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Tag: Diversity & Inclusion

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In the United States, June is designated as LGBTQ+ Pride Month in recognition of the 1969 Stonewall uprising in Greenwich Village. For many activists and historians, the 1969 uprising represented a turning point in LGTBQ+ history and activism. While LGTBQ+ people have more legal and social rights in the aftermath of Stonewall, organizations, communities and activists within the United States and around the world continue to push for protections that ensure LGBTQ+ people can live freely. 

Recently, the Human Rights Campaign (HRC) released a ‘State of Emergency’ for LGBTQ+ people living in the United States. In their release the organization said “The sharp rise in anti-LGBTQ+ measures has spawned a dizzying patchwork of discriminatory state laws that have created increasingly hostile and dangerous environments for LGBTQ+ people…” (Human Rights Campaign, 2023)

Despite the rise in anti-LGBTQ+ legislation, people embrace June as a month reserved for celebration and community. As journalist Erin Reed wrote, “We carry forward a potent legacy, one of not merely surviving but flourishing even in the margins where we’ve been relegated. We return, time and time again, stronger than ever before…The essence of queer joy is resistance in its own right, and the reverberations of the Stonewall resistance continue to echo in our celebrations today.” (Reed, 2023) 

There are many ways to celebrate Pride month! Whether it is reading a book centering LGBTQ+ narratives, attending a local Pride event or watching a documentary, the following list serves as a starting point for celebrating and uplifting the LGBTQ+ community this month and all year long!

A person holding a cut out of a rainbow colored heart
Photo credit: Photo by Pavel Danilyuk

Books:

Reading books written by LGBTQ+ authors or that feature LGBTQ+ characters is an excellent way to celebrate Pride and feel connected to the community. They are a plethora of books that span genres. If you’re not sure where to begin, consider turning to sources such as the Lambda Literary Awards or the Stonewall Book Awards lists that have recognized LGBTQ fiction and non-fiction for years. Or start with some of the following titles: 

For additional community building, consider organizing a book club with your peers. You can select one title to read together and hold a discussion. Or each member of the book club can commit to reading a different book that was written by an LGTBQ+ author and make their pitch as to why the other members should read it as well! 

Documentaries:

Watching documentaries is another way to celebrate Pride this year! Similar to the book club suggestion, you can hold a documentary watch party and discussion to share any insights you have after viewing the film. Some titles that may be worth watching include Paris is Burning  an intimate look at New York City’s drag and ballroom culture in the 1980s; A Secret Love a film about Terry Donahue, Pat Henschel and their decades long love story; Disclosure that explores the depiction of transgender people in cinema; or United in Anger: A History of ACT UP which looks at the rise of the AIDS activist movement.

For additional recommendations on LGBTQ+ documentaries, please see Advocate’s 32 LGBTQ+ Documentaries to Watch for LGBTQ+ History Month, Collider’s Queer History is Pride: 11 of the Best LGBTQ Documentaries or Rotten Tomatoes’ 40 Essential LGBTQ+ Documentaries. 

Local Events:

Washington D.C. and the surrounding area is home to an active and vibrant LGBTQ+ community. Each June the city is nearly bursting with activities to meet new people, learn about the history of Pride or celebrate with your friends. The most popular event is the annual Capital Pride parade and festival which took place this past weekend. But there are still numerous opportunities to celebrate Pride in the area. 

On June 14, As You Are will hold its inaugural Queer Open Mic Night where writers, musicians, comedians and others can share their work! Want to shop for books and meet local readers? Then purchase a ticket for Little District Books’ June 22 Pride Party. The National Portrait Gallery will host an online conversation titled ‘Sexuality and the Harlem Renaissance’ on June 20. Near the end of June, The DC Mayor’s Office will present this year’s District of Pride Showcase at Lincoln Theatre!

Looking for other Pride events in the area? Check out the Pride guides from DC Trans Events, Clock Out DC or Queer Talk DC!

Volunteer:

If you want to give to the LGBTQ+ community, there are local and national organizations in need of volunteers. The DC Center for the LGBT Community sponsors local volunteer opportunities throughout the year. Or become a volunteer for organizations like The Trevor Project, the Human Rights Campaign or PFLAG!

If you are interested in organizing an event at George Washington University, Himmelfarb Library’s Diversity, Equity and Inclusion Committee is open to partnering with student, resident or faculty groups! Please contact the committee’s current chair, Rachel Brill at rgbrill@gwu.edu for more information! 

Whether you are a member of the LGBTQ+ community or an active ally, Pride month is a time to connect with our loved ones and celebrate strides gained through activism. It is also a month where we recognize the many contributions the community has made to our contemporary culture. No matter how you decide to celebrate Pride, what is most important is that we collectively work to build a world where people, regardless of their sexual orientation, gender or gender expression can live as their most authentic selves!

