Introduction
Anti-racism courses equip learners with the knowledge and skills to understand and challenge racism’s root causes, offering a transformative experience. As a result, through such classes, individuals become aware of the institutional and systemic practices perpetuating racism. However, I have completed such a class, developing an understanding of the complexities of racism. This essay examines the course’s impact and the concepts of marginalization and exclusion in healthcare.
The Learning Process
Anti-racism courses aim to help raise individuals’ awareness and confront systemic and structural issues that perpetuate racism. These classes provide learners with the tools to identify and address the root causes of racism. My experience with anti-racist coursework has transformed my perspective, enabling me to understand racism’s complexities. Racism is not limited to individual attitudes or behaviors; but is also about institutional and systemic practices that discriminate against specific groups of people. I have gained knowledge and skills to identify and challenge institutional and systemic racism, such as reflecting on personal attitudes and biases. I have discovered that racism is pervasive and can manifest subtly, even through microaggressions. I have also acquired cultural competency skills, allowing me to communicate effectively with individuals from diverse backgrounds. These abilities are vital for healthcare professionals who serve patients from various cultural and ethnic backgrounds.
Marginalization
Marginalization is a concept that has profoundly influenced the understanding of race and racism in healthcare. Marginalization refers to the social, economic, and political exclusion of certain groups of people from mainstream society (Baah, 2019). In healthcare, marginalization manifests in the unequal distribution of resources and services. For instance, individuals from specific racial and ethnic backgrounds are more likely to live in poverty and have limited access to healthcare services. This lack of access to healthcare services exacerbates health disparities and leads to poor health outcomes for marginalized groups. Marginalization is a systemic issue that requires systemic solutions. One solution is to increase the representation of marginalized groups in healthcare. Research has shown that a more diverse healthcare workforce can improve health outcomes for marginalized groups (Baah, 2019). The author has learned that healthcare professionals can also challenge marginalization by advocating for policies that address the root causes of marginalization, such as poverty and unequal distribution of resources.
Exclusion
Exclusion is another concept that has profoundly influenced the understanding of race and racism in healthcare. Exclusion refers to the deliberate or unintentional exclusion of certain groups of people from healthcare services (Baah, 2019). Exclusion can manifest in various ways, such as through language barriers, cultural misunderstandings, and discrimination. Exclusion can lead to poor health outcomes for excluded groups and perpetuate health disparities. Healthcare professionals can challenge exclusion by adopting a patient-centered approach to care. This approach involves considering patients’ cultural beliefs, values, and practices. Healthcare professionals can also challenge exclusion by providing language services and addressing the social determinants of health that contribute to exclusion.
Creating Safe and Accountable Spaces in Confronting Racism
The experience I will reflect on is a time when I witnessed racism while attending a social gathering with friends. One of my friends, a person of color, was telling a story about an experience they had while shopping when another person at the gathering made a derogatory comment about people of color. I was taken aback and felt uncomfortable. However, I did not speak up or confront the person because I did not want to cause conflict or create an awkward situation. According to Pugh (2021), safety is a feeling produced by particular environments or spaces. These spaces can be understood as being accountable, brave, or safe. In an accountable area, people take responsibility for their actions and behaviors and are willing to learn and grow. In a brave space, individuals are encouraged to take risks, speak the truth, and engage in difficult conversations. A safe space is one in which individuals feel physically and emotionally secure and are protected from harm.
In the experience I described, my triggering response was to remain silent and not confront the person who made the derogatory comment. My fear of retribution and my need for emotional safety drove this response. However, my silence also allowed racism to go unchallenged, undermining the possibility of creating an accountable or brave space. Accountable or brave spaces and safe spaces are different approaches to creating spaces conducive to learning and growth (Pugh, 2021). In a safe space, the focus is on creating a sense of physical and emotional safety. This is important because individuals cannot learn or grow if they feel threatened or unsafe. However, a safe space can also become an echo chamber, where individuals are not exposed to diverse perspectives and experiences. Individuals are encouraged to take risks and engage in difficult conversations in an accountable space. This space promotes learning and growth by challenging individuals to think critically and consider diverse perspectives. However, this type of space can also be challenging and uncomfortable, and individuals may not feel emotionally safe.
