Structural racism is a public health emergency intersecting squarely with inequitable access to addiction treatment, the overdose epidemic, and the enforcement of racist drug laws and policies. We collectively acknowledge that structural racism disproportionately impacts Black, Indigenous, and people of color (BIPOC) communities, specifically regarding drug use, drug law enforcement, and substance use disorder (SUD) treatment. We are committed to centering racial equity within our work to address these inequities.
Creating Capacity
We brought on racial equity leaders, Kara Toles, M.D., Director of Equity and Inclusion at UC Davis Emergency Medicine, and Charles Hawthorne, M.P.H., to envision and lead our racial equity work. Their work has included chairing the Racial Equity Committee, creating an iterative racial equity curriculum for staff and leadership, conducting an organization-wide assessment and evaluation of racial equity work, and building organizational capacity to integrate racial equity throughout processes and procedures at Bridge.
Racial Equity Committee
Our Racial Equity Committee consists of a diverse, cross-sectional group of staff that are passionate about racial equity. The mission of this committee is to advocate for antiracism and to dismantle structural inequity and discrimination within our organization, substance use disorder treatment, and healthcare.
Ongoing Education and Training
Education and training have been keys to our program’s success in developing and implementing racial equity work. Initially, we worked with external racial equity consultants to establish a basic foundational organizational understanding of racism in the United States. Our program has evolved to engage in ongoing education and training organized and facilitated by our racial equity team leaders.
Review and Re-Structure Processes
We intentionally review procedures and processes through a racial equity lens, including:
- Incorporating racial equity into materials development and review processes
- Developing a recruiting and hiring process that centers on equity and transparency for staff and community partners
- Focusing on sustainability mechanisms that include fair/equitable reimbursement for navigators
- Presenting on racial equity statewide and nationally.
Tools and Resources
Foundational Materials
- Equity and Harm Reduction for Communities of Color focuses on reducing harm related to drug use in communities of color and is a call to action for EDs to provide equitable services.
- Compass Opioid Stewardship Expert Spotlight – Opioids, Health Disparities, and COVID-19 podcast is an interview with Dr. Andrew Herring and Charles Hawthorne, MPH, available on [Spotify] or [Apple Music].
- Racial Disparities in Access to Medication for Addiction Treatment documents racial disparities related to buprenorphine access in California even after significant efforts to expand MAT access.
Learning Library
- First Steps for Advancing Diversity, Equity, and Inclusion in Your Emergency Department details how to create a committee to address diversity, equity, and inclusion at the departmental level.
- Police in the Emergency Department is a toolkit encouraging providers to protect patients by safeguarding their rights, complying with privacy laws, and navigating law enforcement interactions.
- Decriminalization of Personal Use and Possession of Small Quantities of Drugs supports policy change for the personal use of drugs and possession of small quantities of drugs for personal use.
Training
- Stigma and Inequity in OUD Care provides background on the roots and manifestations of inequity in addiction care and suggests approaches to care with an equity lens.
- Engaging Special Populations – Part I Tribal Health features our partners, California Rural Indian Health Board (CRIHB) and California Consortium for Urban Indian Health (CCUIH).
- Engaging Special Populations – Part II Racial Disparities connects issues of racial equity with the navigator role, specifically providing tools for engaging people experiencing homelessness and undocumented workers.
- Equity in SUD treatment and the ER environment: NOPLS Conference features Dr. Kara Toles and Charles Hawthorne, MPH, discussing how and why EDs implement racial equity initiatives.
- Big Ideas in Overdose Prevention: Invest in Health Equity features Charles Hawthorne, MPH, addressing how to operationalize racial equity to improve public health.
Accessible Patient Materials
- Guide to Translated Patient Materials highlights many Bridge patient-facing educational materials in Spanish, Chinese, Vietnamese, and Tagalog.
“At Bridge, we have been intentionally engaged in exploring how racism plays a major role in the health inequities we see in some of the most vulnerable communities we serve. We continue the work of building capacity, within ourselves and our organization, to center racial equity into the vision, policies, procedures, and daily work we do, keeping laser-focused on the goal of ensuring equitable access to substance use treatment in hospitals throughout California. We are excited to partner with hospitals throughout the state in our collective journeys incorporating racial equity into substance use treatment. ”
– Kara Toles, M.D., Director of Equity and Inclusion at UC Davis Emergency Medicine
“Racial equity is a core tenet of both harm reduction and emergency services work. Improving ED-based care for people of color who use drugs helps to close the gap in access to treatment and increases everyone’s opportunities to receive quality healthcare. When we ensure that the most marginalized people can access services that improve their health, we make our whole community healthier.”
– Charles Hawthorne, MPH, Former Equity and Harm Reduction Project Manager
“Loving and accepting all people regardless of race/ethnicity (in other words, ‘I don’t see color’) is great. But recognizing and holding space for each individual’s background, features, culture, and race – how that impacts their life, is really stepping it up toward diversity, equity and inclusion.”
– LaToya Mitchell, Navigator Program Coordinator, and Racial Equity Committee Member