Small Steps, Big Change: Becoming an Antiracist Healthcare Student

Americans see race and racism in different ways. But no matter how you view these concepts, it’s important to learn about people from a variety of cultures so you can provide culturally competent care as a healthcare professional.

In this society, where inclusion is a growing necessity, Americans of all skin colors and ethnicities have come to recognize the destructive nature of racism and its systemic presence in all aspects of America — including higher education and healthcare systems. But they’re also acknowledging that it’s important to do more than simply recognize racism — they’re advocating for anti-racism, defined as the practice of actively identifying and opposing racism. According to Boston University, “The goal of anti-racism is to actively change policies, behaviors, and beliefs that perpetuate racist ideas and actions.”

Your role as a healthcare student gives you the chance to further antiracism movements by fostering a more equitable healthcare system that serves all patients while respecting patient autonomy and dignity. Antiracism means going beyond mere intolerance to taking proactive stances that actively challenge and dismantle systemic racism.

This guide outlines the need for antiracism in healthcare, offering strategies and resources — including an expert interview — for healthcare students who want to dismantle systemic racism in higher education and healthcare, microcultures that represent the presence of intolerance across the country.

Step 1: Recognize the Need for Antiracism

Like most people reading this page, you’ve likely recognized the need for antiracism. In any case, the obvious first step to becoming an antiracist advocate is to recognize the need for antiracist advocacy by deepening your understanding of race and racism.

By recognizing that this work requires more than just not being racist, you can commit yourself to actively opposing the myriad forms racism takes in your life.

Step 2: Evaluate Yourself

To become an antiracist healthcare professional, you must evaluate your mind. This requires introspection — deep and continuous self-assessment — so you can identify your biases and assumptions.

This type of deep self-assessment also requires a genuine willingness to confront any default paradigms you may have internalized. This may be scary, but the rewards are a deeper connection to those around you and an improved relationship with your own mind and values.

Acknowledge Implicit Bias

All people have some kind of bias. Those biases you aren’t aware of are your implicit biases, which influence how you think about and treat those around you — especially those who differ from you in either a minor or significant way.

Take a moment to investigate and accept your biases, any unconscious stereotypes and attitudes that can negatively influence your ability to care for patients. You might take one of Harvard University’s Project Implicit tests to discover your biases about various identities as well as your implicit associations with health.

Confront Personal Racist Prejudices

If you have racist prejudices that you’re clearly aware of (explicit biases), confronting them can create significant cognitive and emotional challenges. However, this step is a necessary aspect of creating antiracist environments where everyone can experience physical and psychological safety and a sense of belonging — and the process can be healing.

Honest self-reflection about why you feel certain ways about people with skin colors and ethnic backgrounds that differ from yours allows you to dismantle any racist ideologies you may have internalized. One way to accomplish this goal is to reprogram your mind by consuming media of different ethnic groups that differ from yours.

Understand Your Privilege

Social privileges are unearned advantages that society attributes to people based on various political identity factors that include socioeconomic status, perceived ability, gender, ethnicity, and cognitive styles.

People who live on the most intersections of marginality (like a person who identifies as trans, disabled, and Black) tend to experience the fewest social privileges and the most societal barriers, especially in higher education and healthcare systems.

Take the time to understand and accept your own privileges. There is nothing wrong with having these advantages, and once you’ve recognized your privileges, you can then navigate challenging interactions with empathy rather than defensiveness and denial. Understanding your privilege enables you to address social disparities, amplify marginalized voices, and advocate for equitable healthcare practices.

Step 3: Educate Yourself

Continuous education is paramount to creating antiracist healthcare systems. Becoming an antiracist advocate starts within yourself. You must face not only your implicit and explicit biases, but you also must learn how race and racism impact healthcare disparities in the form of systemic racism. This means developing cultural competence, which includes an understanding of intersectionality — the multiple and interconnected social and political identities each person represents.

Explore the Impact of Racism on Healthcare Disparities

History influences the present, so you can help create equitable healthcare systems by educating yourself about historical factors that have created and currently sustain systemic inequality in America.

As you prepare to change lives in healthcare, it’ll help you to learn what kind of healthcare disparities are present within the system you plan to work. What kinds of health challenges and healthcare barriers exist for marginalized communities?

By learning the root cause of today’s health disparities, you can avoid repeating history and work toward dismantling systemic barriers, becoming an effective healthcare leader and advocate.