References: 

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Photo Credit: Jason Henry via Heinz Awards

Dr. Abraham Verghese is a physician, best-selling author and professor of medicine at Stanford University of Medicine. Verghese is known for work with bedside medicine and the benefits of providing patients with physical examinations. In a 2011 TEDTalk, Verghese said “Too often these days, rounds look very much like this, where the discussion is taking place in a room far away from the patient. The discussion is all about images on the computer, data. The one critical piece missing is that of the patient.” (Verghese, 2011) Verghese is also known for his creative writing career and has published two nonfiction books and two fiction novels. He believes physicians should read more than scholarly or nonfiction texts, saying “I preach to my medical students that to fully imagine their patients’ lives they must read fiction, because fiction is the great lie that tells the truth (to paraphrase Camus).” (Clarke, 2023)

Dr. Abraham Verghese was born in 1955 in Addis Ababa, Ethiopia to two Indian parents. His parents worked as educators in Ethiopia and he first began his medical education in the country. In an article from the New York Times, Verghese credits W. Somerset Maugham’s book Of Human Bondage as influencing his decision to become a physician: 

“Somehow, when I read those words as an underachieving student in high school, it suggested to me that anyone with a curiosity and empathy for their fellow human beings and a willingness to work hard could be a good physician and be rewarded by work that has great meaning.” (Clarke, 2023)

Unfortunately, political unrest interrupted Verghese’ medical education. In the 1970s, the Ethiopian emperor and government were overthrown and a civil war broke out across the country. Verghese, along with his parents and siblings, left Ethiopia for the United States. While living in the U.S. Verghese worked as an orderly. He continued to pursue a career in medicine. He attended Madras Medical College in India and graduated in 1980. He pursued a residency program in Johnson City, Tennessee. In 1983, after completing his residency, he was selected for a fellowship at Boston College School of Medicine. During his time in Boston, he witnessed the HIV outbreak that hit urban areas such as Boston and other major cities. Verghese returned to Johnson City, Tennessee and once again was face to face with the impacts of HIV/AIDS, this time in a rural setting. 

When reflecting on that time, Verghese said “I first toyed with the idea of writing because I was so affected by what I witnessed as an infectious diseases specialist during the early years of the AIDS epidemic, taking care of dying men (mostly) who were my age.” (Clarke, 2023) He later wrote about his experiences in his first book My Own Country: A Doctor’s Story of A Town and Its People in the Age of AIDS.

Verghese took a break from practicing medicine and attended the Iowa Writers Workshop at the University of Iowa. He earned his Masters of Fine Arts in 1991. He served as a Professor of Medicine and Chief of the Division of Infectious Diseases at Texas Tech Health Sciences Center. Then in 2007, Verghese moved from Texas to California to work as a professor at Stanford University School of Medicine, a position he still holds. 

Dr. Verghese also maintains a successful writing practice and career. Besides his first book, My Own Country, Verghese has also published The Tennis Partner: A Story of Friendship and Loss, Cutting for Stone and most recently The Covenant of Water which is an Oprah Book Club selection. The Covenant of Water has received high praise from reviewers. An NPR review stated “Ever the skillful surgeon, Verghese threads meaningful connections between macrocosmic and microcosmic details so elegantly that they are often barely noticeable at first.” (Bhatt, 2023) The reviewer also noted that “Whether describing the spice craze sweeping across Europe, Kerala’s breathtaking coastal views, the overpowering Madras evening breeze, or the lively Anglo-Indian enclaves, Verghese tends to be lyrical. But he writes with such singular detail and restrained precision that it is a pleasure to be swept along and immerse deeper.” (Bhatt, 2023) If you are interested in hearing Dr. Abraham Verghese speak or want to learn more about his latest release, please see this upcoming Politics and Prose event!

If you would like to learn about Dr. Verghese’s experiences as a physician or his clinical research interests, read his recent publications such as “Medicine is Not Gender-Neutral–She is Male,” “Practices to Foster Physician Presence and Connection With Patients in the Clinical Encounter” or watch his 2011 TEDTalk “A Doctor’s Touch.” 

Works Cited:

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Jewish American Heritage Month dates to 2006 when it was first proclaimed by then President George W Bush in reflection of the 350th anniversary of Jews first arriving in America.  A group of 23 Sephardic Jews fled persecution in Dutch Brazil during the Portuguese Inquisition and arrived in New Amsterdam (now New York) in 1654.

Since then the Jewish community has been an important contributor to American culture and prosperity, including many discoveries and advances in medicine. These were achieved despite barriers to becoming health professionals that existed well into the 20th century. Limited quotas for Jewish enrollment were quietly instituted in medical schools and post-graduate training in the 1920’s and there is evidence that the quotas continued until the 1950s. 

The quotas were in response to a wave of immigration by Russian and Eastern European Jews from the 1880s to 1920. Many of these immigrants and their children pursued medical training, due to their high esteem for medicine as a profession and the pathway it provided to a middle class life in America.  The number of Jewish physicians who graduated from medical colleges in 10 major US cities increased from 7 in 1875-1880 to 2,313 in 1931-35. 

Following World War I,  the rise of nativism and anti-Semitism in the United States was reflected in the growth of organizations like the Ku Klux Klan and anti-immigrant groups.  Russian and Eastern European Jews were particularly discriminated against due to prejudice about their culture, countries of origin and suspected revolutionary ideologies, as well as their religion. The institutions that Jewish medical students were entering were largely private, Protestant universities and colleges and there was growing pressure to keep their numbers down, resulting in both official and unacknowledged quotas. 

