Attitudes and Actions Related to Racism: the Anti-RaCism (ARC) Survey Study

Abstract

Background: Racism negatively impacts health and well-being. Members of the medical community must intervene to address racism.

Objective: To assess whether attitudes about the impact of racism on health or society are associated with intervening around racism.

Design: Cross-sectional survey of a large department of medicine in an urban academic setting.

Participants: Interns, residents, fellows, and faculty.

Main measures: The primary outcome was the likelihood of intervening around an observed racist encounter or a racist policy. Predictor variables included age, gender identity, race/ethnicity, and attitudes about racism.

Key results: Although the majority of the 948 respondents endorsed the impact of racism on health and other societal effects, levels of endorsement were lower among older individuals, or those reporting male gender identity or selecting other race. Higher endorsement of the impact of racism on health was associated with increased odds of speaking up about a racist encounter or racist policy, with odds ratios from 1.18 to 1.30 across scenarios. Likelihood of speaking up about racism did not differ by racial or ethnic group, but older individuals were generally more likely to speak up and individuals between 20 and 29 years of age were more likely to speak with someone other than leadership or the source of a racist encounter.

Conclusions: Awareness of the effects of racism on health is associated with increased likelihood of intervening when a racist encounter is observed or a racist policy is noted. Including information on the impact of racism on health and creating safe spaces to discuss racism may increase the likelihood of bystander intervention in anti-racism strategies.

Keywords: attitude; bias; black; bystander; faculty; racism; trainee.