To our colleagues, our patients, and our community at large:

As healthcare professionals and human beings who desire a better future for our country, we are shaken to our core and devastated by the heinous acts of racist violence that have plagued our country. Our hearts are broken. The recent deaths of Ahmaud Arbery, Breonna Taylor and George Floyd, and the potentially deadly targeting of Christian Cooper by a white woman in Central Park, in the aftermath of countless other senseless murders of African Americans, all upon the backdrop of the severely disproportionate impact of COVID19 on Black Americans, collectively demonstrate that 400+ years of racial injustice are still very much present today.

Structural racism is imbedded into every corner of every system and institution in our society and it has caused massive healthcare inequity that manifests as disparities in health outcomes. In addition, deeply rooted systemic racism has led to intergenerational trauma and pain that has been passed down decade after decade, which has further increased the stark healthcare disparities present in our African American communities. Racism is killing Black Americans, and often, this extends to other minority populations as well, including our Latinx and Indigenous populations. This must stop and nothing less is acceptable.

As healthcare professionals, the health and safety of human life is in our hands. We took an oath to safeguard the wellbeing of the public, and we strive to accomplish this through our missions of patient care, education, research and community outreach. Rejecting hatred, bigotry, discrimination and violence must be an integral part of these missions. In fact, it should serve as the foundation of all that we do.

As healthcare professionals, we clearly recognize the public health crisis of structural and systemic racism. Black, Indigenous, and other communities of color suffer from poorer health outcomes, ranging from hypertension, diabetes, cardiovascular disease, obesity, mental health, and so many countless other conditions. We have seen this most recently manifest in the drastically higher rates of COVID19 infection and mortality. There are mountains of data that reveal stark racial and ethnic health and healthcare disparities, and we have seen this replicated in COVID19 statistics, even despite under and non-reporting by many communities.

Our systems and institutions are only as effective for the collective population as they are for our most marginalized. Nowhere is this seen more starkly than in healthcare. COVID taught us that we are not safe as a nation unless we actively take care of and protect all our people. For a more equitable and just future, we must acknowledge our past and intentionally and collaboratively work to change the present.

We will not tolerate racism or discrimination of any kind, whether it be racial, ethnic, gender, based on sexual orientation, physical ability, religion, or socioeconomic status. Every one of these acts is a determinant and driver of health and our nation will continue to suffer from poor healthcare outcomes if we do not act now to change this centuries long trajectory.

Public commentary has recently stated that doctors should “stay in their lane.” Anything that affects the health of the public is not only within our lane but is precisely what we took an oath to fight for and protect. It is not enough to just be outraged; anger without action is not productive.

However, the burden of dismantling racism and its deleterious effects on society must not fall on the shoulders of our Black communities. They did not create this trauma, and they alone cannot fix this trauma. We must not ask them to be on the frontlines of the war that is being waged on them. It is beyond time that the onus of anti-racism and equity work fall on the majority population, but is guided and informed by BIPOC (Black, Indigenous, people of color). Equity work that is not guided and informed by the victims of inequity will fail to achieve its intended purpose.

It is time to listen, learn, study and then act. It is time for the medical profession, including all doctors, providers, learners, staff and administrative leaders -- individually and collectively -- to do the hard work to become part of the solution. It is time to collaborate, build alliances, work with our community and stand up, speak out and reject racism, bigotry, hatred and violence, and demand justice and equity for all persons. We must use recent events as a catalyst for deep introspection of our organization and make the pledge that we will change and adjust in ways that support our transition to an anti-racist organization.

We reject hate speech in our clinics and hospitals. We reject the ask for a white doctor or refusal to see a physician of color by our patients. We reject the present systems of disparate and inequitable care delivery. We reject the preferential selection of the majority population for our healthcare workforce. And we reject the silence that has thus far permeated loud and clear throughout our healthcare systems. We will not sit by and continue to allow the brutal and repeated murders of African Americans, nor the daily, insidious and pervasive effects of unconscious bias, to continue to corrode away at the sanctity of life of our Black communities. This has been permitted this for far too long and it is inexcusable.

To our Black colleagues, learners and community residents, you do not owe us, or anybody, anything, in this fight. You have endlessly endured the trauma and pain, just to wake up and have it repeated over and over. Your pleas and cries for intervention have been thus far ignored. Your skin color has been weaponized and used against you, and then you have been further dehumanized by being blamed for these outcomes. The incredible and intolerable cruelty of this is breathtaking. There are no words of apology that can suffice. Rather, what society owes you is taking the pain you endure and transform it into action -- action at the streets, action at ballot box, action in our schools, clinics, hospitals and in our own homes. Words without action are empty promises and will continue to perpetuate the mistrust that has been sowed over centuries.

In the words of Reverend Dr. Martin Luther King Jr., “Injustice anywhere is a threat to justice everywhere.” If we desire a nation that truly exemplifies the “unalienable rights” of “life, liberty and the pursuit of happiness,” we owe our pledge to not just reject racism, violence, hatred, bigotry, bias and discrimination in all its forms, but to actively work to dismantle racism, violence, hatred, bigotry, bias and discrimination in all its forms.

We pledge to do this work through listening, learning, unlearning and active allyship.

We pledge to use our privilege and platforms to advance health equity in all its forms, with our patients, trainees, colleagues and the people in our communities.

Our SIU community of physicians, healthcare workers, and educators refuses to go one more day in our work and lives without the assurance that we will individually and collectively use our voices and platforms to proactively demand equity and justice for all people, and particularly for those who have been denied these freedoms since the dawn of our nation.