Anti-Racism Resources for Students and Professionals in Healthcare

For health providers, “not being racist” is simply not enough to counter the history of mistreatment and discrimination in healthcare that has disadvantaged communities of color for centuries. Taking daily, concrete steps to eliminate racial disparities in healthcare is critical—in their communities and nationally. Through the following resources, health professionals and students can learn more about anti-racism and equip themselves to eliminate inequities wherever they see them.

Explore the following sections:

What Is Anti-Racism?
The Cycle of Racism as a Moving Walkway
Institutional Racism in Healthcare
Combating Racism in Healthcare
List of Anti-Racism Healthcare Resources

What Is Anti-Racism?

Racism is a system of structures, policies, practices and norms that attribute value and opportunities based on skin color or appearance. In a racist society, some groups of people are advantaged, while other groups are severely disadvantaged.

Anti-racism is fighting this system on every level it operatesExternal link:, from individual and interpersonal, to institutional and structural.

Anti-racism has roots in abolition and the civil rights activism of Black Americans, over decades and centuries. The work of acclaimed scholar and author Ibram X. KendiExternal link: and others has brought the ideology to the forefront in recent years, emphasizing the need for structural changes such as ending medical discrimination.

In practice, anti-racism combines awareness and action. Someone who is anti-racist is actively seeking to understand how racism functions in their society and takes steps to end racial inequities, such as racism in healthcare.

The Cycle of Racism as a Moving Walkway

To better understand the need for anti-racism efforts, author and psychologist Beverly Daniel Tatum External link:asked readers to picture a moving walkway at an airport. Active racist behavior is equivalent to walking quickly down the walkway, and passive racist behavior is standing still. Both are caught in the cycle of racism.

“But unless they are walking actively in the opposite direction at a speed faster than the conveyor belt, unless they are actively anti-racist, they will find themselves carried along with the others,” wrote Tatum in Why Are All the Black Kids Sitting Together in the Cafeteria?

ACTIVE RACIST BEHAVIOR:

walking faster on the walkway

PASSIVE RACIST BEHAVIOR:

standing still on the walkway

ANTI-RACISM:

walking backward on the walkway

The moving walkway carries everyone on it automatically toward a more racist and inequitable society. Active racist behavior is equivalent to walking quickly with the motion of the walkway, whereas active antiracist behavior is walking backward against the walkway. Even though the person demonstrating passive racist behavior is motionless on the walkway, they still get swept along with racism.

In other words, no one is neutral, said Kendi, who founded the Center for Antiracist Research at Boston University. “There is no in-between safe space of ‘not racist.’ The claim of ‘not racist’ neutrality is a mask for racism.”

For health professionals, practicing anti-racism in healthcare starts with understanding their position in a racist society and in a system with a history of medical discrimination.

Going further, anti-racism entails “taking stock of and eradicating policies that are racist, that have racist outcomes, and making sure that ultimately, we’re working toward a much more egalitarian, emancipatory society,” as scholar and professor Malini Ranganathan put it in a 2020 Vox article that breaks down anti-racismExternal link:.

Institutional Racism in Healthcare

Centuries of racism have profoundly harmed the health and well-being of communities of color in the United States. In April 2021, the Centers for Disease Control and Prevention (CDC) declared it a “serious public health threat,”External link: and research continues to affirm this reality.

Racism influences an individual’s housing, education, wealth and employment status—often called social determinants of health. In turn, these conditions drive health inequities between white and non-white groups of people.

Racial Disparities in Healthcare: COVID-19 Case Study

The disproportionate impact of COVID-19 on communities of color helps illustrate the overall racial disparities in healthcare.

FOR EVERY 100,000 PEOPLE, HOW MANY PEOPLE WERE HOSPITALIZED FOR COVID-19 BY RACE GROUP (ADJUSTING FOR AGE)?

1,043

Non-Hispanic Black

1,271

Non-Hispanic American Indian or Alaska Native

1,037

Hispanic or Latino

357

Non-Hispanic Asian or
Pacific Islander

373

Non-Hispanic White

Covid-19 Deaths

Go to a tabular version of this data.

Further examples of institutional racism in healthcare abound. Black patients were 40% less likely than white patients to receive analgesics for acute pain and 34% less likely to be given prescriptions for opioids, as reported in a 2019 analysis of 14 previously published studies on emergency departmentsExternal link:.

For every 100,000 live births, the most recent CDC pregnancy mortality data from November 2020External link: reports 41.7 deaths for non-Hispanic Black women and 28.3 deaths for non-Hispanic American Indian or Alaska Native women. By comparison, the mortality rate fell between 11 and 13 deaths for Hispanic or Latina women and non-Hispanic White and Asian or Pacific Islander women.

For all these reasons, racism is a public health emergencyExternal link:. Health professionals and students have a key role in addressing these racial disparities in healthcare.

Combating Racism in Healthcare

Practicing anti-racism as a health professional requires first understanding that racism operates on multiple levels. Camara Phyllis Jones’ framework proposes that racism has three specific levels (PDF, 228 KB)External link:: internalized, personally mediated and institutionalized. The latter form is often hidden.

