Harvard Law School, U.S. Food & Drug Administration, and the Justice Initiative, Cambridge, MA, USA.
Internal Medicine-Neuroendocrine Division and Pediatric Endocrinology, Nutrition Obesity Research Center at Harvard (NORCH), Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA.
Soc Sci Med. 2022 Apr;298:114856. doi: 10.1016/j.socscimed.2022.114856. Epub 2022 Feb 28.
Medicine is having a reckoning with systemic racism. While some continue to believe medicine is apolitical and grounded purely in science, history and research reveal that medicine is inseparable from underlying systems, laws, and policies. Obesity is a useful case study. Weight loss trials have shown the immense difficulty in achieving and sustaining weight loss without addressing overlying systems. Barriers are double for Black, Indigenous, and People of Color (BIPOC) with obesity, who must contend with multiple layers of oppressive systems. Increasingly, illness is not a matter of bad luck, but is a function of oppressive structures. COVID-19 likely originates in a deteriorating environment, we have an increasing global burden of disease from oppressive sales of food, sugar, alcohol, guns, nicotine, and other harmful products, and social inequality and resource hoarding are at a peak. Medicine can and must participate in redefining these systems. In doing so, it must center the experiences of BIPOC and push change that alleviates power disparities.
医学正在正视系统性种族主义。虽然有些人仍然认为医学是与政治无关的，纯粹基于科学、历史和研究，但事实表明，医学与潜在的制度、法律和政策是不可分割的。肥胖是一个很好的案例研究。减肥试验表明，在不解决潜在系统的情况下，减肥和维持减肥是非常困难的。肥胖的黑人、原住民和有色人种（BIPOC）面临着双重障碍，他们必须应对多层压迫性系统。越来越多的疾病不是运气不好的问题，而是压迫性结构的产物。COVID-19 可能起源于恶化的环境，我们面临着越来越多的因压迫性销售食品、糖、酒精、枪支、尼古丁和其他有害产品而导致的疾病负担，社会不平等和资源囤积达到了顶峰。医学可以而且必须参与重新定义这些系统。在这样做的过程中，它必须以 BIPOC 的经验为中心，并推动改变，以减轻权力差距。
