AMA Prioritizing Equity

American Medical Association

Prioritizing Equity illuminates how determinants of health uniquely impact marginalized communities, public health and health equity, with an eye on both short-term and long-term implications. Prioritizing Equity is produced by The AMA Center for Health Equity and hosted by AMA Chief Health Equity Officer & Senior Vice President, Aletha Maybank, MD, MPH. Listeners can earn CME while gaining valuable lessons in racial justice and health equity from leading voices in medicine and health care. read less

Our Editor's Take

AMA Prioritizing Equity is a podcast from the American Medical Association (AMA). The AMA Center for Health Equity produces the show, and Aletha Maybank hosts it. Maybank is a physician and AMA Chief Health Equity Officer & Senior Vice President. The show's main goal is to determine how health impacts communities-in particular, marginalized groups.

Being run by the AMA, this podcast holds many of the same missions and values as the organization. It promotes the betterment of medicine and public health. Running a podcast is another way they achieve this. It came about after the AMA noticed health inequities among various populations. And so the association turned its efforts toward short- and long-term solutions. That's how AMA Prioritizing Equity began. And this is what the podcast spotlights-the impacts, and how to resolve them.

AMA Prioritizing Equity is a diplomatic and straightforward recount of facts. There is little room for opinion, as the show uses data and analytics in each case. It analyzes prominent and impertinent issues in the health care system. For example, it talks about reproductive health care as a human right. Justice in education is a subject here. Other topics have also included race-based medicine, LGBTQ voices, and police brutality. It provides a voice for those who may not have one.

The topics are delicate and require respectful handling and care. Host Maybank is excellent at doing so. She addresses issues with the utmost sensitivity. Likewise, the qualified panelists who join are well-respected professionals. Often with a lengthy list of acronyms by their names, each is an expert in the field they speak on. Previous guests have included Dr. Torian Easterling and Dr. James L. Madara. Plus, for listeners who would like to find out more, a list of resources is in the show notes too.

AMA Prioritizing Equity illuminates the effect of health on various American communities. It touches on relevant topics of concern, hoping to explain and understand areas that have-until now-remained untouched.

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Examining Physician Gender Inequity in Medicine

Examining Physician Gender Inequity in Medicine

This edition of the Prioritizing Equity series follows recent policy adopted at the AMA’s House of Delegates meeting in June 2022 as panelists will discuss gender equity in medicine and how COVID-19 has exacerbated experiences for people identifying as women. The episode will also explore both historical and present inequities in medical education, employment, and leadership opportunities. Panelists Dr. Tania Jenkins is an assistant professor in the department of sociology at the University of North Caroli both historical and present inequities in medical education, employment, and leadership opportunities. na-Chapel Hill and a faculty research fellow at UNC's Cecil G. Sheps Center for Health Services Research. Twitter: @TaniaMJenkins Jasmine Brown is a 4th year medical student at the University of Pennsylvania, a Rhodes Scholar and the author of TWICE AS HARD: The Stories of Black Women Who Fought to Become Physicians from the Civil War to the 21st Century. Dr. Deena Shin McRae, MD, is the Associate Vice President of Academic Health Sciences for University of California and serves as a faculty member in the Department of Psychiatry at UC Irvine School of Medicine Moderator Aletha Maybank, MD, MPH, Chief Health Equity Officer, Senior Vice President, Center for Health Equity, American Medical Association - Twitter: @DrAlethaMaybank

Episodes

Examining Physician Gender Inequity in Medicine

Examining Physician Gender Inequity in Medicine

This edition of the Prioritizing Equity series follows recent policy adopted at the AMA’s House of Delegates meeting in June 2022 as panelists will discuss gender equity in medicine and how COVID-19 has exacerbated experiences for people identifying as women. The episode will also explore both historical and present inequities in medical education, employment, and leadership opportunities. Panelists Dr. Tania Jenkins is an assistant professor in the department of sociology at the University of North Caroli both historical and present inequities in medical education, employment, and leadership opportunities. na-Chapel Hill and a faculty research fellow at UNC's Cecil G. Sheps Center for Health Services Research. Twitter: @TaniaMJenkins Jasmine Brown is a 4th year medical student at the University of Pennsylvania, a Rhodes Scholar and the author of TWICE AS HARD: The Stories of Black Women Who Fought to Become Physicians from the Civil War to the 21st Century. Dr. Deena Shin McRae, MD, is the Associate Vice President of Academic Health Sciences for University of California and serves as a faculty member in the Department of Psychiatry at UC Irvine School of Medicine Moderator Aletha Maybank, MD, MPH, Chief Health Equity Officer, Senior Vice President, Center for Health Equity, American Medical Association - Twitter: @DrAlethaMaybank

The SCOTUS Affirmative Action Ruling: The Cost to the Physician workforce and Historically Minoritized Communities

The SCOTUS Affirmative Action Ruling: The Cost to the Physician workforce and Historically Minoritized Communities

