1) Individual physicians contribute to health and healthcare disparities through incorporating their biases into their practice. I have personally seen (and reported) many instances of physician discrimination against patients of protected categories, worsening their health, and physician comments contributing to an unsafe learning environment via racist/homophobic/sexist jokes that further teach physician trainees that this behavior is tolerated in medicine, propagating those biases and practices for future physicians. I have a hard time justifying increased research in this area, when we already have substantial knowledge that this is a dangerous and pervasive problem, with easy and straightforward solutions. In my long and frustrating time navigating the reporting process, I have found most administrators extremely hesitant to confront and prevent this behavior in any meaningful way. I have discovered that most physicians will go to great lengths to protect other physicians, at the cost of patient care, and that this toxic loyalty prevents any substantive change in decreasing or eliminating physicians exerting discriminating control over their patient's bodies.
2) Neoliberalism as a macroeconomic force was largely responsible for the extreme privatization of American healthcare, leading to mass wealth inequality and healthcare access dependent on income and further stratifying health by class and race. In the Bay Area, we have seen gentrification ravage low income communities and communities of color, causing mass displacement and having far reaching impacts on public health. From community clinics shutting down, to elderly people being evicted, to new white neighbors calling police leading to homeless folks having their medication stolen, it is difficult to completely capture the scope of the health impacts of gentrification. Related to my response to the first prompt, the social construction of physician power as a structural force has contributed to health disparities. The impunity with which physicians operate, coupled with the immense power and privilege the wield contributes to health disparities through selective direct service provision. Finally, structural racism has immense influence on who has access to what type of care and how that care is delivered, causing or exacerbating health disparities along racial lines. All of these are relevant to my current research, particularly my work around the health impacts of gentrification, which I explicitly study. Although some of the other structural factors are more difficult to quantify, their consideration and incorporation in my research is something I try to do with most projects I am involved in.