“Many times, institutional practices have been so ingrained in the tradition and fabric of our organizations that it is extremely challenging to see the problems that are, and have been, right in front of us,” as described in a 2020 Nursing Outlook article on institutional racismExternal link:.

The following list of anti-racism resources for healthcare professionals can help individuals combat racial bias within themselves and in their interactions with others, as well as recognizing discrimination in nursing and other fields. Fighting racism at the systems level often requires a group, as well as institutional support and investment. The following action steps are guideposts that health leaders may consider.

How to Introduce and Implement Anti-Racism Efforts in Nursing and Healthcare

FIRST, LAY THE FOUNDATION

Activists in health organizations can start combating institutional racism by laying a foundation. Consider the following action steps:

Define the problem(s), and set clear goals.
Incorporate shared anti-racist language in daily communications.
Establish support from leadership.
Dedicate funding and resources.
Bring in expertise where needed.
Create ongoing, meaningful partnerships in the community.

NEXT, BEGIN A MULTI-LEVEL AND LONG-TERM APPROACH

With this foundation, health professionals can build a culture of anti-racism and begin (or continue) meaningful anti-racist work in their communities. Action steps for health organizations may include:

Learn about the legacy of slavery in the American health system.
Create a network of leaders to oversee anti-racism work and give them support.
Provide training and education focused on anti-racism in healthcare.
Re-evaluate policies through an anti-racist lens and implement changes as necessary.
Develop an accountability structure for reporting racism, giving feedback and intervening.
Use the health system’s resources to address structural barriers to care, such as transportation or finances.
Update the selection process for boards of trustees to prioritize inclusivity.
Back scientific research that focuses on addressing and eradicating racism.

Sources:
Hassen, Nadha, et al., “Implementing Anti-Racism Interventions in Healthcare Settings: A Scoping Review,” International Journal of Environmental Research and Public HealthExternal link:, February 3, 2021. Accessed on August 6, 2021.
Legha, Rupinder Kaur, “Teaching Antiracism to the Next Generation of Doctors,” Scientific AmericanExternal link:, October 21, 2020. Accessed on August 6, 2021.
South, Eugenia C., Butler, Paris D., & Merchant, Raina M. “Toward an Equitable Society: Building a Culture of Antiracism in Health Care,” The Journal of Clinical InvestigationExternal link:, July 21, 2020. Accessed on August 6, 2021.

List of Anti-Racism Healthcare Resources

For health professionals and leaders seeking to learn more about anti-racism in healthcare, the following articles, books and organizations—some of which may offer anti-racism training—can help.

Anti-Racism in Healthcare Articles

These articles can educate health professionals and students on historical racism in the medical system and healthcare discrimination.

Achieving Health Equity Through Eradicating Structural Racism in the United States: A Call to Action for Nursing LeadershipExternal link:
Authors: Deena Nardi, Roberta Waite, Marian Nowak, Barbara Hatcher, Vicki Hines-Martin, and Jeanne-Marie R. Stacciarini

Changing How Race Is Portrayed in Medical Education: Recommendations From Medical StudentsExternal link:
Authors: Edwin Nieblas-Bedolla, Briana Christophers, Naomi T. Nkinsi, Paul D. Schumann, and Elizabeth Stein

Drawing on Antiracist Approaches Toward a Critical Antidiscriminatory Pedagogy for NursingExternal link:
Authors: Amélie Blanchet Garneau, Annette J. Browne, and Colleen Varcoe

Getting Our Knees Off Black People’s Necks: An Anti-Racist Approach to Medical CareExternal link:
Authors: Rupinder K. Legha, David R. Williams, Lonnie Snowden, and Jeanne Miranda

“I Can’t Breathe”: A Call for Antiracist Nursing PracticeExternal link:
Authors: Kara S. Koschmann, Noelene K. Jeffers, and Omeid Heidari

The Impact of Racism on Child and Adolescent HealthExternal link:
Authors: Maria Trent, Danielle G. Dooley, and Jacqueline Dougé

Race, Research, and Women’s Health: Best Practice Guidelines for InvestigatorsExternal link:
Authors: Luwam Ghidei, Anne Murray, and Janet Singer

Race, Racism and Health: Disparities, Mechanisms, and InterventionsExternal link:
Authors: Elizabeth Brondolo, Linda C. Gallo, and Hector F. Myers

Rooting Out White Supremacy and Implementing Antiracism in Nursing EducationExternal link:
Author: Amie M. Koch

Systemic Racism and U.S. Health CareExternal link:
Authors: Joe Feagin and Zinobia Bennefield

Teaching Antiracism to the Next Generation of DoctorsExternal link:
Author: Rupinder Kaur Legha

Toward the Abolition of Biological Race in Medicine: Transforming Clinical Education, Research, and PracticeExternal link:
Authors: Noor Chadha, Bernadette Lim, Madeleine Kane, and Brenly Rowland

Understanding Racism as a Historical Trauma That Remains Today: Implications for the Nursing ProfessionExternal link:
Authors: Roberta Waite and Deena Nardi

Anti-Racism in Healthcare Books

These books on race, racism and injustices in the health field offer perspective for students entering the field and professionals already in it.

