DEI PERSPECTIVE
Racial Trauma: The Burden of Being Black in Medicine
SAEM PULSE | JULY-AUGUST 2023
By Ashlea Winfield, MD, MSPH and Sanche Mabins, MD on behalf of the SAEM Academy for Diversity and Inclusion in Emergency Medicine
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Trauma is any event, series of events, set of circumstances or environment that is experienced as harmful, having lasting effects on the individual’s functioning and well-being. While discussions of trauma and trauma informed care often center around adverse childhood experiences (ACEs), we often gloss over the disparate burden of trauma that is carried by individuals from historically marginalized ethnic and racial groups. Racial trauma or race based traumatic stress (RBTS) is mental and emotional injury caused by encounters with racial bias and ethnic discrimination, racism, and hate crimes. Through this article we aim to provide an awareness of race based trauma, highlighting a small fragment of the
burden of racism within medicine and the associated cost.
“Can you refill the paper towels in the bathroom?” Microaggressions as Every Day Racial Trauma Imagine you are busy charting when someone interrupts to ask you to refill the paper towels in the bathroom. You look down at your embroidered scrubs and bright block lettered “DOCTOR” badge to wonder what made them think you were environmental staff. You know this perception that you are in a service position is largely because of your race, because you are Black. This is a microaggression.
Racial microaggressions specifically are “brief, everyday exchanges that send denigrating messages to people of color…” . While we frequently frame microaggressions as little annoyances, they are a form of racism that carries significant health burdens, affecting the mental and physical health of those who experience them. Microaggressions have been shown to lead to higher rates of depression, feelings of hopelessness, suicidal ideation, sleep disturbances, hypertension, and substance use. How others choose to respond to an individual’s experience of microaggressions may also alleviate or exacerbate trauma activation. Imagine talking to a faculty member or colleague