Woke Healthcare

The American Medical Association, working with the Association of American Medical Colleges Center for Health Justice, has published Advancing Health Equity: A Guide to Language, Narrative, and Concepts.

The guide is intended to help healthcare providers work toward “health equity.” Health equity is achieved when gaps in health outcomes are overcome. The guide identifies these gaps as being rooted in “Narratives grounded in white supremacy and sustaining structural racism.” These narratives, according to the AMA guide, “perpetuate cumulative disadvantage for some populations and cumulative advantage for white people, especially white men.” The guide goes on: “Narratives that uncritically center meritocracy and individualism render invisible the genuine constraints generated and reinforced by poverty, discrimination, and ultimately exclusion.”

The guide recommends that doctors turn from “the overwhelming focus on changing individual behavior to improve health,” and consider the “social and economic conditions which generate poor health outcomes.” Instead of pushing individuals to change their lifestyles and health choices, then, doctors ought to give consideration to “the significant barriers faced by the patients in their lives, from not having enough money to pay for their medications, or not having the capability to take time off work, or not being able to secure affordable childcare to participate in an activity.”

We need to be very careful here. The AMA’s language of “cumulative disadvantage” and “cumulative advantage,” as well as language critical of “meritocracy and individualism” smacks of identity politics and could easily be interpreted to mean that healthcare providers need to treat patients of a particular racial or ethnic background according to what may be expected of them given their belonging to a particular racial or ethnic background. In other words: racial and ethnic stereotypes. I seriously doubt that Black people want their doctor assuming they live in poverty, or that they aren’t capable of taking personal responsibility for their healthcare or their lifestyle choices because they are Black. Neither is it helpful for a doctor to assume that a White person must have the resources to take them up on every recommendation they make because they’re White and, therefore, must be doing well financially and have a strong sense of personal discipline.

The guide makes the genuinely helpful recommendation that doctors consider the limitations of their patients’ circumstances in the kind of therapies they suggest or order. It’s very true that limited resources limit what a person can do for him or herself. But, that has little to do with race or ethnicity and a lot to do with economic status and, well … money. There are plenty of White people out there who cannot afford their medications, or who cannot take time off from work, or who cannot secure child care, limiting their ability to comply with their doctor’s plan for improving their health. The fact that a larger percentage of the Black population lives in poverty as compared to Whites doesn’t negate the fact that, in pure numbers, most poor people are White.

If society were not so focused on race and ethnicity right now, the AMA might have put together a reasonable document on how to help anyone, regardless of their race or ethnicity, to increase the likelihood of good health outcomes, even if their resources are limited. But, our culture right now is so focused on race and ethnicity, and on how persons of particular racial and ethnic backgrounds are limited in their opportunities, that the AMA’s guide is reduced to virtue signaling and stereotyping. Too bad.

Be Christ for all. Bring Christ to all. See Christ in all.

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