Abstract
Since early in the Covid-19 pandemic, there have been wide disparities observed between different US racial groups’ rates of Covid-19 infections and deaths. This challenges physicians and patients to untangle what these race-associated risks mean for an individual patient. I argue that this task of providing individualized risk advice requires physicians to apply two skills: structural competency (an understanding of how societal features affect health, since race-associated risks are the result of social conditions, not innate biological differences) and epistemic humility (being mindful of the limitations of individual knowledge and a habit of working collaboratively to get the knowledge that is needed).
Highlights
Examination room conversations about what a patient’s race or ethnicity means for their risk require physicians to understand and communicate the tricky relationship between person and environment
Race is a proxy for a range of medical risks that arise out of the contingencies of an unjust social world, such as the labor inequities of Black Americans being disproportionately employed in “essential worker” jobs that result in high exposure to infection but low pay and social status
For physicians to be able to explain why Covid-19 has burdened some racial and ethnic groups more than others, they need to have some familiarity with the social patterns that lead to the average risks being elevated
Summary
Examination room conversations about what a patient’s race or ethnicity means for their risk require physicians to understand and communicate the tricky relationship between person and environment. The Covid-19 pandemic offers an opportunity for illustrating the way structural thinking can be wielded in the clinic, to the benefit of patients.
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