A Health Equity SOAP Note


L. Latéy Bradford, MD, PhD (PGY-2)
Dept. of Family & Community Medicine
University of Maryland School of Medicine

CC: racial injustice and health inequity


S: The recent highly publicized murders of unarmed Black citizens by those sworn to protect and serve have forced our nation to reckon with its past and live up to its ideals for all people. But make no mistake – the deaths of Breonna Taylor, Ahmaud Arbery, and George Floyd are not outliers. Neither do their deaths only illuminate the transgressions of law enforcement against Blacks. The larger issues at stake are the impacts of systemic racism in communities of color. Rooted in the historical context of slavery and the overt oppression of free blacks, most political, financial, educational, judicial and yes, even health care institutions have strategically been designed to empower and protect the prosperity of White Americans. For centuries, there has been an intentional effort to deny minorities access to the rights, resources, power and privilege entitled to Whites. It is no surprise then, that communities of color in the US are afflicted by egregious inequities, with a disproportionate burden of preventable disease, death, and disability. Racism not only causes and exacerbates, but is in and of itself a public health crisis. While I am grateful for the medical community’s awakening to this reality, acknowledgement doesn’t nearly go far enough. Who better to answer the cry of the community and advocate for the vulnerable than the Family Physician, whose work is not merely to treat disease but to care for the whole person in their complex bio-psycho-socio-economic context?

O: Communities of color experience more barriers to quality health care and are disproportionately impacted by higher rates of morbidity and mortality across a spectrum of chronic disease, infectious disease, cancer, maternal and child health.

A: Communities of color need Family Physicians to take a lead role in paving the road to health equity.

P:

# White coats for Black Lives – On June 5th, healthcare professionals around the country knelt in silent reflection for 8 minutes and 46 seconds as a commitment to improve the health and safety of people of color. As news coverage pivots to other stories and the memory of George Floyd becomes more remote, we need Family Physicians to keep talking about social justice and working toward health care equality and elimination of health disparities.

# Rebuilding trust with communities – We need Family Physicians to continue providing equitable and high-quality health care for people of color, while also engaging with patients in their communities through service, education, and partnership.

# Reforming medical education – Family Physicians must grow the pipeline of minorities in healthcare, while ensuring all medical students and residents are trained and properly equipped to become culturally-competent physicians and champions of social justice.

# Community-based Participatory Research – Family Physicians should be developing evidence-based solutions to health disparities, created in partnership between academia, government agencies and community stakeholders.

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