This is a guest post by Karissa Hansen, Ph.D. Candidate, UCSF Developmental and Stem Cell Biology (DSCB) Program
The readings and conversations in class this week brought forward discussions about how institutions can ensure equitable access and treatment of underrepresented persons in the biomedical professions. The struggles of individuals at each step of this process were highlighted: From early in training during medical school and residency to higher positions of authority at medical institutions. Therefore, extensive changes are not only required at the level of admissions, but also in later career support in hospitals across the country. Despite the conversations that have been reignited in the past year regarding equitable practices, meaningful large-scale change has yet to be seen. Bias in hiring practices accompanied by limited support in part has led to the lack of representation in leadership positions and a reinforcement of such inequities. Moreover, persons of color are often those that are called upon, or volunteer, to expand these efforts at institutions across the country, increasing the burden on these individuals. I feel like I must hold out hope that the education of the current generation of up-and-coming physicians and scientists will lead to such changes as these individuals move into positions of power. It’s hard to be optimistic with such a long road ahead, but the young scientists that I am surrounded by give me hope that we’ll get there.
This is a guest post by Nebat Ali, PhD Candidate, UCSF Biomedical Sciences (BMS) Program
One of the final pieces we read as part of this course was an article by Boyd et al titled “On Racism: A New Standard For Publishing On Racial Health Inequities”. This article encompasses many of the concepts we discussed in class and exemplifies how racism continues to be maintained in our medical and scientific spaces. As the article states, racism is “America’s earliest tradition” and was used as the foundation for all aspects of American society.
As someone who grew up in the Bay Area, there seems to be the misconception that liberal parts of our country are somehow free of these frameworks. This is far from being true, and one can quickly come to this realization by taking a brief look into the history of our institutions.
Fifty years ago, Black employees at UCSF initiated the formation of the Black Caucus- the first affinity-based group established in the UC-system- in order to protest the racist policies and mistreatment they faced at UCSF. Members of the Black Caucus coined The Medical Center at Parnassus “The Plantation on the Hill” due to the discriminatory practices they faced in the workplace (reference linked below). As a united voice the Black Caucus demanded for the improvement of their working conditions and for their fair treatment. In addition, they also fought strongly to advocate for the recruitment and retention of Black students at UCSF. When I casually walk through the halls of my building or sit and have lunch in the cafeteria, I’m often reminded that only fifty years ago Black and Brown UCSF employees didn’t have the right to freely navigate through campus the way that I do. The strikes and protests organized by the Black Caucus were transformative, and while their impacts are still felt today there is still a long road ahead in order to dismantle the systems of oppression these institutions were built on. Within our own communities in San Francisco, we are witnessing and experiencing some of the most alarming disparities in the ongoing COVID-19 pandemic.
I have a vivid memory of a discussion that took place in a microbiology course I was taking early in the pandemic that revolved around genetic predispositions to severe COVID-19 infections. It was even more troubling to see subsequent studies that additionally failed to assert the contributions of racism in the prevention, detection, and treatment of COVID-19 infection. As we discussed through some of our previous readings, studies like these result in both the erasure of systemic racism’s impact on health as well as the large numbers of Black scholars who specialize in this area of research. Some of the recommendations provided by the Boyd et al article will be critical in improving the practices in scientific research that ultimately contribute to this. In the case of the pandemic, I always find myself wondering how beneficial NIH funds could have been if they were redirected to provide care to highly impacted Black and Brown communities instead of being used to do poor research and/or research that is only tangentially related to the virus. In order to begin repairing the damage that’s been done, it will additionally be important to consider how federal funds are allocated to agencies like the NIH and CDC. Improper allocation of funds to these agencies can sequester money away from developing sustainable care programs in underserved communities and subsequently direct them to research practices that only reinforce racism in science and medicine.
This is a guest post by Eliza Gaylord, Ph.D. Candidate, UCSF Developmental and Stem Cell Biology (DSCB) Program
What you publish in science is soaked in opinion – regardless of the objectivity it tries to maintain. What you publish in science is accessible forever – regardless of the truth it holds. And if science is opinion, and science is accessible forever, then by definition of the mathematical transitive property of equality, opinion-based published literature perpetuates throughout the years and is treated as fact simply due to its accessibility to read and cite. However, just because something was published does not mean it is sound or accurate. What are the consequences when this undying nature intrinsic to publication is mixed with ‘bad’ science, written to immortalize the author’s opinion instead of biological truth? One familiar example is Dr. Andrew Wakefield’s work published over two decades ago where he wrongfully claimed that the Measles, Mumps, and Rubella vaccine caused autism in children. Despite the retraction of his paper, multiple lawsuits, and the uncovering of conflicts of interest that inspired his original piece, thousands of individuals across the world still believe in his work over twenty years later and put their children at risk by refusing to vaccinate them out of the false fear of developing autism.
Though the harmful consequences from this specific example have only persisted 20 some years, another harrowing example of fabricated and harmful science has persisted for over a century: the collection of work centered on identifying physical racial differences. These studies relied upon the torture and robbery of Black people’s bodies and highlighted false ideologies of biological differences between the races to justify slavery and perpetuate racism. And doctors still reference and support these false beliefs to this day, many ignorant to the racist history that gave rise to the findings. These works are dangerous to the Black community, as they ensure implicit bias, inferior medical treatment, and structural racism will persist in the American health care system. Like the Wakefield study, a first step toward improving the Black experience in American medicine demands the identification and retraction of these false and dangerous studies. But beyond the retraction of these works, medical education programs must incorporate coursework to actively discuss and condemn these racist ideologies and the fabricated works that support them.