4.7 Article

Black Patients Matter in Neurology Race, Racism, and Race-Based Neurodisparities

Journal

NEUROLOGY
Volume 99, Issue 3, Pages 106-114

Publisher

LIPPINCOTT WILLIAMS & WILKINS
DOI: 10.1212/WNL.0000000000200830

Keywords

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Funding

  1. Dartmouth Swigart Clinical Ethics Fellowship

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This article highlights the disproportionate health disparities experienced by Black people in the United States in the field of neurology. It emphasizes that race is a social construct and that racism, rather than biological differences, is the root cause of these disparities. The article calls for neurologists to actively promote measures to counteract racism and work towards health equity in neurology.
Black people living in the United States suffer disproportionate morbidity and mortality across a wide range of neurologic conditions. Despite common conceptions to the contrary, race is a socially defined construct with little genetic validity. Therefore, racial health inequities in neurology (neurodisparities) are not a consequence of biologic differences between races. Instead, racism and associated social determinants of health are the root of neurodisparities. To date, many neurologists have neglected racism as a root cause of neurologic disease, further perpetuating the problem. Structural racism, largely ignored in current neurologic practice and policy, drives neurodisparities through mediators such as excessive poverty, inferior health insurance, and poorer access to neurologic and preventative care. Interpersonal racism (implicit or explicit) and associated discriminatory practices in neurologic research, workforce advancement, and medical education also exacerbate neurodisparities. Neurologists cannot fulfill their professional and ethical responsibility to care for Black patients without understanding how racism, not biologic race, drives neurodisparities. In our review of race, racism, and race-based disparities in neurology, we highlight the current literature on neurodisparities across a wide range of neurologic conditions and focus on racism as the root cause. We discuss why all neurologists are ethically and professionally obligated to actively promote measures to counteract racism. We conclude with a call for actions that should be implemented by individual neurologists and professional neurologic organizations to mitigate racism and work towards health equity in neurology.

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