Topic 19: Racism and its impacts
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Connection with curriculum |
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This topic relates to the concept: Racism
Generate strategies for incorporating anti-racist and affirmative action approaches in Intensive Care Medicine.
Introduction
There is clear evidence of the intergenerational effects of racism and colonisation. Trauma experienced in previous generations impacts the health outcomes of younger generations today (Zubrick et al., 2005). It is not only intergenerational trauma that affects health outcomes. One-third of Aboriginal and Torres Strait Islander Peoples report racism in health and medical care settings some or all the time (Paradies & Cunningham, 2009).
Culturally safe organisations recognise that racism is a significant public health and public policy issue. Public health researchers Cunningham and Paradies (2013) emphasise that organisations must actively work to eliminate all forms of racism, white privilege, and cultural bias that Aboriginal and Torres Strait Islander Peoples continue to experience in all aspects of health service delivery. It should also be noted that racism has a significant impact on recruitment, retention and the development of the Aboriginal and Torres Strait Islander workforce. When the Aboriginal and Torres Strait Islander health workforce is subject to racism - and the Aboriginal and Torres Strait Islander health workforce is impacted - there should be continued care from the non-Aboriginal and Torres Strait Islander workforce.
An emphasis on cultural safety is a powerful mechanism for overcoming the normalised and systemic racism experienced by Aboriginal and Torres Strait Islander Peoples in mainstream healthcare.
Select each heading to read more.
Racism must be understood within the context of privilege, oppression and power. Systemic and individual racism has been embedded within Australia’s healthcare delivery since the invasion in 1788 (Gatwiri et al., 2021). Individual racism refers to an individual's racist assumptions, beliefs or behaviours and is a form of racial discrimination that stems from conscious and unconscious personal prejudice (Tator & Henry, 2006). This form of racism can be intentional or unintentional.
Examples include telling a racist joke, believing in the inherent superiority of white people and crossing the street to avoid passing a Black man. Systematic racism refers to laws and regulations (formal and informal) that discriminate or prejudice against someone based on race. Whether or not people intend to be racist or consider themselves to be good moral people, the implications of their actions, if coming from a position of unconscious bias or privilege, are very real.
Understanding these forms of racism results in a deeper engagement with how racism manifests in society and how it can be perpetuated at the individual and organisational levels. It is through this understanding that anti-racism work can begin, and inequitable health outcomes caused by racism can be addressed.Racism directly impacts health outcomes for Aboriginal and Torres Strait Islander Peoples. A recent study from Victoria found that at least one-third of the gap in health outcomes between Aboriginal and Torres Strait Islander Peoples and non-Indigenous people can be attributed to racism in the public health system (Markwick et al., 2019). It is not only adults that face racism. 22% of children aged between 12 and 17 years in the 2001–02 Western Australian Aboriginal Child Health Survey (WAACHS) reported experiencing racism (Zubrick et al. 2005). The Commonwealth Government has taken the important step of recognising that racism is a key social determinant of health for Aboriginal and Torres Strait Islander people in the National Health Plan.
Caution
As a subset of a society that struggles with racism and other explicit biases, it is inescapable that some medical specialists and healthcare employees will have the same explicit biases as the general population.
Types of racism
Racism can be expressed in different ways - individual, interpersonal, organisational, institutional and systemic.
Select each heading to read more.
- Occurs within individuals
- Private beliefs about race and racism, influenced by our culture
- Stems from personal prejudice, it can be expressed consciously but in many instances is unconscious
- May include negative beliefs about people of colour or entitlement by white people
- Occurs between individuals
- Occurs when individuals interact with others and their private racial beliefs affect public interactions
- Occurs within institutions and systems of power
- Unfair policies and discriminatory practices of institutions (schools, hospitals etc) that could routinely produce racially inequitable outcomes for people of colour and advantages for white people
- Occurs amongst institutions and across society
- Cumulative and compounding effect of an array of societal factors including the history, culture, ideology and interactions of institutions.
- Ongoing policies that systematically privilege white people and disadvantage people of colour
While the most common understanding of racism in our country is limited to the “interpersonal” level of racism, racism is not only an individual ideology but an entire system of behaviours, ideas, practices, conditions, structures, policies and processes that maintain a racial advantage or disadvantage. Individual racism focuses on whether individual people are either ‘racist’ or ‘not racist’. As much as individuals can be the agents of racism, it is not just an individual trait; it’s systemic and works to protect privileged relationships in our society.
It is important to note that racism can be subtle or overt.
Even if every worker in an institution has been trained in cultural safety and anti-racism, it is not enough to make the organisation/institution culturally safe and non-racist. Workplace cultures, policies, funding, and leadership also impact an organisation’s racism or cultural safety.
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Activities to facilitate learning |
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The following activities will enhance your learning on this topic.
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Listen |
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Read |
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Read and reflect on the news article about unconscious bias, racism and its impact
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Additional recommended resources |
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- Watch the video “Fear of a brown planet - reverse racism.”
- Read about racism in the Aboriginal and Torres Strait Islander Mental Health and Wellbeing Principles and Practice (pages 15 - 18)
- Read the article by Markwick et al. (2019) about racism in the health system in Victoria
- Read about an instance of unsuitable health care due to racial profiling
- Review the data regarding youth suicide in Queensland
Reflect on your learningSelect the image to answer the reflection question for this topic. |
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