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Reckoning With Racial Trauma in Rehabilitation Medicine

      The story of structural racism and brutality toward black and brown people is well known to the communities who endure it. While the suffocating stream of violence affecting these communities has been historically entrenched, this reality has too often been unseen or ignored by others. But as reports spread of George Floyd’s death in police custody in late May, the United States appeared to reach a tipping point. In this latest instance of a notorious pattern, a video showed Mr Floyd in handcuffs and subdued by 3 officers, with his neck lethally pinned beneath a fourth officer’s knee. “I can’t breathe,” Mr Floyd said in a tragically familiar refrain before his death. Two autopsies ruled his killing a homicide. Mr Floyd’s death, along with the recent extrajudicial killings of Ahmaud Arbery and Breonna Taylor, have catalyzed a rallying cry for justice. From policing to business to academia, the United States faces an overdue reckoning with the trauma of racism—a reckoning to which rehabilitation medicine is not immune.

      List of abbreviations:

      COVID-19 (coronavirus disease 2019)
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      References

        • Pinheiro P.S.
        • Medina H.
        • Callahan K.E.
        • et al.
        Cancer mortality among US blacks: variability between African Americans, Afro-Caribbeans, and Africans.
        Cancer Epidemiol. 2020; 66: 101709
        • Ferdinand D.P.
        • Nedunchezhian S.
        • Ferdinand K.C.
        Hypertension in African Americans: advances in community outreach and public health approaches.
        Prog Cardiovasc Dis. 2020; 63: 40-45
        • Centers for Disease Control and Prevention
        COVID-19 in Racial and Ethnic Minority.
        (Available at:)
        • Ocampo-Piraquive V.
        • Nieto-Aristizábal I.
        • Cañas C.A.
        • Tobón G.J.
        Mortality in systemic lupus erythematosus: causes, predictors and interventions.
        Expert Rev Clin Immunol. 2018; 14: 1043-1053
        • Selvaraj S.
        • Shah S.J.
        • Ommerborn M.J.
        • et al.
        Pulmonary hypertension is associated with a higher risk of heart failure hospitalization and mortality in patients with chronic kidney disease: the Jackson Heart Study.
        Circ Heart Fail. 2017; 10e003940
        • Meagher A.D.
        • Beadles C.A.
        • Doorey J.
        • Charles A.G.
        Racial and ethnic disparities in discharge to rehabilitation following traumatic brain injury.
        J Neurosurg. 2015; 122: 595-601
        • Manuel J.I.
        Racial/ethnic and gender disparities in health care use and access.
        Health Serv Res. 2018; 53: 1407-29
        • Chae D.H.
        • Martz C.D.
        • Fuller-Rowell T.E.
        • et al.
        racial discrimination, disease activity, and organ damage: the Black Women's Experiences Living With Lupus (BeWELL) Study.
        Am J Epidemiol. 2019; 188: 1434-43
        • The Dartmouth Institute for Health Policy & Clinical Research
        Variation in the care of surgical conditions: diabetes and peripheral arterial disease: a Dartmouth Atlas of Health Care Series.
        (Available at:)
        • Dinca-Panaitescu M.
        • Dinca-Panaitescu S.
        • Raphael D.
        • Bryant T.
        • Pilkington B.
        • Daiski I.
        The dynamics of the relationship between diabetes incidence and low income: longitudinal results from Canada's National Population Health Survey.
        Maturitas. 2012; 72: 229-235
        • Stevens C.D.
        • Schriger D.L.
        • Raffetto B.
        • Davis A.C.
        • Zingmond D.
        • Roby D.H.
        Geographic clustering of diabetic lower-extremity amputations in low-income regions of California.
        Health Aff (Millwood). 2014; 33: 1383-1390
      1. Presser L. The Black American amputation epidemic. Available at: https://features.propublica.org/diabetes-amputations/black-american-amputation-epidemic/, Accessed August 3, 2020.

      2. Godoy M. Black Medicare patients with COVID-19 nearly 4 times as likely to end up in hospital. Available at: https://www.npr.org/sections/health-shots/2020/06/22/881886733/black-medicare-patients-with-covid-19-nearly-4-times-as-likely-to-end-up-in-hosp. Accessed August 3, 2020.

        • Ford T.
        • Reber S.
        • Reeves R.V.
        Race gaps in COVID-19 deaths are bigger than they appear.
        (Available at:)
        • Cogburn C.D.
        Culture, race, and health: implications for racial inequities and population health.
        Milbank Q. 2019; 97: 736-61
        • Machtinger E.L.
        • Cuca Y.P.
        • Khanna N.
        • Rose C.D.
        • Kimberg L.S.
        From treatment to healing: the promise of trauma-informed primary care.
        Womens Health Issues. 2015; 25: 193-197
        • Gerber M.R.
        • Gerber E.B.
        An introduction to trauma and health.
        in: Gerber M. Trauma-informed healthcare approaches. Springer, Cham2019
        • Metzl J.M.
        • Hansen H.
        Structural competency: theorizing a new medical engagement with stigma and inequality.
        Soc Sci Med. 2014; 103: 126-133
      3. US Department of Health and Human Services, Health Resources and Services Administration, Bureau of Health Workforce, National Center for Health Workforce Analysis. Sex, race, and ethnic diversity of U.S. health occupations (2011-2015).
        (Available at:) (Accessed August 3, 2020)
        • KFF
        Population distribution by race/ethnicity.
        (Available at:) (Accessed August 3, 2020)
        • Cohen J.J.
        • Gabriel B.A.
        • Terrell C.
        The case for diversity in the health care workforce.
        Health Aff (Millwood). 2002; 21: 90-102
        • Barnhill J.
        • Fisher J.W.
        • Kimel-Scott K.
        • Weil A.
        Trauma-informed care: helping the healthcare team thrive.
        in: Gerber M. Trauma-informed healthcare approaches. Springer, Cham2019
        • Hardeman R.R.
        • Medina E.M.
        • Boyd R.W.
        Stolen breaths.
        N Engl J Med. 2020; 383: 197-199