Jan 13, 2021
Regina James, MD, tells her personal story and discusses how to
understand health equity with guest host Carol A. Bernstein,
James is deputy medical director and chief of the division of
diversity and health equity at the American Psychiatric
Association. She also serves on the advisory board of The PACT
group (Pan African Clinical Trials) and receives no income from the
Bernstein, a past president of the APA, is vice chair for
faculty development and well-being at Montefiore Medical
Center/Albert Einstein College of Medicine, New York. She has no
- The Robert Wood Johnson Foundation defines health equity as:
“Everyone has a fair and just opportunity to be as healthy as
possible. This requires removing obstacles to health such as
poverty, discrimination, and their consequences, including
powerlessness and lack of access to good jobs with fair pay,
quality education and housing, safe environments, and health care.”
Equity embraces the idea of inclusiveness and evaluates a whole
health care system instead of focusing only on individual
marginalized communities. For example, it is essential to
understand the social determinants that lead to groups being
medically underserved and then to understand the impact of the
medically underserved on the entire system.
- Dr. James led a 20-year career in research and leadership
within the National Institutes of Health, including the National
Institute of Mental Health, the National Institute on Minority
Health and Health Disparities, and the Eunice Shriver National
Institute of Child Health and Human Development. She later
transitioned to 2M, a research consulting agency, and then to the
- Within the APA, Dr. James has developed a 5-point strategic
plan with the vision that all APA members will be culturally
competent and sensitive, and able to provide mental health care for
any individual regardless of age, race, gender, or sexual
- The strategic plan focuses on raising awareness about mental
health equity and destigmatization and leveraging the expertise of
the APA membership in their communities. A cornerstone of the plan
is an educational agenda, including materials on health equity in
psychiatry and outreach to APA members and their community
partners. In addition, Dr. James and her office partner with APA
leadership to lobby the government for mental health equity and
- Dr. James describes structural racism as current policies
within an organization that lead to racial inequalities. Separate
from the Office of Diversity and Health Equity, the APA established
Presidential Task Force to Address Structural Racism Throughout
Psychiatry to identify the scope and targets of structural
racism within organized psychiatry, including the APA. It also
seeks to identify how structural racism affects practicing
psychiatrists and their patients.
Braveman P et al. What is health equity?
Robert Wood Johnson Foundation. 2017 May 1.
American Psychiatric Association. Diversity
and health equity.
American Psychiatric Association.
Mental health disparities: Diverse populations.
APA Presidential Task Force to Address Structural Racism
Throughout Psychiatry. https://www.psychiatry.org/psychiatrists/structural-racism-task-force
Rosenkranz KM et al. J Surg Education. 2020.
Simonsen KA and Shim RS.
Psychiatr Clin North Am. 2019 Sep;42(3):463-71.
Alves-Bradford J-M et al.
Psychiatr Clin North Am. 2020 Sep;43(3):415-28.
Aggarwal NK et al.
Patient Educ Couns. 2016 Feb;99(2):198-209.
Show notes by Jacqueline Posada, MD, associate producer of the
Psychcast; assistant clinical professor in the department of
psychiatry and behavioral sciences at George Washington University
in Washington; and staff physician at George Washington Medical
Faculty Associates, also in Washington. Dr. Posada has no conflicts
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