The Beauty in BreakingExternal link:
Author: Michele Harper
Memoir of a female, African American emergency room physician covering systematic disenfranchisement and her personal journey of healing.

Black Man in a White CoatExternal link:
Author: Damon Tweedy
Memoir of a Black physician, exploring the challenges faced by Black doctors and the disproportionate health burdens carried by Black patients.

Breathing Race Into the Machine: The Surprising Career of the Spirometer from Plantation to GeneticsExternal link:
Author: Lundy Braun
Narrative history of the spirometer, a medical instrument, that helps illuminate the ways medical instruments “naturalize racial and ethnic differences.”

Fatal Invention: How Science, Politics, and Big Business Re-Create Race in the Twenty-First CenturyExternal link:
Author: Dorothy Roberts
Nonfiction book on how the myth of race as a biological concept continues to create inequalities and harm to non-white individuals.

Heavy: An American MemoirExternal link:
Author: Kiese Laymon
Coming-of-age memoir of a Black boy in Jackson, Mississippi, that explores class, race, weight, eating disorders and sexual violence to highlight national, systemic failures.

The Immortal Life of Henrietta LacksExternal link:
Author: Rebecca Skloot
Nonfiction, bioethics narrative about Henrietta Lacks, whose anonymized cells became an extremely lucrative human biological material, and her descendants, who never received any profits.

Medical Apartheid: The Dark History of Medical Experimentation on Black Americans from Colonial Times to the PresentExternal link:
Author: Harriet A. Washington
A history of the mistreatment of Black Americans by medical practitioners, which is considered as context for their mistrust of health researchers today.

The Morehouse Model: How One School of Medicine Revolutionized Community Engagement and Health EquityExternal link:
Authors: Ronald L. Braithwaite, Tabia Henry Akintobi, Daniel S. Blumenthal, and W. Mary Langley
A how-to book exploring the partnership between the Morehouse School of Medicine and their community, detailing the ways in which they are improving health equity.

The Racial Divide in American Medicine: Black Physicians and the Struggle for Justice in Health CareExternal link:
Author: Richard D. deShazo
Nonfiction book documenting the struggle for health equity among Black physicians, linking current racial disparities in healthcare to a history of segregation, neglect and mistreatment.

The Science of Health Disparities ResearchExternal link:
Editors: Irene Dankwa-Mullan, Eliseo J. Pérez-Stable, Kevin L. Gardner, Xinzhi Zhang, and Adelaida M. Rosario
Textbook that presents policies for addressing the diseases, disorders and poor health outcomes that more often affect minority population groups and individuals from socially disadvantaged communities.

Stamped From the Beginning: The Definitive History of Racist Ideas in AmericaExternal link:
Author: Ibram X. Kendi
Nonfiction book exploring the history of racism in America and a guide for individuals to practice anti-racism in their daily lives.

Anti-Racism in Healthcare Organizations and Websites

These nursing and medical organizations are dedicated to promoting social justice and health equity throughout the United States.

African American Policy ForumExternal link:
American College of EpidemiologyExternal link:
Asian American/Pacific Islander Nurses AssociationExternal link:
Capitol City Black Nurses AssociationExternal link:
Healthy African American FamiliesExternal link:
National Alaska Native American Indian Nurses AssociationExternal link:
National Association of Hispanic NursesExternal link:
National Association of Indian Nurses of AmericaExternal link:
National Black Nurses AssociationExternal link:
National Commission to Address Racism in NursingExternal link:
National Nurses UnitedExternal link:
North Carolina Environmental Justice NetworkExternal link:
Nurses for Social JusticeExternal link:
Nursing Community CoalitionExternal link:
Pennsylvania Action CoalitionExternal link:
Philippine Nurses Association of AmericaExternal link:
Society for the Analysis of African American Public Health IssuesExternal link:
Texas Nurses AssociationExternal link:
The Spirit of 1848 CaucusExternal link:

How were COVID-19 deaths distributed across race groups (adjusting for age)?

The following section contains tabular data from the graphics in this post.

Source: <a href=”https://www.cdc.gov/coronavirus/2019-ncov/community/health-equity/racial-ethnic-disparities/disparities-deaths.html” target=”_blank” rel=”noreferrer noopener”>“Disparities in Deaths from COVID-19,” CDC</a>, December 10, 2020. Accessed August 6, 2021.
Race	Distribution of COVID-19 Deaths (%)	Percentage of the Population
Non-Hispanic white	33.6	58.7
Hispanic	35.5	19.4
Non-Hispanic Black	22.6	12.7
Non-Hispanic Asian	3.9	5.8
Non-Hispanic American Indian or Alaska Native	2.6	0.7
Non-Hispanic Native Hawaiian or Other Pacific Islander	0.7	0.2

Source: “Disparities in Deaths from COVID-19,” CDCExternal link:, December 10, 2020. Accessed August 6, 2021.

Return to graphic.

Last updated August 2021.