The nation’s COVID-19 pandemic has brought to light glaring systemic inequities in the provision of care to marginalized demographic groups. A panel of medical students working to address those issues through organized medicine recently offered insight on the injustices, how the pandemic has amplified them and potential remedies.

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Hosted by Aletha Maybank, MD, MPH—the AMA’s chief health equity officer, overseeing the Association’s Center for Health Equity—the panel brought together student leaders from the AMA, Association of American Medical Colleges (AAMC), Asian Pacific American Medical Student Association (APAMSA), Medical Organization of Latino Advancement (MOLA), Student National Medical Association (SNMA) and Association of Native American Medical Students (ANAMS). A recording of the panel discussion is available on YouTube.

Confronting racism, xenophobia

Amid reports of individuals and organizations encouraging use of language like “the Wuhan virus,” “the Chinese coronavirus,” and similar variations, the AMA recently released a statement calling for an end to those references. The verbiage serves no legitimate purpose and is ethically inappropriate, derogatory and divisive.

According to APAMSA president, Yingfei Wu, those remarks are affecting medical students of Asian descent as well as the larger Asian American community.

“Through APAMSA we have heard about a lot of different instances of [that language] toward medical students and of people in the community being abused and having racist remarks directed toward them,” said Wu, a medical student at the Medical College of Wisconsin.

APAMSA members have been sharing their reflections with each other and offering advice on how to cope.

“We are supposed to be this ‘model minority,’” Wu said of a common conception regarding Asian Americans. “We are supposed to have expectations that we are safe and nothing will happen to us. This has been challenging.”

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The blue collar-white collar disconnect

As Dr. Maybank has highlighted, the need to understand how the COVID-19 pandemic is affecting communities of color is imperative to addressing its spread. But even within those communities, there is a divide.

“One thing I have noticed as we are seeing a lot of data showing that [COVID-19] is impacting the Latinx community significantly is a fact that there’s a disproportionality among those who can work from [home] and those who have to go out in the environment for work,” said Richard Gomez, a member of MOLA’s board of directors and a medical student at Loyola University Chicago Stritch School of Medicine.

“There have been these moments or arguments I have had with [community] members who are in white-collar jobs and have the fortune of earning a paycheck to work from home being very critical of those who don’t. Some people don’t have the fortune of being able to work from home. They have to go out and endanger themselves whether it’s through work in restaurants or in airports as flight-crew staff. I’ve noticed that is something significant with the Latinx and Hispanic community, especially for immigrants.”

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The context of marginalized patients

Disparity figures are one thing. Why they exist is another. To tell a true story of inequity, both are required. That dynamic is playing out in Native American communities.

“When I first started medical school, a physician in the community told me the only thing I needed to know about Native American health as a medical student is that if a tribe has a casino they have great health care, which couldn’t be further from the truth,” said Alec Calac, a medical student at the University of California, San Diego School of Medicine. He is the school’s ANAMS chapter president, and national policy director for the larger ANAMS organization.

“The pandemic has really laid bare the inequities we are seeing in tribal communities and the Indian Health Service. People don’t understand why the Indian Health Service exists. They don’t understand that this system that cares for than 3 million people has less than 100 ventilators in the entire system. You can go from factoid to factoid, but the reality today is there are more than 4,600 cases of COVID-19 in areas served by the Indian Health Service.”

Throughout the COVID-19  pandemic, the AMA is carefully compiling  critical health equity resources from across the web  to shine a light on the structural issues that contribute to and could exacerbate already existing inequities.  

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