Develop an Understanding of Intersectionality

You’ll benefit from developing a comprehensive understanding of how intersectionality plays out in healthcare. Everyone’s experience is shaped by the intersection of multiple, often marginalized, identities: ethnicity, gender, sexual and religious orientations, socioeconomic status, race, neurotype, and ability among them.

Research shows that intersectionality, or the addition of marginalized identity markers, compounds healthcare inequality in the industry as well as in academic environments where healthcare students prepare for the profession. Further evidence on intersectionality can be found in books by activist and author bell hooks, in podcasts, and through YouTube videos like Kimberlé Crenshaw’s Ted Talk.

Learning about intersectionality will allow you to give care that addresses the unique needs and experiences of diverse patient populations. You’ll meet a lot of different people, so it helps to develop a nuanced, culturally sensitive care approach when treating and interacting with patients.

Learn About Systemic Racism

Systemic racism refers to policies, practices, and attitudes within political, economic, and social systems that disadvantage people and communities based on their perceived ethnic backgrounds. This ongoing tragedy stems from America’s founding as a racist nation that stole land from peaceful Natives and forced African slaves to build the country’s infrastructure. What remains — systemic racism — holds pervasive influence over and within healthcare systems.

You can explore how historical injustices such as discriminatory practices and unequal distribution of wealth and power have shaped healthcare delivery and outcomes by researching key related concepts such as medical apartheid, redlining and segregation, the social model of disability, and social determinants of health.

Step 4: Emphasize Empathy

Step 4 explores the underlying role of empathy in creating antiracist healthcare spaces. Empathy allows you to connect with the lived experiences of the patients you care for, no matter their cultural backgrounds. When you embody the power of empathy, you feel what other people feel — the struggles of those you support. In this way, empathy can empower you to dismantle systemic barriers that promote racism.

Expand Cultural Competency

A key aspect of promoting empathy is expanding your cultural competency. No matter your background, there is much about the human experience you aren’t aware of because we’re all foreign to cultures to which we don’t belong.

You can even learn more about the nonracial cultures that live within your culture — such as neurodivergent, disabled, and queer and trans communities — who come from all ethnic backgrounds, including yours.

Seek knowledge about different cultures, traditions, and perspectives, including the Natives who own the land on which you currently live and work. By engaging in meaningful cross-cultural exchanges, we educate ourselves, so we’re better equipped to cultivate deep relationships across ethnicities.

Listen to the Experiences of People of Color

Even if you identify as a person of color, it’s important to listen to a diversity of voices to understand the full range of experiences marginalized people face. Keep in mind: Listening isn’t limited to synchronous conversation. It also includes media, like podcasts; public events, such as lectures, readings, and conferences: and all types of books — fiction, nonfiction, and poetry.

Step 5: Promote Antiracism in Your Sphere of Influence

In the journey to become an antiracist healthcare professional, you must eventually move beyond self-reflection to taking actionable steps: promoting antiracism in your sphere of influence. These actions are as contagious as joy and empower you and those around you to make positive impacts by challenging microaggressions, fostering inclusive dialogue and action, and speaking out against racism in all its forms — speech, behavior, and policies.

Challenge Microaggressions

Microaggressions refer to subtle, sometimes unintentional behaviors that target marginalized people based on their cultural background. By learning to recognize microaggressions, you’ll equip yourself to take appropriate action when you recognize these behaviors in healthcare settings.

When you address microaggressions, you help create a culture of respect and inclusivity — where everyone feels a sense of belonging, no matter their identities. Small steps are still steps. You can create change one interaction at a time.

Foster Inclusive Dialogue and Action

While challenging microaggressions and promoting antiracism within your sphere of influence, you can also engage in open and inclusive dialogue with your colleagues and those in your household and community about the impacts of racism on different people.

Find and join communities on campus and around your home that foster cultures of continuous learning and growth, places that encourage a diversity of antiracist ideas. Advocacy groups and organizations can also equip you with the necessary skills to create inclusive healthcare systems.

Speak Up Against Racist Behaviors and Policies

Use different platforms to amplify your voice and the voices of victims and fellow advocates to speak against racist behaviors and policies.

Whether you identify as privileged or marginalized, you can be an ally to those who are marginalized, no matter their backgrounds. Speaking up against intolerance and dismantling systemic and attitudinal barriers are steps toward creating equitable higher education and healthcare systems.

Step 6: Take Active Steps Toward Inclusion

Inclusive environments don’t just create themselves. Everyone involved, including you, must take active steps toward creating inclusive environments. In this step, you’ll learn how to advocate for equitable policies, engage the wider community, and understand how to help create inclusive healthcare environments.

