Magazines on wooden table on bright background.

Citational Racism: How Leading Medical Journals Reproduce Segregation in American Medical Knowledge

By Gwendolynne Reid, Cherice Escobar Jones, and Mya Poe

Biases in scholarly citations against scholars of color promote racial inequality, stifle intellectual analysis, and can harm patients and communities.

While the lack of citations to scholars of color in medical journals may be due to carelessness, ignorance, or structural impediments, in some cases it is due to reckless neglect.

Our study demonstrates that the American Medical Association (AMA) has failed to promote greater racial inclusion in its flagship publication, the Journal of the American Medical Association (JAMA), despite an explicit pledge to do so.

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Austin, TX, USA - Oct. 2, 2021: Two women participants at the Women's March rally at the Capitol protest SB 8, Texas' abortion law that effectively bans abortions after six weeks of pregnancy.

Organizing and Activism of Adopted and Displaced People

By Lina Vanegas

I am a transracial and transnational displaced person. I was separated from my country, language, and culture and taken to Michigan, which has no connection to me or my ancestors. I was taken there to create a family for strangers who had the privilege and resources to buy me. I had family in Colombia and I was far from being a true orphan. I was bought in Bogota, Colombia and sold to a white couple living in the Midwest in 1976. 

I use the word “displaced” intentionally, because the word “adopted” does not define my lived experience in an accurate way. The word “adopted” is language that was created by the child welfare-industrial complex, also known as the adoption industry. I do not subscribe to any of the constraints or barriers that they attempt to put onto my life with their language choices. Using the word “displaced” defines the intentional separation from my family by the child welfare-industrial complex. 

My lived experience has informed who I am and has inspired and motivated the work that I do online and in the world. It is very rare that adopted and displaced people’s lived experiences are seen, heard, validated, centered, and believed, so my mission is to do that online, on my podcast, Rescripting The Narrative, and in the work that I do as a social worker and with the organization Adoptees for Choice.

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Empty hospital bed.

Native Reproductive Justice: Practices and Policies from Relinquishment to Family Preservation

By Lauren van Schilfgaarde

Adoption can be, and frequently is, a celebrated extension of kinship ties within Native communities. But we cannot ignore the historical context of adoption as a tool to empty tribal communities and delete tribal cultures. Nor can we ignore the historical context of the simultaneous deprivation and weaponization of reproductive health care, both of which deny Native women reproductive self-determination. 

It is these contexts in which anti-abortion proponents seek to ameliorate the further denial of health care through increased adoption. The proposal is eerily familiar. 

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Judge's gavel, handcuffs and scales on grey background, flat lay with space for text. Criminal law concept.

The Reproductive Violence of Family Policing & Separation

By Dorothy E. Roberts

In the Dobbs v. Jackson Women’s Health Organization oral arguments, Justice Amy Coney Barrett presented parental relinquishment as an alternative to abortion access. In the leaked Supreme Court opinion in Dobbs, which overturned Roe v. Wade, Justice Alito referred to this idea approvingly.

We asked Professor Dorothy E. Roberts, George A. Weiss University Professor of Law and Sociology and the Raymond Pace and Sadie Tanner Mossell Alexander Professor of Civil Rights at the University of Pennsylvania, to highlight some of the problems with that claim. 

Drawing on her recently published book, Torn Apart: How the Child Welfare System Destroys Black Families – and How Abolition Can Build a Safer World (Basic Books, 2022), Roberts explains in the conversation below how the child welfare system uses family separation (or the threat thereof) as a means of policing Black families (as well as Native families, other non-white families, and poor families). This, she adds, is a result of the state’s failure to invest in families in fundamental ways, and is a clear manifestation of reproductive violence.

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Abortion rights protest following the Supreme Court decision for Whole Women's Health in 2016

The Danger of Forced Pregnancy

By Laura Briggs

When Amy Coney Barrett suggested that adoption and safe-haven laws were an adequate substitute for abortion care for people who did not want to be pregnant, she was essentially insisting that they do a kind of high-risk, uncompensated labor to produce a baby or child for adoptive families like hers. 

Like the anti-abortion movement that supported her nomination for the Supreme Court, Coney Barrett is not shy about acknowledging that she is in favor of forced pregnancy, and that this labor — in both senses of the term — could benefit other people who were childless or had fewer children than they wanted. 

We know this work has value; people who hire women in the United States to carry a surrogate pregnancy pay them $30,000 to $50,000. Denying abortion to women who want them, and then expecting them to relinquish the resulting baby for adoption, is asking them to do that same labor for free.

As Black feminist legal scholar Pamela Bridgewater has pointed out, there is a word for forcing people to do unpaid reproductive labor on behalf of others: enslavement. In fact, as she argues, forced pregnancy was key to the historic labor system of slavery in the United States — the children of enslaved mothers were themselves enslaved, and once the importation of African people for purposes of enslavement was banned in the United States in 1808, it was how slavers kept the system going and increased their own wealth, including by raping enslaved women. Slavery was outlawed in the United States with the passage of the Thirteenth Amendment, but Coney Barrett apparently means to reinstitute a version of it. 

