CHICAGO —The American Medical Association (AMA) today released an ambitious strategic plan to dismantle structural racism starting from within the organization, acknowledging that equity work requires recognition of past harms and critical examination of institutional roles upholding these structures.

The framework of the plan—which is central to the work of the AMA Center for Health Equity and the responsibility of AMA leadership, membership, and external stakeholders—is driven by the immense need for equity-centered solutions to confront harms produced by systemic racism and other forms of oppression for Black, Latinx, Indigenous, Asian, and other people of color, as well as people who identify as LGBTQ+ and people with disabilities. The groundwork for the plan began in 2019 when the AMA Center for Health Equity was launched as a result of a resolution passed by the AMA’s House of Delegates. Its urgency is underscored by ongoing circumstances including inequities exacerbated by the COVID-19 pandemic, ongoing police brutality, and hate crimes targeting Asian, Black, and Brown communities.

“This strategic plan represents a step forward in a much longer journey to ground the AMA, health care, and our nation’s health care system around equity with a vision of achieving optimal health for all,” said AMA President-Elect Gerald E. Harmon, M.D. “As leaders in medicine, we commit to accountability toward the goal of eliminating inequities —systemic, preventable, and unjust differences—in the health of our patients. Fulfilling the AMA’s mission of promoting the art and science of medicine and the betterment of public health requires us to use our resources, influence, and power to push toward a more equitable future, which also means reversing the historic harms we caused and forging paths towards truth, reconciliation, racial healing, and transformation.”

The plan outlines five strategic approaches to begin tackling these challenges:

• Embed equity and racial justice throughout the AMA by expanding capacity for understanding and implementing anti-racist equity strategies via practices, programming, policies, and culture.
• Build alliances with marginalized physicians and other stakeholders through developing structures and coalitions to elevate the experiences and ideas of historically marginalized and minoritized health care leaders.
• Push upstream to address all determinants of health and root causes of inequities by strengthening, empowering, and equipping physicians with the knowledge of and tools for dismantling structural and social drivers of health inequities.
• Ensure equitable structures and opportunities in innovation through embedding and advancing racial justice and health equity within existing AMA efforts to advance digital health.
• Foster pathways for truth, racial healing, reconciliation, and transformation for AMA’s past by accounting for how policies and processes excluded, discriminated, and harmed communities, and by amplifying and integrating the narratives of historically marginalized physicians and patients.

“With this blueprint for embedding racial and social justice, we are dedicated to comprehensively analyzing the structures, systems, policies, and practices that have had harmful impacts within our organization and beyond,” said AMA Chief Health Equity Officer Aletha Maybank, M.D., M.P.H. “Achieving equitable solutions requires disruption and dismantling of existing norms and taking collective action. It also requires a sense of urgency and ambition, and the time is now.”

The plan is centered around an overarching, aspirational vision of a nation in which all people live in thriving communities where resources work well; systems are equitable and do not create or exacerbate harm; everyone has the power, conditions, resources, and opportunities to achieve optimal health; and all physicians are equipped with the consciousness, tools, and resources to confront inequities. Several guiding principles have been set to ensure equitable practices in carrying out the plan, and internal performance indicators and evaluation metrics and tools will be used to measure success and impact while maintaining transparency and accountability.

“Embedding equity is an all-hands-on-deck effort that will enable AMA to further our impact on behalf of all people in our country—but especially those who have historically been marginalized. AMA leaders are creating opportunities to embed equity into our ongoing work so that equity serves as an accelerator of everything we do to improve the health of our nation,” said AMA CEO and EVP James L. Madara, M.D.

In 2008, the AMA issued a public apology for its past discriminatory actions against Black physicians as a modest first step toward healing and reconciliation. In 2019, the AMA launched its Center for Health Equity following a Board-approved recommendation from the Health Equity Task Force. The Center remains the anchor for facilitating, strengthening, and amplifying the AMA’s work to eliminate health inequities and their root causes. Through research, collaborations, advocacy, and leadership, the AMA believes in supporting system-level solutions and identifying and addressing root causes of inequities while elevating their importance to patients, communities, and stakeholders. Within the past year, some of these actions include: passing AMA policies that:

• Acknowledge racism as a public health threat
• Rids race as a proxy for biology
• Eliminates racial essentialism in medicine
• Recognizes police brutality as a product of structural racism
• Launching the Medical Justice in Advocacy fellowship to advance equity in medicine
• Removing the name of AMA founder Dr. Nathan Davis from an annual award and display in recognition of his contribution to explicit racist exclusion practices
• Calling on the federal government to collect and release COVID-19 race/ethnicity data
• Investing financially in Chicago’s West Side neighborhoods

To learn more about the AMA’s strategic plan, click here.

To read an AMA Viewpoint authored by Dr. Harmon on this topic, click here.