When you actively participate in these actions, you help foster a more inclusive and equitable healthcare field — including the education environments that train healthcare professionals like you.

Advocate for Equitable Policies

Every voice matters. So use yours to advocate for policies that promote health equity. You’ll need to stay informed about legislative developments by listening to whichever media outlets interest you. Three government websites offering such legislative updates are The United Nations, The White House, and the American Civil Liberties Union (ACLU).

Engage in the Wider Community

Along with joining advocacy groups and organizations, you can extend your advocacy beyond campus by engaging with the local community. One way to help the community is to volunteer your knowledge and skills to organizations that provide healthcare services to underserved communities. Try to learn the experiences and needs of community members, so that you can reduce healthcare inequities at a grassroots level.

Help Create Inclusive Healthcare Environments

Everyone deserves dignity, so diversity should never include denying autonomy or addressing people with prejudices and stereotypes. You can take an active role where all patients feel safe and respected by advocating for cultural competency training for healthcare professionals and the leaders who teach them. Try to find support initiatives that foster patient-centered care and culturally sensitive approaches.

Support Diversity Initiatives on Campus

A great way to help improve patient experiences and health outcomes is to join on-campus diversity initiatives, supporting campus organizations that promote diversity, equity, inclusion, and belonging. While most groups gladly accept new members, you’ll benefit from looking for groups designed for healthcare students and professionals.

If you can’t find a student group focused on diversity and inclusion in healthcare, or if the groups you find don’t fully align with your values, consider starting one. Getting involved in campus politics by collaborating with campus leaders is a great way to prepare for leadership roles in the healthcare system.

Step 7: Continue Learning and Growing

Stepping into antiracism advocacy requires continuous learning and growth. Like any journey, this one will challenge and change you. So maintain a commitment to personal development by staying informed about current issues in society as they relate to race and racism.

Reflect and Adjust Yourself Accordingly

While speaking against racism, learn your own worldview — how you see race and racism — rather than accepting the first, or most popular, antiracist narratives and principles to which you’re presented. Absorb a range of philosophies of race to learn what you believe and why, then allow those ideas to empower you to advocate for policies that promote equity and inclusivity within healthcare systems and institutions.

Seek Out Diverse Perspectives

No matter your cultural background, you need to learn from a diversity of perspectives. While many people gravitate toward those who share similar backgrounds, instead surround yourself with people from a variety of different cultural, ethnic, and socioeconomic backgrounds. Engage in conversation with others, choosing to seek and share knowledge.

Read and share books, periodicals, and research by writers from diverse thinking styles and educational, cultural, and professional backgrounds. You can also attend conferences, webinars, and workshops that address racist healthcare disparities. You deepen your empathy when you expose yourself to diverse perspectives; you challenge your assumptions and refine your patient-centered care skills.

Stay Informed on Current Issues

Consume content from whichever reputable media outlets interest you and consider exploring new outlets. You can follow reputable news sources, professional and advocacy organizations, and accurate research dedicated to racial equality.

No matter how you consume media or learn about the society you live in, it’s crucial to stay informed. This allows you to contribute to dialogue and advocate for evidence-based practices, driving change within the healthcare system.

Resources for Further Promotion of Antiracism

Now that you’ve walked through seven actionable steps that will advance your practice of antiracism in healthcare, you may be hungry for more information about the topic. Here are a variety of resources that will help you grow in your understanding of antiracism.

• Color of Change – Healthcare students can join Color of Change, the nation’s largest online racial justice organization. This organization’s 7 million members persuade corporate and government leaders to create a more human world for Black Americans.
• Race Forward – This racial justice nonprofit offers a wealth of resources, programs, trainings, and other events to build communities with the collective power to dismantle cultural racism.
• 1619 Project – Developed by writers from The New York Times, this long-form journalism project critically examines traditional historical figures, reckoning with the reality of America’s past.
• Theory of Racelessness – Through its podcast, programs, and a book published by Macmillan, this nonpartisan organization — lead by Dr. Sheena Mason — offers a solution to the problem of racism: racelessness.
• Black Lives Matter – Perhaps the most well-known antiracism organization, Black Lives Matter is a decentralized movement that offer toolkits and other resources for people interested in antiracism.
• Code Switch Podcast – Hosted by journalists of color, this podcast presents fearless conversations about racism. Listen and you’ll learn how racism influences all aspects of society.
• The Price of the Ticket: Collected Nonfiction by James Baldwin – Published in 1985 and reprinted in 2020, this expansive collection holds Baldwin’s essays written between 1948 and 1985. Baldwin, a renowned writer of fiction and nonfiction, was a dedicated advocate for racial justice.
• Racecraft: The Soul of Inequality in American Life by Karen E. Fields and Barbara J. Fields – Written by a sociologist and a historian, this work explores how racism creates the illusion of race through what they’ve coined “racecraft.”
• Strength of Soul by Naomi Raquel Enright – This essay collection uses personal narratives and criticism to examine the language that upholds racism. Enright highlights how resisting the ideology of racial difference can defeat racism and white supremacy.
• Your Silence Will Not Protect You by Audre Lorde – This book is a posthumous collection of Lorde’s finest poetry and prose. An influential activist and writer, Lorde described herself as a “Black, lesbian, mother, warrior, poet” and is renowned for writing that confronts injustice and creates change.

