ABSTRACT
Public health crises palpably demonstrate how social determinants of health have led to disparate health outcomes. The staggering mortality rates among African Americans, Native Americans, and Latinx Americans during the COVID-19 pandemic have revealed how recalcitrant structural inequities can exacerbate disparities and render not just individuals but whole communities acutely vulnerable. While medical curricula that educate students about disparities are vital in rousing awareness, it is experience that is most likely to instill passion for change. The authors first consider the roots of health care disparities in relation to the current pandemic. Then, they examine the importance of salient learning experiences that may inspire a commitment to championing social justice. Experiences in diverse communities can imbue medical students with a desire for lifelong learning and advocacy. The authors introduce a 3-pillar framework that consists of trust building, structural competency, and cultural humility. They discuss how these pillars should underpin educational efforts to improve social determinants of health. Effecting systemic change requires passion and resolve; therefore, perseverance in such efforts is predicated on learners caring about the structural inequities in housing, education, economic stability, and neighborhoods-all of which influence the health of individuals and communities.
Subject(s)
COVID-19/psychology , Education, Medical/ethics , Ethnicity/statistics & numerical data , Racism/ethnology , Black or African American , Awareness , COVID-19/diagnosis , COVID-19/epidemiology , COVID-19/virology , Education, Medical/statistics & numerical data , Female , Healthcare Disparities/ethnology , Humans , Male , Minority Groups , Problem-Based Learning/statistics & numerical data , Public Health/ethics , Public Health/statistics & numerical data , SARS-CoV-2/genetics , Social Determinants of Health/ethnology , Social Determinants of Health/statistics & numerical data , Social Justice/ethics , Stakeholder Participation , Students, Medical/statistics & numerical data , United States/epidemiologyABSTRACT
The COVID-19 pandemic is exacerbating longstanding challenges facing children with tracheostomies and their families. Myriad ethical concerns arising in the long-term care of children with tracheostomies during the COVID-19 pandemic revolve around inadequate access to care, healthcare resources, and rehabilitation services. Marginalized communities such as those from Black and Hispanic origins face disproportionate chronic illness because of racial and other underlying disparities. In this paper, we describe how these disparities also present challenges to children who are technology-dependent, such as those with tracheostomies and discuss the emerging ethical discourse regarding healthcare and resource access for this population during the pandemic.