JMIR Publications

ABSTRACT

Recent mass shootings and increasing firearm injuries have resulted in collective trauma, especially among racial, ethnic, and cultural minorities. The result is deepening racism, widening social antagonism, and panic production. Fear of discriminations against various social characteristics (eg. encompassing gender, race, socioeconomic status, and education) in health care affects physician preference, patient satisfaction, and medical compliance. A survey covering 29 medical specialties found that dermatology has one of the biggest gaps in specialist visits between Black respondents and White respondents. This highlighted the inherited role of skin color in racial categorization. We hypothesized that mass shootings and resultant social insecurity may raise the demand for racial concordance dermatologic care. We retrieved daily mass shooting data from Gun Violence Archive. Weekly Google search history for ‘Black dermatologist’ and ‘White dermatologist’ in the United States (US) during 2018/05/06 and 2022/06/12 was obtained from Google Trends. There were 9,744 and 1,373 entries for Black and White dermatologist; and 10,185 casualties (8,209 injuries, 1,976 death) in 876 mass shooting events. Searches for Black dermatologist fluctuated throughout the time, while that for White dermatologist had less variations. Numbers of mass shooting event and casualties were moderately associated with Black dermatologist searches but not with White dermatologist searches. The highest correlation appeared between the date of mass shooting and searches during the week but not before or after. Furthermore, there was a moderate geographic correlation between the total number of mass shooting events and Google search per capita (p = 0.0038). Our results indicated that race-based medical distrusts may be more pronounced in the Black population following mass shooting events. Higher firearm-associated death and injuries were consistently reported in Black people across the US. Skin color as the first visual cue for human classification therefore subjects dermatologic practice to the impact of racial segregation during social unrest. With the rocketing gun violence epidemic and relatively staggering racial representation in dermatology, the gap between demand and supply for racial concordant care is likely to widen, hampering the delivery of dermatological care to racial minorities even further. Given that physicians play an important role in mitigating the social determinant of health, physician diversity, especially in dermatology, is encouraged to not only improve the quality of care, but also to facilitate access to care in underrepresented minorities.