Expert Advice: Hear From a Researcher Studying Racism in Healthcare

What are some common misconceptions about racism in healthcare?

One important thing to make clear is that my experience is primarily in research related to healthcare. Given that, I think there are many misconceptions in how racism impacts research related to healthcare.

Some obvious examples involve how we talk about “racialized diseases” like sickle cell anemia and Tay-Sachs disease. While sickle cell anemia is often considered evidence that reifies the importance of racial awareness, it turns out that the determining factor for whether a population has sickle cell is tropical clines (exposure to malaria) rather than race.

From your perspective, how does systemic racism impact healthcare outcomes? Can you share specific examples?

The racialization of disease does not just lead to confusion with respect to naming, but it also leads to serious harms because of the impact it has on genetic screening. In fact, while the majority of Americans that carry a copy of the Tay Sachs allele are in fact Jewish, the vast majority of babies diagnosed with Tay Sachs disease are not Jewish.

It is truly indefensible that racialization of disease might hinder efforts to fund the cheap universal genetic screening necessary to prevent infant paralysis, but it’s cruelly ironic when contrasted with the revenues (close to a billion dollars per year) of mail-order genetic tests by companies whose main utility is an estimation of one’s racial makeup.

Many medical assumptions are so intertwined with conflicting stereotypes that they render themselves almost absurd. For example, the assumption that renal values be adjusted to take into account the fact that Black Americans have higher amounts of muscle mass (and thus faster metabolism) is hardly compatible with recent claims that suggest black genetics cause obesity, nor the almost magical claims that differences in metabolism mean diets simply don’t work for Black women.

Combined with new research related to the ever-popular subject of black athletic superiority in running, the totality of scientific evidence suggests that Black Americans are both more (and less) muscular and metabolically active as well as both predisposed to asthma and resigned to obesity (as well as predisposed for cardiovascular excellence).

While these claims are in no way vanishing and often cause real harm when taken all the way to drug development (i.e. BiDil), they are today being supplanted by what is purported to be an awareness of the “social construct of race.”

What steps can individual healthcare students or professionals take to combat racism within the healthcare industry?

Focus on social differences rather than skin color. Instead of pointing attention to race — splitting America into different countries by race — identify and acknowledge what “race” stands for. A lot of antiracists say that people need to be around people who “look like them.” That’s the opposite of diversity. We learn more when we’re surrounded by people who don’t look like us — when we’re surrounded by a diversity of humans.

How can healthcare institutions work toward creating a more inclusive and equitable environment?

They could offer solutions. There is plenty of medical research, but most of this focuses on problems without offering solutions to the problems.

Could you share any successful initiatives or strategies you’ve seen that have helped reduce racism in healthcare?

I haven’t. Antiracism movements have resulted in research papers that fashion all healthcare problems as racial. Healthcare is already a mess. Many people can’t figure out how their insurance works. The system is inaccessible to everyone. There are ways to get the healthcare we need, but many don’t know how to find the care they need.

What are the biggest challenges in trying to implement antiracist policies and practices in healthcare, and how can they be addressed?

People in charge make rules that benefit them. Medical professionals use race as a justification to create financial opportunities. Race is appealing in a financial sense because if you say there’s an allele that belongs to Black people, then you can create a drug or treatment specifically for Black people. Then you can say you’ve solved a racial problem in healthcare. People in charge want a story like that.

What resources would you recommend for healthcare students wanting to learn more about antiracism?

Montague Cobb. His research determined that there were no racial differences. But the government wants to hold onto this idea that racial differences are a reality. But if something reifies race in any way, it doesn’t count as antiracism.