How the Black Lives Matter Movement Relates to O&P
August 2020 Issue
As America battles COVID-19, another epidemic is also being fought: the deep ways racism has been impacting Black Americans. Racism is prevalent in every system in the US, including medicine, education, employment, and incarceration.
There have been conversations about actions to take that recognize the Black community's struggle and how to bring forth valuable improvements in medicine. Specifically, in O&P there is limited representation of practitioners, educators, and students who are Black or people of color. An understanding of how health disparities and lack of healthcare access significantly disadvantages Black Americans is vital.
The Black community is overrepresented in O&P patients due to high rates of diabetes and amputations resulting from it. In fact, statistics show that Black adults are almost twice as likely as white adults to develop type 2 diabetes, with about 66 more cases per 1,000 people.1
When the question arises about why the Black community is more likely to suffer from diabetes and vascular disease, it's imperative to understand the contributing systemic blockages. With more Black people living in impoverished neighborhoods with inadequately funded schools, denied access to equal jobs, and limited preventive healthcare, they are set up for increased stress and decreased access to healthier lifestyles.3 Foluso A. Fakorede, MD, said, "While the roots of unequal and inequitable healthcare for African Americans date back to the days of slavery, the modern mechanisms of discrimination in healthcare has shifted from legally sanctioned segregation to inferior or non-existent medical facilities due to market forces."3
Given that our profession works closely with people who have disabilities, another important question is how does inequality make Black Americans more susceptible to developing disabilities as a result of diabetes and vascular disease? Reports show that Black Americans with disabilities face great discrimination at schools, workplaces, and with the police. In fact, Black people are shot by the police at a rate of 31 per million, with 30-40 percent of those deaths involving someone with a mental or physical disability.2
In your O&P education, how were health disparities discussed? How about disability justice and using language that doesn't limit people with disabilities? Our field works heavily with the intersection of low-income, marginalized communities, Black people, and people of color. O&P education can increase awareness by including classes to talk openly about the ways medical bias and racism show up; continuing education and residencies must also address these concerns.
The Black Lives Matter movement has brought up significant questions that need introspection and action. Clinics and programs must outline the changes being made, such as outreach programs to recruit more Black people and people of color as O&P students and including those voices on O&P boards and organizations. Lastly, use the intention versus impact perspective to evaluate who your statement and changes will impact. While we can create change and be well intentioned about them, if the impact is minimal or even harmful, it can become performative. Examples of this include creating a statement of solidarity, but not continuing the work beyond the statement. Consistent effort is required to show solidarity with Black people in our profession and our patients. The commitment begins by uplifting the voices of Black practitioners, students/residents, and patients. O&P EDGE
Safa Doost is an orthotist at Pacific Medical Prosthetics & Orthotics' Walnut Creek, California, patient care facility. She can be contacted at email@example.com.
1. "Factors Contributing to Higher Incidence of Diabetes for Black Americans." National Institutes of Health, U.S. Department of Health and Human Services, 23 Jan. 2018, www.nih.gov/news-events/nih-research-matters/factors-contributing-higher-incidence-diabetes-black-americans.
2. Carter-Long, Lawrence, and David Perry. "THE RUDERMAN WHITE PAPER ON MEDIA COVERAGE OF LAW ENFORCEMENT USE OF FORCE AND DISABILITY ." Https://Rudermanfoundation.org/Wp-Content/Uploads/2017/08/MediaStudy-PoliceDisability_final-Final.pdf, 2017, rudermanfoundation.org/wp-content/uploads/2017/08/MediaStudy-PoliceDisability_final-final.pdf.
3. Presser, Lizzie. "The Black American Amputation Epidemic: Black Patients Losing Limbs at Triple the Rate of Others." Mississippi Today, 19 May 2020, mississippitoday.org/2020/05/19/the-black-american-amputation-epidemic-black-patients-losing-limbs-at-triple-the-rate-of-others/.
4. Williams, D R, and T D Rucker. "Understanding and Addressing Racial Disparities in Health Care." Health Care Financing Review, CENTERS for MEDICARE & MEDICAID SERVICES, 2000, www.ncbi.nlm.nih.gov/pmc/articles/PMC4194634/.