Structural competency meets structural racism: Race, politics, and the structure of medical knowledge

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Title
Structural competency meets structural racism: Race, politics, and the structure of medical knowledge
Contributors
Metzl, Jonathan M. (Author)
Roberts, Dorothy E. (Author)
Date Created
2014-09-01
Abstract
In this article, Metzel and Roberts write about the importance of a “structural competency” curriculum for medical practitioners. They argue that many health-related variables that were previously attributed to culture, ethnicity and race, are actually the end-results of structural inequities, in domains from health care to housing. To illustrate this, they outline three examples. They first explore the overdiagnosis of paranoid schizophrenia is African American men the the 1960s-70s, as a result of structural shifts in the framing of mental illness. They then examine the labeling of primarily those in low socioeconomic or minority groups as ‘non-compliant’ patients in regards to following a healthy diet, and how this labeling ignores the structural factors that impact unhealthy food “choice.” Finally, they outline the history of punitive treatment of Black women who use drugs during pregnancy, and how it perpetuated false stereotypes about Black motherhood. These examples are used to demonstrate that, while often-well intentioned, efforts to incorporate “culture” into the diagnosis and treatment of disease often overlook the impact of structural factors that affect patient’s choices and health outcomes. They conclude by outlining interventions and strategies that can be used to incorporate structural competency into medical training and practice.
Keywords
medical education
obstetrics
mental health
graduate medical education
racism
psychiatry
structural competency
medical knowledge
structural interventions
health services delivery
interventions
Notes
Please note that this article is appropriate as an introductory article for readers with no prior background in these topics.
Access Conditions
This work is licensed under a Creative Commons Attribution 4.0 International License

Citation

Metzl, Jonathan M., and Roberts, Dorothy E., "Structural competency meets structural racism: Race, politics, and the structure of medical knowledge" (2014). Medicine and Race: AMS Annotated Bibliography. Brown Digital Repository. Brown University Library. https://repository.library.brown.edu/studio/item/bdr:788171/

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    This annotated bibliography was created to serve as a resource for medical students, residents, and faculty interested in learning more about how race is used in medicine and how racism results in disparate health outcomes for racial and ethnic minorities ...

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