“In an era in which it was estimated that 32-50% of U.S. medical school applicants were Jews, the medical historian Henry Sigerist wrote that “Jewish students are subject to a tacit, but nevertheless highly effective, quota-system and in most schools the number of Jewish students rarely exceeds 10 per cent. …”

(Halperin, 2019)

The president of Harvard in the 1920s, A. Lawrence Lowell, was a member of the Immigration Restriction League and openly endorsed admission quotas. Columbia and Yale both had explicit quotas starting in 1918 and 1920. At Yale, the admissions committee was to admit no more than 5 Jewish students per medical class.  The University of Michigan began requiring interviews for entry to medical school in the late 1920s and subsequently rejected many Jewish applicants based on their personalities.  Many schools also required disclosure of religion and family background on applications.

“A 1946 review of thirty-nine U.S. medical school application forms showed that all asked the applicant’s religious preference or affiliation, ten asked for the religion of the applicant’s parents, fifteen asked the parents’ race, and eleven inquired if the family name had ever been changed.”

(Halperin, 2001)

As the Second World War ended, attitudes began to change and there was increased sympathy for the Jewish community and Holocaust survivors in the US. Jewish associations worked to enact anti-discriminatory education policies and had the support of President Truman’s Commission on Higher Education. The state of New York and city of Philadelphia both launched investigations into the quota system, exposing it to the public. New York’s Hart Report found that Jews, African-Americans and Italian Roman Catholics were selectively denied admission to the medical schools at Cornell and Columbia. The State University of New York system was founded in the wake of the Hart report, creating new public medical schools in the state.  Several Jewish medical schools were established in the 1950s including Albert Einstein Medical College and Mt Sinai School of Medicine. 

The AMA and AAMC did little to investigate or condemn the quota system. In 1947 when the two organizations published findings of a survey of medical schools, they defended the practice of asking questions about race, religion and family background on applications and opposed anti-discriminatory policies saying they would interfere with school’s freedom to select students “who will most advance the quality of medical education.” 

Despite all of these challenges, the achievements of Jewish physicians and medical researchers in the 20th century are remarkable. We can thank them for the polio and hepatitis b vaccines, the invention of Novocain and streptomycin, pioneering surgical procedures, and important genetic advances.  See this Wikipedia entry for a list of the many Jewish American Nobel laureates in Physiology and Medicine.

References

Halperin E. (2001) The Jewish Problem in U.S. Medical Education, 1920–1955, Journal of the History of Medicine and Allied Sciences, 56(2), 140–167. https://doi.org/10.1093/jhmas/56.2.140

Halperin E. (2019). Why Did the United States Medical School Admissions Quota for Jews End? The American Journal of the Medical Sciences, 358(5), 317–325. https://doi.org/10.1016/j.amjms.2019.08.005

Sokoloff L. (1992). The rise and decline of the Jewish quota in medical school admissions. Bulletin of the New York Academy of Medicine, 68(4), 497–518.

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Himmelfarb’s Diversity, Equity and Inclusion Committee (DEI Committee) is pleased to announce the release of the new Antiracism in Healthcare research guide! This guide is one of many ways Himmelfarb Library is showing its commitment to cultivating an inclusive and welcoming environment within the library. The guide features healthcare organizations, journal collections, virtual tutorials and more to help you learn about antiracism and racial biases in healthcare. Some of the resources listed include:

Please note that some of the resources, such as ebooks and journal collections, may require GW credentials to access. 

The DEI Committee envisions this guide growing over time and we are interested in community feedback and being transparent about the selection process. To show our commitment to community building and transparency, the resource selection criteria is featured on the guide’s homepage and the Committee will evaluate suggested resources based on the five listed categories and evaluation questions. Students, staff and faculty members are invited to submit resources they believe will make an excellent addition to the guide. If there is a book, documentary, podcast show/episode, online training, healthcare organization or other valuable resource that you believe should be included, please fill out the ‘Resource Suggestion Google Form’.

Additionally, if you are a member of a GWU organization and would like for your organization to be featured on the research guide or if you’re interested in partnering with the DEI Committee, please contact the current committee chair, Rachel Brill, at rgbrill@gwu.edu!

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Trans and gender diverse people often report encountering many barriers to care when seeking health care services. According to researchers, some of these barriers include trans and gender diverse people being uninsured/underinsured, patients having to teach their providers about transgender health, experiencing transphobic discrimination during healthcare visits, and a general lack of healthcare providers knowledgeable about transgender health (Safer et al., 2016; Warner & Mehta, 2021). Citing the 2015 United States Transgender Survey, Warner & Mehta write that “Among the conclusions provided, 33% of respondents seen by a healthcare provider within the year prior to completing the survey reported having at least one negative experience related to their gender identity” (Warner & Mehta, 2021, pg. 3359).

Providing a safe and nonjudgmental healthcare environment is necessary when interacting with any patient. Many trans and gender diverse people report that many of the solutions are relatively simple and will improve the quality of care for everyone. In an effort to continue the discussion on supporting the trans community, particularly in healthcare settings, this article will serve as a follow-up post to our recent article International Transgender Day of Visibility, and provides tips on how to interact with trans and gender diverse patients.

