Plenary 1 - Dx: Racism: The Role of Diagnostic Error in Maternal Health Inequities

Sunday, October 16
1.25 CME/CNE

Each year in the United States, about 700 people die during pregnancy or in the year after. Another 50,000 people each year have unexpected outcomes of labor and delivery with serious short- or long-term health consequences. For Black people in the United States, the risk of death during pregnancy or in the year after is 3 times that of their white counterparts. The reasons behind these troubling statistics are multi-fold and complex but have their root in a history of racism in the United States (U.S.). 

Delays in recognition of risk factors and escalation of care are known to be associated with preventable maternal morbidity and mortality. These include delays in assessing clinical warning signs, providing accurate diagnoses, implementing optimal treatment, and coordinating care with multidisciplinary teams.  We must ask ourselves what’s at the root of diagnostic errors such as these? And how and why are they contributing to the preventable deaths of Black birthing people at such alarming rates?

In this talk I will describe the history of racism in health care delivery and how it shows up in diagnostic error as it relates to maternal and infant health. I will also offer thoughts, ideas, and strategies we might consider as practitioners, researchers and leaders to address this issue from a lens of antiracism and diagnostic equity. 

Learning Objectives

  • Identify and describe how structural racism affects health outcomes.
  • Apply an antiracism framework to the field of health.
  • Evaluate and incorporate values of equity and inclusion in health care professional practices.
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    Rachel Hardeman

    Rachel Hardeman, PhD, MPH

    Associate Professor
    Blue Cross Endowed Professor in Health and Racial Equity
    Division of Health Policy & Management at the University of Minnesota’s School of Public Health
    Founding Director
    Center for Antiracism Research for Health Equity

    Dr. Rachel R. Hardeman is a tenured Associate Professor in the Division of Health Policy & Management at the University of Minnesota’s School of Public Health, the Blue Cross Endowed Professor in Health and Racial Equity, and the Founding Director of the Center for Antiracism Research for Health Equity. A reproductive health equity researcher, she applies the tools of population health science and health services research to elucidate a critical and complex determinant of health inequity—racism. Dr. Hardeman leverages the frameworks of critical race theory and reproductive justice to inform her equity-centered work which aims to build the empirical evidence of racism’s impact on health particularly for Black birthing people and their babies. Dr. Hardeman’s research includes a partnership with Roots Community Birth Center, in North Minneapolis, one of five Black-owned freestanding birth centers in the United States. Her work also examines the potential mental health impacts for Black birthing people when living in a community that has experienced the killing of an unarmed Black person by police. Published in journals such as the New England Journal of Medicine and the American Journal of Public Health, Dr. Hardeman’s research has elicited important conversations on the topics of culturally-centered care, police brutality, and structural racism as a fundamental cause of health inequities. Her overarching goal is to contribute to a body of knowledge that links structural racism to health in a tangible way, identifies opportunities for intervention, and dismantles the systems, structures, and institutions that allow inequities to persist. 

    Dr. Hardeman is the recipient of several awards for her work as an early career investigator including the Dr. Josie R. Johnson Human Rights and Social Justice Award from the University of Minnesota (2019) the 2020 recipient of the Association of Schools and Programs of Public Health (ASSPH) Early Career Public Health Research Award. She was recently named a McKnight Presidential Fellow awarded for her excellence in research and scholarship, and leadership and recently received the AcademyHealth Alice S. Hersh Emerging Leader Award for the impact her research has had on health policy. She is also active locally and nationally with organizations that seek to achieve health equity such as the Minnesota Maternal Mortality Review Committee and the Board of Directors for Planned Parenthood of the North Central States. 

    Dr. Hardeman earned an undergraduate degree in chemistry and Spanish from Xavier University of Louisiana, an MPH in Public Health Administration and Policy, and a PhD in Health Services Research and Policy from the University of Minnesota School of Public Health.