Guest column: We must talk about racism in healthcare

A father of young children dies from a brain hemorrhage that healthcare staff interpreted as a “cultural fainting.” In my dermatology course, only examples of conditions on light skin are given. In gynecology, it is noted that Black women face higher risks of birth complications.

During my medical studies, I saw how inequalities in healthcare lead to marginalized groups receiving poorer treatment and suffering more from illnesses. This is not only ethically unacceptable but also undermines healthcare’s fundamental principle of equity.

I was a medical student when I initiated the Doctors’ Call Against Racism in spring 2021. Xenophobic voices had become normalized in the public sphere, and I saw Sweden moving toward a harsher climate. The appeal was published in Expressen with 1,011 signatures from doctors and medical students. We called for greater attention to racism in both medical education and clinical practice. My starting point was that even when healthcare professionals strive to make decisions based on facts and medical principles, this never happens entirely independently of the human and social contexts in which we operate.

Healthcare’s perspective is shaped by society

Healthcare is based on medical science but implemented in a politically governed system. There are several layers to examine in order to see the racism. Which populations are included in large research projects? How are educational programs designed? What resources does healthcare receive, and how are they distributed among the population? How does societal discourse affect collective awareness of marginalized groups? What perspective does the caregiver bring?

Today, I work in psychiatry. I meet undocumented immigrants, the homeless, and the unemployed. Many of our patients are directly affected by political decisions. At one point, I worked at a psychosis clinic specializing in newly diagnosed patients. A large majority had non-European backgrounds and lived in what are classified as “particularly vulnerable areas.” A risk factor for developing psychosis is migration, but also being a child of a migrant. External stressors are one explanatory model, and trauma’s impact on genetics is another.

I also learn that certain populations with origins in parts of Africa metabolize antipsychotic medication faster than documented, increasing the risk of under-treatment. When I visit an addiction clinic, an experienced colleague explains how the dismantling of schools and healthcare is evident in patient encounters, such as when young patients arrive wearing ankle monitors.