Tips:

  • Use a patient’s personal name and pronouns: A simple way to make trans and gender diverse patients comfortable is by using their personal name and pronouns. If you are unsure of how to refer to your patients, ask what their pronouns are and how they would like to be referred to. You can also offer your name and pronouns first and offer them the opportunity to share their information. In an article in Healthline, KB Brookins also suggests providers evaluate their intake forms and include information fields such as “Legal name for insurance, chosen name/nickname, sex assigned at birth (if necessary), sex listed on insurance, pronouns, gender identity, sexual orientation (if necessary)” (Brookins, 2022). Consider leaving open fields for people to write in their responses instead of checking off a set number of boxes. Using a person’s correct pronouns and name will build trust between patients and providers and this will encourage patients to return for future appointments. 
  • Do not ask personal questions not related to care: Trans and gender diverse people are subjected to frequent and invasive questioning about their bodies or any medical procedures they may have experienced. This form of questioning is deeply personal and can make trans and gender diverse people uncomfortable. Vermeir, Jackson & Marshall write “Many trans people encounter HCPs [healthcare providers] who ask inappropriate questions regarding their trans identity or bodies, or questions that are irrelevant to their care” (Vermeir, Jackson & Marshall, 2018, pg. 16). To avoid these uncomfortable situations, Vermeir et al. suggests that providers maintain professional boundaries and ask questions that are directly related to the reasons behind a patient’s current visit. “Participants recommended that HCPs remember that a patient’s purpose is not to satisfy one’s interest, and that even if a question is relevant to one’s care, it must be asked with sensitivity and appropriateness” (Vermeir, Jackson & Marshall, 2018, pg. 16). 
  • Learn more about the community from multiple perspectives: Understanding the transgender community allows providers to better understand their patients’ needs and provide a high standard of care. It may seem easy to ask your patients about the history and current state of the transgender community, but some trans and gender diverse people report that they feel burdened when placed in this position. There are organizations, novels, memoirs, historical accounts, and other resources that may serve as appropriate sources of information. Resources will be listed in the ‘Reference’ section. Here is a brief selection of titles:

These tips are just a starting point for treating transgender and gender diverse patients with respect and dignity. Vermeir, Jackson & Marshall also suggest that educational organizations broaden the scope of their curriculums to include transgender health and healthcare. The authors say “...we believe that there is also a need for education organizations and regulatory bodies to incorporate this topic into their curriculums and continuing education opportunities to promote HCPs’ cultural competence including an acknowledgment of the power differentials between HCPs and trans patients” (Vermeir, Jackson & Marshall, 2018, pg. 15). Ultimately, healthcare providers must listen to transgender and gender diverse patients and unlearn any biases they may have about the transgender community. By incorporating these and other tips into your practice, you will build trust with your trans and gender diverse patients making it easier to meet their healthcare needs.

References:

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The Transgender pride flag done in chalk on a gravel background
Photo credit: Photo by Katie Rainbow 🏳️‍🌈

LGBTQ+ news outlets and civil rights organizations are reporting that across the country local, state and federal legislatures are continuing to introduce legislation that targets the transgender community. The Human Rights Campaign’s (HRC) President Kelley Robinson noted in an a recent interview that the organization is “currently tracking over 400 bills against our community” (Riedel, 2023, para. 9) and the HRC released a new report which found that “more than one-fifth of trans youth live in states that have passed bans on gender-affirming care for minors” (Factora, 2023, para. 1). For many transgender individuals, supportive family members, and friends and allies, the onslaught of anti-trans bills and legislation feels stifling and overwhelming. To honor this year’s International Transgender Day of Visibility, this article will offer resources and tools to help transgender people and allies in the fight for safe and affirming healthcare. 

Most legislation seeks to limit children’s and teen’s access to gender-affirming services, though some journalists note that certain states are now moving to limit trans adults’ access to care. Independent journalist and activist Erin Reed “is particularly concerned about a new type of gender-affirming care ban that includes trans adults….These new bills would, in effect, force trans adults to detransition by restricting the gender affirming care they may already have been accessing.” (Haug, 2023, para. 5)  

Them, an online LGBTQ+ news outlet, reported that “Bills targeting the rights of trans youth at school and in health care are also gaining ground…These include school-based bills, which often target trans students’ privacy around using their correct pronouns and names at school, as well as bills targeting pronoun use more generally” (Haug, 2023, para. 12). 

On a federal level, H.R.5 which was introduced in the House of Representatives earlier this year, would “require elementary and middle schools that receive federal funding to obtain parent consent before “changing a minor child’s gender markers, pronouns, or preferred name on any school form; or allowing a child to change the child’s sex-based accommodations, including locker rooms or bathroom” (Mizelle & Wilson, 2023, para. 4). While this bill passed in the House of Representatives, it is not expected to be voted on in the Senate. 

Some states are moving to secure or expand the healthcare rights of transgender people. In Maryland, the legislature passed the Maryland Medical Assistance Program–Gender-Affirming Treatment also known as the Trans Health Equity Act and this is expected to be signed into law by Governor Wes Moore. This bill will go into effect on January 1, 2024, and many activists see the bill as one of the most positive pieces of legislation to date. The Trans Health Equity Act “would require Maryland Medicaid, beginning Jan. 1, 2024, to provide coverage for additional gender-affirming treatments…The expanded treatments include hormone therapy, hair alteration, voice therapy, physical alterations to the body, and fertility preservation” (Gaines & Sears, 2023, para. 9). Maryland’s bill could serve as a template for other states that seek to provide healthcare services to trans individuals. 

While many anti-trans bills fail to become laws, their existence impacts the mental health of transgender people. The Trevor Project, an LGBTQ+ youth advocacy organization, reported in January that “state-level anti-trans laws negatively affected the mental health of 86% of trans and nonbinary youth between ages 13 and 24” (Factora, 2023, para. 6). Researchers found that trans and gender-diverse youth who receive gender-affirming care experience “lower rates of adverse mental health outcomes, build [their] self-esteem, and improve [the] overall quality of [their] life…” (Department of Health and Human Services, n.d., pg. 1; Green et al. 2022). It is important to support the transgender community and work alongside activists and organizers as they seek to expand trans people’s access to gender-affirming healthcare. 

