Racism, xenophobia, discrimination, and the determination of health

Devakumar, Delan; Selvarajah, Sujitha; Abubakar, Ibrahim; Kim, Seung-Sup; McKee, Martin; Sabharwal, Nidhi S.; Saini, Angela; Shannon, Geordan; White, Alexandre; Achiume, E. Tendayi

doi:10.1016/s0140-6736(22)01972-9

Cited by 76 publications

(40 citation statements)

References 82 publications

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“…There is increasing evidence it not only effects the discriminated groups but all groups within. Changing these systems requires doctors that can support legal and political measures and empowerment of affected communities to promote change [ 9 , 10 , 12 , 48 , 47 , 48 ].…”

Section: Discussionmentioning

confidence: 99%

“…The rise of GH historically has a strong connection with colonialist attitudes [ 7 , 8 ]. Understanding the role of colonialism is important to address health inequity and the calls for decolonizing GH have been growing recently to move towards health equity and sustainable partnerships with mutual benefits [ 9 – 16 ]. It is clear that medical tourism can be harmful, especially when performed by unsupervised students [ 17 , 18 ] or even laypersons [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

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Applicability of working abroad for physicians with a specialization in Global Health and Tropical Medicine

et al. 2023

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Background In The Netherlands, physicians specialized in global health and tropical medicine (Ps-GHTM) are trained to work in low-resource settings (LRS) after their training program of 27 months. After working for a period of time in LRS, many Ps-GHTM continue their careers in the Dutch healthcare system. While there is limited evidence regarding the value of international health experience for medical students and residents, it is unknown to what extent this applies to Ps-GHTM and to their clinical practice in the Netherlands. Methods In this qualitative study we conducted semi-structured interviews and focus group discussions (FGDs) with Ps-GHTM to explore the perceived applicability of their experience abroad for their subsequent return to the Netherlands. Topic guides were developed using literature about the applicability of working abroad. Findings from the interviews served as a starting point for FGDs. The interviews and FGDs were analysed using directed content analysis. Results 15 themes are described relating experience abroad to healthcare delivery in The Netherlands: broad medical perspective, holistic perspective, adaptive communication skills, creativity, flexibility, cultural awareness, self-reliance, clinical competence, cost awareness, public health, leadership, open-mindedness, organization of care, self-development, and teamwork. Highlighting the variety in competencies and the complexity of the topic, not all themes were recognized by all respondents in the FGDs nor deemed equally relevant. Flexibility, cultural awareness and holistic perspective are examples of important benefits to work experience in LRS. Conclusion Ps-GHTM bring their competencies to LRS and return to the Netherlands with additionally developed skills and knowledge. These may contribute to healthcare delivery in the Netherlands. This reciprocal value is an important factor for the sustainable development of global health. Identifying the competencies derived from work experience in LRS could give stakeholders insight into the added value of Ps-GHTM and partly help in refining the specialization program.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Applicability of working abroad for physicians with a specialization in Global Health and Tropical Medicine

et al. 2023

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“…Not all people in the global North are more economically powerful, just as not everyone in the global South experiences struggle. Oppression by the elite bourgeoisie is shared by minoritised people all over the world, across multiple realities [25]. The climate and ecological crises can therefore not be separated from the elites' wealth accumulation at the expense of the health, rights, and dignity of the global majority, which includes many people within rich countries themselves.…”

Section: "Do We Choose Industry or Do We Choose Life?"-kanahus Manuel...mentioning

confidence: 99%

Breaking free from tunnel vision for climate change and health

Deivanayagam

Osborne

2023

PLOS Glob Public Health

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Climate change is widely recognised as the greatest threat to public health this century, but ‘climate change and health’ often refers to a narrow and limited focus on emissions, and the impacts of the climate crisis, rather than a holistic assessment of economic structures and systems of oppression. This tunnel vision misses key aspects of the climate change and health intersection, such as the enforcers of planetary destruction such as the military, police, and trade, and can also lead down dangerous alleyways such as ‘net’ zero, overpopulation arguments and green extractivism. Tunnel vision also limits health to the absence of the disease at the individual level, rather than sickness or health within systems themselves. Conceptualising health as political, ecological, and collective is essential for tackling the root causes of health injustice. Alternative economic paradigms can offer possibilities for fairer ecological futures that prioritise health and wellbeing. Examples such as degrowth, doughnut economics and ecosocialism, and their relationship with health, are described. The importance of reparations in various forms, to repair previous and ongoing harm, are discussed. Breaking free from tunnel vision is not simply an intellectual endeavour, but a practice. Moving towards new paradigms requires movement building and cultivating radical imagination. The review highlights lessons which can be learnt from abolitionist movements and progressive political struggles across the world. This review provides ideas and examples of how to break free from tunnel vision for climate change and health by highlighting and analysing the work of multiple organisations who are working towards social and economic transformation. Key considerations for the health community are provided, including working in solidarity with others, prioritising community-led solutions, and using our voice, skills, and capacity to address the structural diagnosis—colonial capitalism.

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“…Just a few weeks ago, The Lancet launched a large series of articles devoted to analyzing the role of racism, xeno phobia and discrimination, with race being placed at the center of these regrettable, albeit ubiquitous, human behaviors [4]. The following definition was stated in one of these articles, 'Race is a socially constructed classifica tion that relies on someone's actual or perceived physical appearance and ancestry.…”

mentioning

confidence: 99%

“…The meaning and categories of race can change over time, location and context. Race has been used as a mechanism for assigning superiority and inferiority, and determining access to resources and human rights, despite racial hierarchies being biologi cally baseless' [5]. Historically, medicine has plenty of ominous examples to which the concept of race has been applied to perpetrate unethical and even criminal acts.…”

mentioning

confidence: 99%

Race: a sometimes relevant aspect that is immensely difficult to categorize in emergency medicine

Miró¹

2023

European Journal of Emergency Medicine

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Racism, xenophobia, discrimination, and the determination of health

Cited by 76 publications

References 82 publications

Applicability of working abroad for physicians with a specialization in Global Health and Tropical Medicine

Applicability of working abroad for physicians with a specialization in Global Health and Tropical Medicine

Breaking free from tunnel vision for climate change and health

Race: a sometimes relevant aspect that is immensely difficult to categorize in emergency medicine

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