• Veronica Carey, PhD, CPRP

Structural Racism and Its Impact on Nurse Anesthetists

October 2022

PANA is seeking a more inclusive and diverse nurse anesthetist membership and workforce. The National Academies of Sciences, Engineering, and Medicine (2022) generated statements of task based on the Structural Racism and Rigorous Models of Social Inequity: Proceedings of a Workshop symposium conducted in Washington, DC May 16-17, 2022. The three Academies assembled to provide independent, objective analysis and advice to the nation and conduct other activities to solve complex problems and inform public policy decisions (NAP, 2022). The information gleaned from this symposium has application to the stated goals of PANA 1) Advance Professionalism, 2) Promote Quality of Care, and 3) Advocate and Educate.

Addressing PANA goal number 1: Advance Professionalism, there was information disclosed focusing upon how structural racism and anti-racist practices impact health disparities and health inequities. It comes down to three pivotal areas for PANA’s attention to influence the knowledge of current professionals and to encourage a more robust professional overture in the immediate future of current diversity attention: 1) review the national and state levels for the attention to social inequality as they result in poor health outcomes; 2) review the multidimensional (and varied intersectional) research on impact of health resources on marginalized populations. The Saturday, August 27, 2022, Diversity, Equity, and Inclusion presentation by Dr. Veronica Carey, Assistant Dean for Diversity Equity, and Inclusion for Drexel University addressed 6 (six) various intersections for the PANA Board’s attention: race, ethnicity, culture, diversity, equity, and inclusion. The final application to the first goal is 3) review how minoritized [Pennsylvanians] view the health field and its practices. These may seem lofty, but when chunked can most certainly offer pathways to advancing professionalism of nurse anesthetists in Pennsylvania.

Goal number 2 of Promoting Quality of Care for PANA lends itself to the information gleaned from the symposium as well with respect to the connection of structural racism to social determinants of health. Hedy Lee, professor of sociology at Duke University, reminds us not to be distracted by the shiny and new data but instead structural racism data may be new, but structural racism is not new and has foundation in the United States. Structural racism looks like colonization, genocide and current but overt population health differences (Lee, 2022 personal communication). Cornel West, professor at Harvard University and prolific writer and presenter on diversity, equity and inclusion, speaks about the value gap and weapons of distraction in higher education (AIA, 2020). West (2018) proffers the value gap pertains to the fact that most Americans focus upon the wealth, empathy, and achievement gaps and the false ideal that some persons are valued more than others (value gap). To close the value gap, habits must change at institutions that perpetuate the value gap (unwittingly is an implicit bias). West (2018) continues to share that [PANA] may be susceptible to the weapons of distraction, for example, calling issues a problem when it is a catastrophe or needing to be the ‘smartest’ in the room (majority rule) when the outliers in the crowd may offer other insights (Harper & Davis, 2020). Instead, PANA can achieve the second goal of Promoting Quality of Care by being sensitive to the vulnerable in both the 3,500 memberships in Pennsylvania and the 56,000 memberships nationwide of nurse anesthetists. PANA might shape the Board in a way to illustrate inclusion, be Socratic to the core, and be prepared to defend the decisions to grow the field from an inclusionary posture.

Advocation and education, goal 3 of PANA, aligns with information addressed at the symposium pertaining to ensuring the work done has the potential both to contribute to well-being, reduce [diversity] disparities, and improve population health (NAP, 2022). PANA’s goal of advocacy would look like thinking about racism only as a form of prejudice makes it impossible to understand the drivers of structural racism; instead, a theoretical understanding of the racialized social system would be beneficial (Glaude, 2018). Education, on the other hand, would resemble addressing current pedagogy, evaluating diversity within curriculum, instating andragogy (Malcome Knowles) as a strategy for including the adult student in the learning process, and reducing the sense of invisibility amongst disenfranchised, marginalized and minoritized faculty, student, and employed alumni of PANA.


AIA Resource page for Guides for Equitable Practice (2020). https://www.aia.org/resources/6246433-guides-for-equitable-practice

Eakins, A. & Eakins, S. (2017). African American students at predominately white institutions: A collaborative style cohort recruitment and retention model. Journal of Learning in Higher Education, 13(2), 51-57.

Glaude, E. (2018). Racism is a congenital disease. Retrieved: https://www.youtube.com/watch?v=MfK4jGstcO8

Harper, S.R.& Davis, C.H.F. (2020). Eight actions to reduce racism in college classrooms. American Association of University Professors.

National Academies Press (2022). 26690.pdf

Ohio State University: Kirwan Institute for the Study of Race and Ethnicity: http://kirwaninstitute.osu.edu/research/understanding-implicit-bias/

West, C. (2018). Speaking truth to power: https://www.youtube.com/watch?v=-Bc6TRjptKI