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Washington, DC, USA, May 5, 2022: people protest the leaked draft Supreme Court opinion overturning Roe v. Wade and the right to abortion

Adoption, Family Separation & Preservation, and Reproductive Justice

By Gretchen Sisson

When a draft of the Supreme Court decision in Dobbs v. Jackson Women’s Health was leaked last week, its content was a jarring shock for many. Over a few days, the surprise of the leak and the appall at the decision narrowed into specifics, and more people noticed what might have been missed in first reading: in a footnote, a passing citation from a fourteen-year-old report from the Centers for Disease Control that read, “the domestic supply of infants relinquished at birth… had become virtually nonexistent.” 

In coverage, this note sparked rage anew at the connection between abortion bans and increasing the supply of adoptable infants being made overt. Yet, much like those of us who study abortion in this country were not surprised by the draft of the decision, those of us who study adoption were even less surprised by this note. In the Dobbs oral arguments, Justice Amy Coney Barrett told us this was about adoption – and pre-Roe history has shown us how closely adoption and abortion are linked rhetorically, if not actually in people’s pregnancy decision-making. Yes, the Dobbs decision will also be about constraining people’s choices and controlling their lives and futures to conform to fundamentally regressive ideas about family, gender, and race. But then again: most often, so is adoption.

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Child's hands planting small plant in garden.

Why Do Municipal Governments Impede Local Efforts at Health?

By Bailey Kennedy

As spring continues to bubble into life (even in Massachusetts), people across the country are planting gardens in anticipation of a fall harvest. A few of these happy people will probably be harvesting something else along with their vegetables: a hefty fine from their municipal government.

Many state and municipal governments have adopted regulations and ordinances which, while well-intentioned, may discourage people from starting at home gardens — or even force people to abandon their gardening project after it is already in the ground. That’s a problem with implications for health at a hyperlocal scale.

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Waiting area in a doctor's office

Churntables: A Look at the Record on Medicaid Redetermination Plans

By Cathy Zhang

The COVID-19 Public Health Emergency (PHE) expires at the end of this week, with Department of Health and Human Services (HHS) Secretary Xavier Becerra expected to renew the PHE once more to extend through mid-July.

When the PHE ultimately expires, this will also trigger the end of the Medicaid continuous enrollment requirement, under which states must provide continuous Medicaid coverage for enrollees through the end of the last month of the PHE in order to receive enhanced federal funding. This policy improves coverage and helps reduce churn, which is associated with poor health outcomes.

After the PHE, states can facilitate smooth transitions for those no longer eligible for Medicaid by taking advantage of the full 12- to 14- month period that the Centers for Medicare & Medicaid Services (CMS) has established for redetermining eligibility.

In August 2021, CMS released guidance giving states up to 12 months following the end of the PHE to redetermine whether Medicaid enrollees were still eligible and renew coverage. Last month, CMS released new guidance specifying that states must initiate redeterminations and renewals within 12 months of the PHE ending, but have up to 14 months to complete them. The agency is encouraging states to spread its renewals over the course of the full 12-month unwinding period, processing no more than 1/9th of their caseloads in a month, in order to reduce the risk of inappropriate terminations.

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Emergency room.

Hospitals in Poor Rural Counties Face the Greatest Financial Threat from COVID

By Robert I. Field and Anthony W. Orlando

The latest wave of COVID cases and hospitalizations has raised concerns about the financial resilience of many hospitals in the United States. Throughout the pandemic, we have witnessed shortages of medical supplies, exhaustion of frontline workers, and the overflow of patients beyond the physical capacity of hospital beds and buildings. Now, after nearly two years of repeated COVID surges, there is a real danger that some institutions might run so low on funding that they will need to downsize or close altogether.

Large hospitals in metropolitan areas have, for the most part, weathered the storm. Ample financial resources enabled them to survive with fewer lucrative elective procedures and sudden overwhelming demand for less profitable intensive care for COVID patients. But in many parts of the country, especially rural regions, smaller hospitals lack such financial cushions. For them, COVID could be an existential threat.

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GHRP affiliated researchers.

Introducing the Global Health and Rights Project’s New Affiliated Researchers

(Clockwise from top left: Alma Beltrán y Puga, Luciano Bottini Filho, Ana Lorena Ruano, María Natalia Echegoyemberry)

By Alicia Ely Yamin and Chloe Reichel

Leer en español.

In the years before the pandemic, and especially since the pandemic began, there have been increasing calls to decolonize global health. Setting aside what Ṣẹ̀yẹ Abímbọ́lá rightly characterizes as the slipperiness of both the terms “decolonizing” and “global health,” these calls speak to the need to reimagine governance structures, knowledge discourses, and legal frameworks — from intellectual property to international financial regulation.

Global health law itself, anchored in the International Health Regulations (2005), purports to present a universal perspective, but arguably rigidifies colonialist assumptions about the sources of disease, national security imperatives, priorities in monitoring “emergencies,” and governance at a distance. The diverse tapestry of international human rights scholarship related to health is often not reflected in analyses of the field from the economic North. In turn, that narrow vision of human rights has also increasingly faced critiques from TWAIL, Law & Political Economy, and other scholars, for blinkered analyses that fail to challenge the structural violence in our global institutional order — which the pandemic both laid bare and exacerbated.

In an attempt to enlarge discussion of these important topics and amplify diverse voices, the Petrie-Flom Center is welcoming four new affiliated researchers to the Global Health and Rights Project (GHRP).

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