By Dina Weinstein

From her years in clinical practice to working in the classroom, Meera Pahuja, M.D., says she has seen how the healthcare system can perpetuate discriminatory practices that can greatly impact the care of patients and their trust in providers.

When she teaches her students in the Virginia Commonwealth University School of Medicine about the disparity that some residents have a life expectancy that is 18 years less than other Richmonders just 11 miles apart, students want to see the data.

“There are systemic reasons. There's our bias,” said Pahuja, assistant professor at the School of Medicine's Department of Internal Medicine. “We talk about the historical legacy of segregation at VCU Health, patient experience and the systems that create it.”

In the School of Medicine course Patient, Physician and Society, students focus on social medicine and professional identity formation.

Pahuja emphasizes to students that though they want to provide the best patient-centered care that’s equitable, just and fair — they are up against numerous challenges.

“Our patients come from a context and a lived experience,” Pahuja said. “Only 25% of their health outcomes are really related to medication that a doctor may prescribe, the other 75% depends on the data that is related to where that patient lives, what food they have access to and what they were exposed to growing up.”

For Pahuja, the new Racism and Health research guide on the VCU Libraries website — filled with videos, articles, books, primary sources and database links — serves as an important source to lead the critical discussions in her class. She links to the guide from her course’s online platform for her students to delve into the materials on their own.

Published over the summer, the Racism and Health research guide is just one of many research guides VCU librarians have produced to help students and faculty get started investigating topics or adhere to a standard academic writing or citation style. The materials are curated and vetted resources, verified for accuracy and legitimacy by dedicated librarians. Much like many resources at VCU libraries, the guide is also available for free to people outside of the university, including patients and families.

“The home page starts by saying that racism impacts health,” said Erica Brody, a research and education librarian at the VCU Health Sciences Library who initiated the project. “There are several reputable places like the Centers for Disease Control and Prevention, the American Medical Assocation, the AARP and even the Virginia General Assembly that have made statements to this effect. In addition, there are links to selected evidence of the impact of racism on health. I think this is powerful information to include on the home page.”

Brody was inspired by racism and health linked events and research at VCU and VCU Health as well as the racial justice reckoning after the murder of George Floyd that extended to library work. Brody collaborated with fellow research and education librarian Samantha Guss, the liaison to the VCU School of Population Health.

“It's impossible to talk about social determinants of health without also talking about the history of racism in this country,” Guss said. “Where people live is not random.”

From public health classes focusing on health equity and cancer, to dental hygiene lectures, the materials in the guide are already being incorporated into courses.

“As librarians we respond to the education and research that's happening here,” Brody said. “People all across VCU, certainly on the MCV campus, are interested in teaching, studying and researching this topic. I also hope this resource will aid people in their clinical practice.”

Guss and Brody included materials from the VCU Office of Health Equity’s History and Health program to show the synergies of efforts around VCU. National and state data is available to help students and staff with research as well as TED Talk videos from published experts on racism and health care.

“[The research guide] prominently connects history and health,” said Logan Vetrovec, director of education and research at the VCU Office of Health Equity. “They have some topics that they signal out in social determinants of health as [the Office of Health Equity] does - housing, climate inequities and the maternal health crisis.”

Easy accessibility is also key, as noted by Anne Massey, director of patient and community services at the VCU Office of Health Equity. She says it “requires university level resources” to promote these efforts across both campuses for students, faculty, researchers and medical staff.

Broadening perspectives of the healthcare workforce and the next generation of medical professionals is at the heart of this academic resource. Swati Sharma recognizes this first-hand as a third-year medical student.

“Having resources such as the Racism and Health VCU Libraries Guide is so important for our learning as medical students because we will have patients from diverse backgrounds and need to learn how to provide healthcare equitably. Learning more about the topic can guide our social understanding as future physicians to deliver the best possible care to our future patients,” Sharma said.

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