Dean Lloyd Minor, MD, kicked off Monday's Race, Policing and Public Health Symposium by reminding the several hundred attendees why physicians — who are trained primarily to care for the physical body — should care about issues of race, law enforcement-related violence and discrimination.
"I think it's simple and obvious that if we as physicians and health-care professionals are concerned about the health of our patients and society, then... we should be concerned about the social environment that so dramatically affects so many in our society," Minor said, as he and Stanford Law School Dean Liz Magill, JD, began the day-long event.
Following a keynote address by social psychologist and University of California, Berkeley chief academic officer Claude Steele, PhD, a panel moderated by Stanford psychologist Keith Humphreys, PhD, tackled the tough topic of how racial discrimination affects public health. Providing community health care depends on trust and cooperation, just as providing public safety requires community participation, Humphreys said.
In many places, that trust has been shattered by historical events such as the infamous Tuskegee syphilis study, said panel member Marcella Alsan, MD, PhD, a Stanford infectious disease specialist and economist. Although the experiment was exposed and ended in the early 1970s, its effects are still being felt in communities such as Oakland, Alsan said. She's currently examining the role that mistrust plays in keeping African American males from visiting doctors for preventative care services.
The other two panelists, Stanford child psychiatrist Victor Carrion, MD, and Amanda Geller, PhD, a sociologist at New York University, discussed the effects that continual low-level stress, punctuated by events of intense stress, have on physical and mental health. "If you are a little kid and you feel like a truck is coming at you every day, that has a cost," Carrion explained. "The stress we get from discrimination is high, and there is a direct relationship between what we experience and our health."
Geller said her research has examined people, primarily men, who had interactions with the New York Police Department when its stop-and-frisk policy was in effect."There were strong associations between those stops and symptoms of PTSD," Geller said. And, those stops occurred primarily to non-white males, she pointed out.
There are several steps that can be taken to build trust and support public health, the speakers said.
"One of the things that's increasingly being recognized is the need for broad accountability," Geller said. For example, rather than disciplining one police officer who uses excessive violence, digging deeper to find the root, institutional cause for that individual's behavior.
Increasing the number of non-white physicians and police officers in a disadvantaged community could help reduce bias and discrimination, Alsan argued.
And education and open discussion about bias and training for police officers on issues such as dealing with mental health crises could also improve trust, Carrion said.
Carrion and Alsan also believe progress could come by a generational shift. "I am very hopeful about our youth," Carrion said.
Previously: Stanford biomedical community shows support for those affected by police violence, Exploring how physicians can handle discrimination by patients and Mistrust of medicine in the wake of Tuskegee: A student's reflection
Photo of Marcella Alsan and Victor Carrion by Paul Keitz