Adopting an intersectionality framework to address power and equity in medicine

Samra, Rajvinder and Hankivsky, Olena (2021). Adopting an intersectionality framework to address power and equity in medicine. The Lancet, 397(10277) pp. 857–859.

DOI: https://doi.org/10.1016/S0140-6736(20)32513-7

Abstract

Responses to police brutality and the disproportionate effects of COVID-19 among ethnic minority populations have widened realisations about racism, and social and health inequities. Typically, medical institutions such as the Association of American Medical Colleges outline their position against racism separately from their mission for achieving gender equity. However, in western settings, the downstream effects of medical education on doctors and patients is shaped by patriarchal and colonial histories and values. Patriarchal cultures in medicine constrain women doctors’ career choices and progression internationally. Medical textbooks reinforce norms based on Whiteness by under-representing racial and ethnic minorities—eg, different presentations and clinical signs for patients with darker skin tones. Exporting western biomedical knowledge to other global settings reinforces inequality. Dismantling the power structures in medicine, however, requires complex thinking that goes beyond focusing on one dimension at a time—eg, patriarchy or racism. This requirement is also relevant to the decolonising global health movement.

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