With any civil rights issue, it is vital to listen to activists, organizations and the people most impacted. Journalists and trans rights organizations are actively tracking new and upcoming bills that target their community and they often provide new, verified updates as soon as they’re made available. Organizations and individuals who are actively working to inform the public include:

  • Erin Reed is an activist, journalist, and content creator who shares updates on anti-LGBTQ+ legislation in the United States and around the world. She seeks to “achieve gender justice for queer and marginalized people through education and understanding” (Reed, n.d., para. 1). Her content is available via Twitter, TikTok, Instagram, and her Substack newsletter. Her website also features an informed consent HRT (hormone replacement therapy) map and an anti-trans legislative risk map. Both of these resources are updated frequently. 
  • The Trans Formation Project is a grassroots organization “dedicated to tracking and educating about the anti-trans legislative crisis currently sweeping the United States” (Trans Formation Project, 2023, para. 1). The organization’s website features resources that educate people on the current landscape of legislation that impacts the lives of trans people. The organization tracks local, state and federal legislation and also has a ‘Legislator Scorecard’ for people interested in learning about their representatives’ stances on trans rights and the trans community. 
  • The Human Rights Campaign (HRC) is another organization that seeks to support the LGBTQ+ community and strives to build an inclusive environment within the United States and around the world. The organization also actively tracks current legislation. The HRC provides resources to educate people on LGBTQ+ issues and the community. Their ‘Myths and Facts: Battling Disinformation About Transgender Rights’ and ‘Transgender and Non-Binary People FAQ’ are examples of some of the resources that affirm the lived experiences of trans and gender-diverse individuals. 

Himmelfarb Library’s collection contains resources that discuss trans healthcare. Some of the titles include:

Our Diversity and Disparities in Health Care collection features over a hundred items and is an invaluable resource for users who wish to learn more about trans healthcare and how to interact with their trans and gender-diverse patients. 

The amount of new discriminatory legislation and harmful rhetoric surrounding the trans and gender-diverse community is overwhelming. If you are mentally or emotionally impacted by the continuation of anti-trans sentiments and laws, please seek mental health services, if possible. SMHS’s Mental Health Resources page can connect you with mental health resources that may be beneficial. GW’s Counseling and Psychological Services (CAPS) provides mental health counseling to GW students and the community.  

On this year’s International Transgender Day of Visibility, we recognize that the fight to protect and affirm transgender and gender-diverse people is still ongoing. In February 2023, Gabrielle Union-Wade and her husband Dwyane Wade gave an emotional and inspiring speech that called on people to continue to fight for trans rights. We would like to share their speech in an effort to remind people of the importance of this work:

References:

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Five people seated at a conference table.

Since 2020, many people have actively sought out books, podcasts, webinars and other media to help them understand the origins of and ways to dismantle systemic injustices. People interested in incorporating anti-discriminatory techniques and practices into their daily lives may find it difficult knowing where to start. Taking large steps such as attending a rally or contacting your elected official may appear to be the only way to move towards change. But smaller actions are equally important and necessary. 

According to scholars, without education and a deeper understanding of systemic harms, it is difficult to address these harms or work towards solutions. Education is the first and crucial step in uncovering implicit and explicit biases. If you are interested in learning more about the history of racism, sexism, homophobia or any other form of discrimination, please visit GW SMHS Office of Diversity and Inclusion’s Anti-Racism Resources for Physicians or explore any of the resources listed in the references section. Journalist Anna North quotes educator and author Cornelius Minor in a Vox article, stating “Once you’ve educated yourself, the next step is “to actually take action that benefits the members of your community…”” (North, 2020, para. 22)

Scholars, activists and others have suggestions for allies who wish to address long-standing systemic issues:

  1. Be mindful of how you use social media: Social media is a useful tool for spreading awareness, sharing resource lists, connecting with like-minded individuals/organizations or listening to marginalized voices. Yet the ease in which people can ‘like’, comment or reshare posts means people may engage with content on a superficial level or mimic their peers without a deeper awareness of why an issue is important. This may be seen as ‘virtue signaling’ or ‘performative allyship.’ Virtue signaling is defined as “an attempt to show other people that you are a good person, for example by expressing opinions that will be acceptable to them, especially on social media.” (Cambridge Dictionary, n.d.) While performative allyship is “the practice of words, posts and gestures that do more to promote an individual’s own virtuous moral compass than actually helping the causes that they’re intending to showcase.” (Kersten, 2020, para. 6) Information moves rapidly on social media platforms and you may feel as if you need to share your opinion online. Before rushing to Facebook, Twitter or Instagram, ask yourself if you’re posting to alleviate your own anxiety or because you genuinely wish to show support and think about if there are alternative actions you can take instead of relying on social media. “With any kind of supposed social media activism, we need to be critical and examine who it’s actually helping and if there is a way it could be more effective.” (Rudhran, 2020, para. 11) There is no harm in expressing your support of marginalized communities online, but make sure your support is also visible and tangible offline. 
  2. Have difficult conversations: Challenging the opinions of your social circle can be hard and may activate complex emotions or responses. You may hear a harmful remark from a close friend or family member, but feel anxious about addressing the remark. “This physiological impact of conflict and stress prompts the brain to release cortisol and adrenaline into the bloodstream, putting the body into a fight, flight, or freeze response. In this state, we are biologically primed to respond to imminent danger–not to do complex thinking or bring our social graces to bear.” (Jackson, 2019, para. 23) Despite this, having difficult conversations not only provides space to educate and learn from others, but it also takes stress away from marginalized people who are already handling the stress of frequent systemic harm. If you’d like to engage in more in-depth conversations, there are resources that can assist you such as this guide from Teaching Tolerance or this article from Jamilah King. (North, 2020)
  3. Donate time or resources: Volunteering is a great way to connect with your local community. Nonprofit organizations often rely on volunteers to operate and deliver relief to the neighborhood. If there is an organization you’re interested in helping, research to see if they have volunteer opportunities. You can commit to becoming a regular volunteer or you can volunteer as your schedule permits. Consider bringing friends or family members with you as well. If you’re unable to volunteer your time, then think about making a financial donation to an organization if it is feasible. No matter how you decide to donate time or resources, supporting and uplifting organizations is a way to reaffirm your commitment to anti-discrimination ideals. 
  4. Speak out against discriminatory practices: Being aware of and understanding socioeconomic disparities enables you to speak out against discriminatory policies and practices that discriminate. In the workplace, long-standing hiring practices may unintentionally keep the selection pool small and homogeneous. If you’re in a position to evaluate hiring practices, speak up. “If you’re hiring, strengthen your own processes. Insist on open job listing and targeted recruiting to avoid an overreliance on referrals…Make sure candidate pools are diverse–with at least one person and ideally many people from marginalized groups. Finally, enforce fair application reviews and committee deliberations, watching for and calling out red-flag comments.” (Melaku et al., 2020, para. 32) You can also push back against harmful laws and regulations by contacting your elected representatives, attending community forums, signing petitions or by participating in other civic duties. 
  5. Admit mistakes: Being an ally means being visibly and vocally supportive of marginalized communities. But sometimes people make mistakes. If this occurs, it is best to admit to the mistake, pause for reflection and continue to show support where you can. “Being an ally is an ongoing process, and you are bound to say or do the wrong thing at certain points. Sometimes, the best way to learn is through trial and error. The important thing is to acknowledge when you’re wrong, and to not make those same mistakes again.” (Kersten, 2020, para. 10) View mistakes as opportunities to learn and grow. If someone corrects you, remain open and thank them for being willing to educate you. Being an ally does not mean you must aim for constant perfection. Instead it means offering support when you can and learning from any missteps you encounter. 

Education provides us with tools to grow and act as better allies. Action presents us with opportunities to show our commitment in tangible ways. Education and action create a steady cycle of allyship and advocacy that moves us closer towards an equitable and inclusive world. As this year’s Black History Month comes to an end and Women’s History Month approaches, spend time reflecting on how you wish to ally yourself with marginalized communities and search for opportunities to share your time or other resources with organizations in need of support. 

References:

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Photo by Wilson Rodriguez

Rev. Dr. Martin Luther King, Jr. is well known for his passionate and thoughtful speeches that examined racial discrimination in the United States, the negative impacts of poverty and a need for communities to rally behind and support vulnerable populations. One of his most well known speeches, ‘I Have a Dream,’ occurred on the steps of the Lincoln Memorial on August 28, 1963 during the March on Washington for Jobs and Freedom. 

Dr. King’s speeches primarily focused on education, access to housing, racial desegregation in public and private spaces and building an equitable country. But on March 25, 1966, Dr. King spoke at a meeting of the Medical Committee for Human Rights where he discussed racial inequities and health. The full transcript for this speech has not been discovered, though fragments of it were printed in newspapers. Similar to Dr. King’s other speeches, his speech at the meeting not only addressed the harsh realities of people of color, particularly Black Americans, in the country, but also urged the listeners to educate themselves on these inequities and pursue action to dismantle systemic oppression. 

Due to the lack of a speech transcript, there are different iterations of Dr. King’s words and thoughts on health inequity. Professor Charlene Galarneau uses the following quote in her article ‘Getting King’s Words Right’: 

“We are concerned about the constant use of federal funds to support this most notorious expression of segregation. Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death. 

I see no alternative to direct action and creative nonviolence to raise the conscience of the nation.” (Galarneau, 2018, p. 5)

Galarneau states that these words were spoken during a press conference before the annual meeting and were documented by news sources such as the Associated Press. We may never know Dr. King’s exact words during the press conference or during his speech, but this quote shows that Dr. King understood the pressing need to address injustices in health. 

During the time of his speech, Black patients and healthcare providers were facing widespread discrimination in healthcare centers. Organizations like the Medical Committee for Human Rights sought to address the healthcare needs of underserved communities, while also building healthcare centers that would continue the work once the committee’s healthcare workers relocated. “A predominantly white organization, the committee would continue to assist civil rights workers in Mississippi and other southern states but shifted its focus to deal with health problems facing thousands of poor blacks who lacked any medical services.” (Dittmer, 2014, p. 746)

Dr. King’s speech highlighted another area of society that suffered from racial and economic discrimination, thus furthering the divide between the privileged and underserved. As Galarneau writes in her article “King’s words remind us that health and health care are social goods at the community and national levels. As such health and health care are socially created and require social responsibility in a collective agreement about what constitutes health in/justice.”(Galarneau, 2018, p. 7)

Dr. King’s remarks are also a call to action. He believed that everyone had a role to play in dismantling injustices domestically and globally. He strongly encouraged people to seek out information about the issues related to racism and economic inequality and apply this knowledge to establish and maintain inclusive communities.

As we all spend the MLK holiday weekend reflecting on the words and legacy of Rev. Dr. Martin Luther King Jr., Himmelfarb Library would like to offer resources and promote events that build upon the advocacy work that Dr. King participated in. Himmelfarb Library’s Diversity and Disparities in Health Care, Diversity in Dermatology and Humanities & Health Collection highlight library resources that explore topics related to inequities in health care and how to build a more inclusive health care system. 

On Wednesday, January 25 at noon, the Anti-Racism Coalition will hold the 7th Annual SMHS Dr. Martin Luther King, Jr. Lecture Series–Advancing the Dream: Why We Can’t Wait. Milken Institute School of Public Health professor, Dr. Wendy Ellis, will participate in a conversation about “race, advocacy, and finding your voice in the fight for racial justice…” Registration for this event is now open. 

If you are interested in taking action to address health inequities, consider joining local student or professional organizations such as White Coats for Black Lives, Antiracism Nursing Student Alliance or Black Public Health Student Network. Collaborate with your peers to find creative solutions to teach the public about health injustices or search for local issues that may need your support. 

Dr. King understood that a coalition was required to build an inclusive and equitable future and we can honor his legacy by connecting with like-minded community members and seeking out their advice and feedback.

References:

Galarneau, C. (2018). Getting King’s Words Right. Journal of Health Care for the Poor and Underserved, 29(1), 5–8. https://doi.org/10.1353/hpu.2018.0001

Dittmer, J. (2014). The Medical Committee for Human Rights. AMA Journal of Ethics, 16(9), 745-748. https://doi.org/10.1001/virtualmentor.2014.16.9.mhst1-1409

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Photo by EVG Kowalievska

The United States has a history of assisting vulnerable populations with community needs, often with varying degrees of success. The Indian Health Service (IHS), part of the Department of Health and Human Services, is one such government organization that provides healthcare for millions of Indigenous people and since its inception, the service has positively impacted federally recognized Native nations despite budgetary constraints. The Service employs physicians, nurses, dentists and other healthcare professionals to meet the healthcare needs of Indigenous populations and the organization sponsors professional opportunities for Indigenous students at both the undergraduate and graduate levels who express an interest in entering the healthcare field.

The Indian Health Service was created in 1955 and was born out of a long history of the United States government providing assistance to Indigenous nations. “The provision of health services to members of federally-recognized tribes grew out of the special government-to-government relationship between the federal government and Indian tribes. This relationship, established in 1787, is based on Article 1, Section 8 of the Constitution, and has been given form and substance by numerous treaties, laws, Supreme Court decisions, and Executive Orders.”(Warne & Frizzell, 2014, p. S263) The federal government would send military physicians to Indigenous communities in an effort to address the spread of diseases such as smallpox. Unfortunately the government spent far less money on the healthcare of Indigenous people in comparison to members of the military. In 1880, the Commissioner of Indian Affairs, Thomas J. Morgan requested more funding to cover expenses and he “calculated the disparity in resources, finding that the Army spent $21.91 per soldier and the Navy $48.10 per sailor, while the government only appropriated $1.25 per Indian patient.” (Trahant, 2018, p. 118)

In 1911 President William Howard Taft urged Congress to raise the salary of healthcare workers employed in the Indian Service. But the history of underfunding Indigenous healthcare continued. When the Bureau of Indian Affairs opened a health division in 1921, the system suffered from poor funding, unsanitary facilities and inadequate supplies which placed a strain on the quality of care provided. In 1955, Congress transferred the health programs away from the Bureau of Indian Affair to the newly formed Indian Health Service. They also raised the service’s budget from $10 million to $17.7 million a year. Finally in 1976, “Congress proposed a sweeping new authorization for Indian health programs. The Indian Health Care Improvement Act…called on Congress to appropriate at least $1.6 billion in new funding for Indian health, spending resources on improving staffing, facilities, access to care for urban Indian populations, and, for the first time, opened up Medicare and Medicaid revenue.” (Trahant, 2018, p. 119)

The Indian Health Service’s headquarters is located in Rockville, Maryland and has twelve service areas located across the country. The current head of the service is Roselyn Tso, an enrolled member of the Navajo Nation. Tso began working for the Service in the 1980s and has worked in many different capacities, including serving as the director of the Indian Health Service Navajo Area in 2019. The Indian Health Service provides access to hospitals, health centers, dental clinics and behavioral health facilities to Indigenous communities in the twelve service areas. The organization also offers healthcare education so people can improve their quality of health outside of regularly scheduled appointments. The Indian Health Service is one of the few federal organizations that prioritizes Indigenous applicants during the job search process and they also host funding opportunities for students interested in a career in healthcare. Scholarships are available for undergraduate, graduate and preparatory school students. The Indian Health Service also offers an extern program where participants earn valuable, hands-on skills while working in IHS facilities. 

