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Racial Disparities in Medicine: Glossary

Shared Language for Understanding Systemic Racism and Antiracism

Ancestry: reflects the fact that human variations do have a connection to the geographical origins of our ancestors (Chou, 2017).

Antiracism: refers to supporting antiracist policies by one's actions or expressing antiracist ideas (Kendi, 2019, page 22). 

Bias: a one-sided point of view without objectivity and influences one's decisions and opinions.

Disparity: a difference or variation between groups.

Diversity: encompasses all dimensions of human differences and is defined in the broadest sense to mean inclusion of all persons regardless of racial and ethnic background, nationality, gender, gender identity, sexual orientation, veteran status, religious beliefs, ability, age, or socioeconomic status. Diversity embodies inclusiveness, mutual respect, and multiple perspectives, and serves as a catalyst for change resulting in health equity (Annie E. Casey Foundation, 2020). 

Dominant culture: refers to a majority ethnic group in which immigrants and members of other ethnic groups are expected to come to resemble the majority group in terms of norms, values, and behavior. A dominant culture appears in societies where the majority group does not tolerate different ethnic or racial identities (Kendi, 2019, pages 28-31). 

Equity: defined as "the state, quality or ideal of being just, impartial and fair" (Annie E. Casey Foundation, 2020) and is achieved by promoting fair treatment and proactively working to remove barriers that have prevented full participation by some populations. Equity is not achieved by treating everyone equally, but by treating everyone equitably. Racial equity specifically is defined as "a state in which outcomes such as health outcomes are no longer predictable by race" (American Public Health Association, 2020). 

Ethnicity: denotes groups (i.e. Irish, Fijian) that share a common identity-based ancestry, language or culture and is often based on religion, beliefs, and customs as well as memories of migration or colonization (Cornell and Hartmann, 2007).

Health disparity: a health difference that is closely linked with economic, social, or environmental disadvantage. Health disparities adversely affect groups of people who have systematically experienced greater social or economic obstacles to health based on their racial or ethnic group, religion, socioeconomic status, gender, age, mental health, cognitive, sensory, or physical disability, sexual orientation or gender, geographic location, or other characteristics historically linked to discrimination or exclusion. 

Health equity: the idea that everyone should have a fair opportunity to attain their full health potential and that non one should be disadvantaged from achieving this potential. Health equity is the absence of avoidable, unfair, or remediable differences among groups of people, whether those groups are defined socially, economically, demographically or geographically or by other means of stratification. 

Implicit bias: the automatically expressed negative associations that people unknowingly hold and that affect their understanding, actions, and decisions, are known as unconscious or hidden bias. 

Justice: the systematic and fair treatment of all people that results in equitable opportunities and outcomes for everyone. 

  • Racial justice: describes the systematic and fair treatment of all people so that everyone is able to achieve their full potential in life, regardless of race, ethnicity, or the community in which they live.
  • Social justice: constitutes a form of activism based on principles of equity and inclusion that encompasses a vision of society in which the distribution of resources is equitable and all members are physically and psychologically safe and secure. Social justice involves social actors who have a sense of their own agency as well as sense of social responsibility toward and with others and society as a whole.

Oppression: refers to a combination of prejudice and institutional power that creates a system that regularly and severely discriminates against some groups and benefits other groups (National Museum of African American History and Culture, 2020).

Privilege: refers to how some people benefit from unearned and largely unacknowledged advantages, even when those advantages are not discriminatory. White privilege refers to whites' historical and contemporary advantages in access to quality education, jobs and livable wages, homeownership, retirement benefits, and wealth (Kendi, 2019, page 38). The following quotation from a publication by Peggy McIntosh can be helpful in understanding what is meant by white privilege: "As a white person, I realized I had been taught about racism as something that puts others at a disadvantage, but had been taught not to see on of tis corollary aspects, white privilege, which puts me at an advantage...I have come to see whit privilege as an invisible package of unearned assets that I can count on cashing in every day, but about which I was 'meant' to remain oblivious."

Race: a nonbiologically based power construct of collected or merged difference that lives socially (Kendi, 2019, page 35).

Racism: refers to a complex system of racial hierarchies and inequities. There are multiple levels of racism, including the micro or individual level of racism, which denotes internalized and interpersonal racism. At the macro level of racism, we look beyond individuals to broader dynamics, including institutional and structural racism (Annie E. Casey Foundation, 2020). 

Biological racism refers to the idea that races are meaningfully different in their biology and that these differences create a hierarchy of value.
Institutional racism refers to discriminatory treatments, unfair policies, and biased practices based on race that result in inequitable outcomes for whites over people of colorand extend considerably beyond prejudice (Kendi, 2019).
Individual racism refers to the beliefs, attitudes, and actions of individuals that supportor perpetuate racism in conscious and unconscious ways (Kendi, 2019).
Systemic racism refers to whites’ historical and systematic oppression of non- European groups that manifests in the structure and operations of racist societies like the United States. It is reflected in disparities regarding wealth, income, criminal justice, employment, housing, health care, and education, among other factors (Kendi, 2019).
Structural racism is a system in which public policies, institutional practices, cultural representations, and other norms work in various, often reinforcing ways to perpetuate racial group inequity. 

In many ways, systemic racism and structural racism are synonymous. If there is a difference between the terms, it can be said to exist in the fact that a structural racism analysis pays more attention to the historical, cultural, social, and psychological aspects of our currently racialized society.

 

 

Source: Association of American Medical Colleges 

 

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