The experience I described in which I remained silent while racism occurred at a social gathering triggered my sympathetic nervous system response. According to Scott-Solomon et al. (2021), the sympathetic nervous system response is a physiological response to perceived danger or threat, which can cause physical reactions such as increased heart rate, sweating, and shallow breathing. This response is commonly known as the “fight or flight” response, and it can lead to feelings of anxiety and stress. In the case of the racist event I witnessed, my sympathetic nervous system response may have been triggered by the derogatory comment made by the person at the gathering. My fear of retribution and my need for emotional safety may have led me to remain silent and not confront the person.
It is essential to understand the vagus nerve’s role in regulating the sympathetic nervous system response. According to Scott-Solomon et al. (2021), the vagus nerve is critical in regulating the autonomic nervous system, including the sympathetic nervous system. The vagus nerve promotes feelings of relaxation and calmness, which can counteract the effects of the sympathetic nervous system response. Practices such as deep breathing and mindfulness can activate the vagus nerve, promoting relaxation and reducing feelings of anxiety and stress.
Furthermore, self-care practices that promote relaxation and calmness can benefit all individuals, regardless of their racial identity. White individuals must be responsible for their emotional labor in creating and maintaining safe, accountable, and brave spaces. In this way, self-care practices that promote relaxation and calmness can support white individuals in engaging in difficult conversations and challenging racist behavior, creating more inclusive and equitable spaces. As such, somatic practices that activate the vagus nerve can be essential in promoting self-care and creating safe, accountable, and brave spaces for all individuals.
Barriers
In the article “Accent bias: A barrier to Black African-born Nurses Seeking Managerial and faculty positions in the United States” by Iheduru-Anderson (2020), the author explores the experiences of Black and Brown nurses in healthcare settings and the various forms of racism they face. One of the main themes that emerged from the study was “structural and institutional racism,” which refers to the systemic barriers that limit the opportunities and advancement of Black and Brown nurses within healthcare organizations. The experiences shared by the nurses in the study suggest that structural and institutional racism manifests in various ways, including discriminatory hiring practices, limited opportunities for advancement, and unequal treatment compared to their white colleagues.
The author notes that these experiences can lead to feelings of isolation, burnout, and even leaving the profession altogether. One example of structural and institutional racism in healthcare settings is the lack of diversity in leadership positions. According to a study by Nardi et al. (2020), Black and Hispanic individuals are significantly underrepresented in leadership positions in healthcare organizations. This lack of diversity can perpetuate systemic racism and limit the opportunities for Black and Brown nurses to advance in their careers.
Conclusion
Creating accountable or brave spaces is essential to confront racism and challenge exclusion and marginalization in healthcare. The experience described in this essay illustrates the importance of creating spaces conducive to learning and growth. Silence and inaction in the face of racism undermine the possibility of creating accountable or brave spaces. Understanding the role of the sympathetic nervous system and the vagus nerve in regulating stress and anxiety can help individuals develop self-care practices that promote relaxation and calmness, leading to better overall well-being. Healthcare professionals can challenge exclusion and marginalization by adopting a patient-centered approach to care and advocating for policies that address the root causes of marginalization. Creating a more diverse healthcare workforce is crucial to improving health outcomes for marginalized groups.
References
Baah, F. O., Teitelman, A. M., & Riegel, B. (2019). Marginalization: Conceptualizing patient vulnerabilities in the framework of social determinants of health — An integrative review. Nursing Iquiry, 26(1), e12268. Web.
Iheduru‐Anderson, K. (2020). Accent bias: A barrier to Black African‐born nurses seeking managerial and faculty positions in the United States. Nursing Inquiry, 27(4), e12355. Web.
Nardi, D., Waite, R., Nowak, M., Hatcher, B., Hines‐Martin, V., & Stacciarini, J. M. R. (2020). Achieving health equity through eradicating structural racism in the United States: A call to action for nursing leadership. Journal of Nursing Scholarship, 52(6), 696-704. Web.
Pugh, M., Perrin, P. B., Rybarczyk, B., & Tan, J. (2021). Racism, mental health, healthcare provider trust, and medication adherence among black patients in safety-net primary care. Journal of Clinical Psychology in Medical Settings, 28, 181-190. Web.
Scott-Solomon, E., Boehm, E., & Kuruvilla, R. (2021). The sympathetic nervous system in development and disease. Nature Reviews Neuroscience, 22(11), 685-702. Web.