolled: