Racism in Medicine? Healthcare and the Digital Divide
I have long called out the digital divide as both reflecting and reinforcing structural racism. I have also called out healthcare’s blindness to the digital divide. But now I must ask whether that blindness in fact embodies racism in medicine as described in Clarence Gravlee’s analysis of the JAMA incident in Somatosphere: “How Whiteness Works: JAMA and the Refusals of White Supremacy.”
Gravlee’s piece includes a summary of Andrea Gibbon’s’ “Five Refusals of White Supremacy” and Charles Mills’ “epistemology of ignorance“—described by Gravlee as “structured ways of not knowing that allow whites to claim innocence.”
I am pleased to be helping several healthcare systems in Cleveland and across the country that are now trying to do the right thing–close gaps in patients’ digital connectivity and engagement. Yes, seniors have one set of challenges, and rural populations have another set. But the bulk of disconnectivity is in poor, urban, often Black communities in particular.
It’s possible for healthcare to try to close these gaps while ignoring underlying structural racism.
But recognizing and confronting it is a better approach.
Here are some seemingly simple solutions that do NOT work:
- Giving out smartphones and wi-fi hotspots.
- Pointing someone to a place they can get discount internet service
- Giving out written instructions or a website to demonstrate how to use telehealth or a patient portal
An effective solution requires institutions to:
- Articulate your values around digital patient engagement
- Have a vision for equitable digital patient engagement
- Set goals for achieving equitable engagement
- Develop methods to monitor equity, and metrics for judging your success
- Establish strategies for achieving your goals
- Create partnerships with community organizations expert in digital navigation (unless you want to attain these core competencies)
- Train your staff or hire appropriate people to serve as digital health navigators to encourage and coach your patients
Don’t try to reinvent the wheel. Public Health Innovators has first hand experience with promoting digital patient engagement, and also recommends best practices from other experts around the country.
Schedule a call to learn how we can help your organization attain equitable, meaningful digital patient engagement.