Citation:
Telhan, R., McNeil Ba, K. M., Lipscomb-Hudson, A. R., Guobadia, E. L., & Landry, M. D. (2020). Reckoning With Racial Trauma in Rehabilitation Medicine. Archives of physical medicine and rehabilitation, 101(10), 1842–1844. https://doi.org/10.1016/j.apmr.2020.07.001
Summary:
This article provides a brief overview of two issues facing the field of rehabilitation. The first is how to integrate an understanding of racial disparities, racism, and racial trauma. The second is the need to examine our own institutions for diversity and inclusion. The authors summarize some sobering findings such as Black patients with diabetes undergo amputation at triple the rate of other groups, and Black and Latinx adults with traumatic brain injury are less likely to receive rehabilitation services, regardless of insurance status. In another recent study on individuals with traumatic brain injury five years post-injury, Black race was one of the main predictors of unmet needs (Mahoney et al., 2020). The authors also make the important point that all health care has been impacted by the unequal effects of COVID-19 on Black and Brown Americans.
One effect of racism that is part of these racial disparities is the effect of racial trauma. Racial trauma has been compared to post-traumatic stress disorder but differs in that the individual continues to experience re-exposure due to ongoing racism and race-based stress (Comas-Díaz et al., 2019). This article is a call to all rehabilitation professionals to understand the link between systemic trauma and health because we may not be able to adequately provide care as long as structural barriers exist. As a starting point the authors suggest using a broad trauma-informed approach that includes structural circumstances such as racism, economic inequality, and access to care (including transportation, childcare availability, etc.). In working together to plan care, we can include support for the effects of racial trauma and recognize the intersection of racial trauma and other psychological and physical goals.
The second point the authors make is that we must examine each of our care teams to determine if they have adequate representation of a diversity of voices to help guide planning and treatment decisions. They provide sobering data on the mismatch between the racial and ethnic communities represented by rehabilitation providers and the populations they serve. Active and immediate changes need to be made to recruit, hire and retain providers from diverse communities, especially those that have been marginalized. The APA has a website with suggestions here.
The article ends with these questions: How will we measure those inequities in rehabilitation? How will we hold ourselves and our society accountable to addressing them?
I chose this article because I believe that rehabilitation psychologists are uniquely positioned to understand and guide others in integrating an awareness of the impact of racial trauma on the rehabilitation process. We are all still learning about these processes and this article provided a helpful summary. I recently attended a seminar by Jennifer Manly, PhD in which she said “race is made biological by racism” and I think this article captures that idea.
This month’s Rehabilitation Science Spotlight was chosen by Sarah Raskin, Ph.D., ABPP. Dr. Raskin is a Professor of Psychology and Neuroscience at Trinity College and member of the APA Div. 22 Science Committee. Thank you for your valuable contribution, Dr. Raskin!