While the organization continues to suffer from poor funding in comparison to other federal organizations, the Indian Health Service has improved the overall health of their patients. For example, the infant mortality rate for Indigenous communities has drastically decreased since 1955 and “The Centers for Disease Control and Prevention reported that, in the United States from 2004 to 2008, 84 percent of American Indians and Alaska Natives have a ‘usual place for health care.’” (Trahant, 2018, p. 120) Besides the lack of adequate funding, another criticism of the Indian Health Service is the organizations’ lack of focus on Indigenous people who live in urban areas.  Over the years, the IHS has sought  to provide resources to patients in urban areas,  and to meet the needs of over 2 million Indigenous patients.

The Indian Health Service was born out of the numerous treaties, legally binding agreements and promises made between the US federal government and the governments of Indigenous nations such as the 1832 treaty between the War Department and the Winnebago Tribe in Wisconsin in which the federal government promised two physicians in exchange for land (Trahant, 2018). The healthcare and administrative workers in the IHS search for creative solutions to meet the pressing healthcare needs of their patients. And by offering scholarships and externships, the organization aims to tackle the healthcare industry’s lack of Indigenous workers. The Indian Health Service’s mission is “To raise the physical, mental, social, and spiritual health of American Indians and Alaska Natives to the highest level” and by fulfilling this mission, the IHS provides an example for other healthcare organizations committed to addressing health disparities in other vulnerable and underserved communities.

References:

Indian Health Service. (n.d.). Indian Health Service: The Federal Health Program for American Indians and Alaska Natives. https://www.ihs.gov/

Marcinko, T. (2016, November 13). More Native American Doctors Needed to Reduce Health Disparities in Their Communities. AAMCNEWS. https://www.aamc.org/news-insights/more-native-american-doctors-needed-reduce-health-disparities-their-communities. 

Warne, D. & Frizzell, L.B. (2014). American Indian Health Policy: Historical trends and contemporary issues. American Journal of Public Health, 104(3), S263-S267. https://doi.org/10.2105/AJPH.2013.301682

Trahant, M.N. (2018). The story of Indian health is complicated by history, shortages, & bouts of excellence. Daedalus, 147(2), 116-123. https://doi.org/10.1162/DAED_a_00495

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Portrait of Dr. Antonia Novello.
Photo By United States Department of Health and Human Services

Dr. Antonia Novello is a healthcare professional who for many decades focused on improving the health of women, children and those most vulnerable in modern society. 

She was born in Puerto Rico on August 23, 1944 and is the oldest of three children. During her childhood, Dr. Novello suffered from congenital megacolon which impacted her large intestine. Treatment options were available, but due to her family’s financial situation, Dr. Novella was unable to receive surgery to cure the condition until she was eighteen years old. This experience had a lasting impact on her and was one factor that inspired her to pursue a career in health sciences. Dr. Novello earned a multitude of degrees and certificates including a Bachelor of Science and a Doctor of Medicine from the University of Puerto Rico in 1965 and 1970 respectively and a master degree in Public Health from John Hopkins University in 1982.  

After marrying Joseph R. Novello and moving to Michigan, Dr. Antonia Novello completed an internship and residency in pediatrics and a fellowship in pediatrics nephrology. She took an interest in nephrology after a beloved family member died due to complications with their kidneys. Dr. Novello practiced medicine in a private office for two years, but eventually transitioned to work for the National Institutes of Health (NIH) in 1978. Novello focused on health issues related to women, children and marginalized communities during her time at NIH. She was instrumental in the legislation that led to the creation of the national organ transplant registry and she also played a significant role in requiring all cigarette containers be labeled with a health warning. In 1989, President George H.W. Bush selected her as the new United States Surgeon General making her both the first woman and the first Hispanic American to fill the role. 

Novello served as the U.S. Surgeon General from 1990 until 1994 when the Clinton Administration began. During her tenure, Novello continued to advocate for women and children. “In March 1992, she and James S. Todd, executive vice-president of the American Medical Association (AMA), held a news conference at which they denounced the R.J. Reynolds Tobacco Company’s advertisements featuring the cartoon character Joe Camel, because research showed that it appealed to young children.” (Meier et al., 1997, p. 272) Novello was also vocal about the alcohol industry’s marketing practices, particularly the industry’s use of advertisements which showed people skiing, surfing or mountain climbing with alcoholic beverages close by as it suggested people could perform these activities while consuming alcohol. Novello also raised awareness on domestic violence and its impact on women. (Meier et al. 1997)

After 1994, when a new Surgeon General was appointed, Novello continued to work within the healthcare industry until her retirement in the 2010s. Novello currently spends her time between Puerto Rico and Florida and is still an active advocate for the health needs of others. Most recently during the COVID-19 vaccine rollout, Novello spoke with parents and other community members of the importance of vaccination and even participated in local vaccination clinics and programs. And in August of 2021, she and other living former surgeon generals participated in a White House event where they discussed “getting information and access to vaccines to communities of color, who have been the hardest hit during the pandemic.” (Sesin, 2021)

Novello has received recognition for her work as a healthcare provider and public health advocate. Some of the awards she has received over the course of her career include “the Public Health Service Commendation Medal (1983); Congressional Hispanic Caucus Medal (1991); Order of Military Medical Merit Award (1992); and the James Smithson Bicentennial Medal (2002).” (Brandman, 2021) Dr. Antonia Novello’s lengthy career is inspirational for people committed to serving their communities and her legacy of speaking up for women and children will have profound effects for years to come. 

References:

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