This week's episode of Prioritizing Equity will discuss how the recent affirmative action ruling undermines policy dedicated to increasing physician diversity, which is vital to the healthcare ecosystem and will have negative implications towards increasing medical career opportunities for marginalized and minoritized people as well as for patients and communities. Panelists Jessica Faiz, MD, MSHPM, Assistant Clinical Professor of Emergency Medicine at UCLA, Core Investigator with the VA Center for the Study of Healthcare, Innovation, Implementation, and Policy @im_jesssayinn Merlin Chowkwanyun, PhD, MPH, Assistant Professor for Sociomedical Sciences at Columbia University, @merlinc2  David Henderson, MD, VP Equity, Diversity and Belonging in Medical Education American Medical Association Moderator Fernando De Maio, PhD, Vice President of Health Equity Data and Research, American Medical Association, Center for Health Equity and Professor of Sociology, DePaul University - Twitter: @fernandodemaio

Anchor Strategy — A Place-Based Approach for Health Equity

Anchor Strategy — A Place-Based Approach for Health Equity

This week's edition of the Prioritizing Equity series, we explore the Anchor Strategy — a place-based approach to building community health and wealth by means of local hiring, investing, purchasing, and community engagement via the West Side United case study and model. Panelists Ayesha Jaco, Executive Director, West Side United – Twitter: @WSUnitedChiAdam Alonso, Chief Executive Officer of BUILD ChicagoDavid Ansell, MD, MPH, SVP, Community Health Equity Rush University Medical Center Moderator Diana Derige, DrPH, Vice President, Health Equity Strategy, American Medical Association, Center for Health Equity - Twitter: @double_DRPH Subscribe to the Prioritizing Equity podcast: https://www.ama-assn.org/about/publications-newsletters/ama-podcasts#ama-prioritizing-equity

Health Care Planning and Caring for Patients Experiencing Houselessness

Health Care Planning and Caring for Patients Experiencing Houselessness

In this edition of the Prioritizing Equity series, we explore the unique health care and social needs of patients experiencing houselessness and discuss the importance of equitable, holistic, cost effective, evidence-based discharge planning. Panelists Margot Kushel, MD, Professor of Medicine and Division Chief at the Division of Vulnerable Populations at Zuckerberg San Francisco General Hospital and Trauma Center – Twitter: @MKushel Stephen Brown, MSW, LCSW, Director of Preventive Emergency Medicine at the University of Illinois Hospital and Health Sciences SystemDenise De Las Nueces, MD, MPH, Chief Medical Officer at Boston Health Care for the Homeless Program Yinan Lan, MD, Homeless Health Medical Director, NYC Health + Hospitals Dez Martinez, Founder of We Are Not Invisible and member of the BHHI Lived Expertise Advisory Board: @weinvisible Moderator Emily Cleveland Manchanda, MD, MPH, Director of Social Justice Education and Implementation, Center for Health Equity, American Medical Association - Twitter: @EClevelandMD Subscribe to the Prioritizing Equity podcast: https://www.ama-assn.org/about/publications-newsletters/ama-podcasts#ama-prioritizing-equity Learn more: https://edhub.ama-assn.org/ama-center-health-equity The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

Embracing Public Safety and Health for Improved Firearm Violence Prevention

Embracing Public Safety and Health for Improved Firearm Violence Prevention

Firearm violence is a public health crisis. In this week's Prioritizing Equity panel, we explore the work of physicians in health systems and beyond in the realms of public health, public safety, and firearm violence prevention. Panel: Megan Ranney, MD, MPH, FACEP, Incoming Dean of Yale School of Public Health – Twitter: @meganranney Eric Reinhart, MD, PGY2 psychiatry resident at Northwestern University – Twitter: @_Eric_Reinhart Joseph V. Sakran, MD, MPH, MPA, FACS is the Vice Chair of Clinical Operations, Surgery at Johns Hopkins Medicine – Twitter: @JosephSakran Dr. Brian Williams, MD, Trauma & Acute Care Surgeon in Dallas, TX – Twitter: @BHWilliamsMD Moderator: Aletha Maybank, MD, MPH, Chief Health Equity Officer, Senior Vice President, Center for Health Equity, American Medical Association - Twitter: @DrAlethaMaybank Subscribe to the Prioritizing Equity podcast: https://www.ama-assn.org/about/publications-newsletters/ama-podcasts#ama-prioritizing-equity Learn more: https://edhub.ama-assn.org/ama-center-health-equity The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

Advocating for Change in Native Health Policy: For Us, By Us

Advocating for Change in Native Health Policy: For Us, By Us

In this edition of our Prioritizing Equity series, join medical student organizers and policy advocates as they discuss increasing access to care in native communities and improving care within the Indian Health Services through health policy. Panel: Tamee Livermont [Tam/Me - Liv/er/Mont], MPH, Oglala Lakota Medical Student, UMN Medical SchoolAlec Calac [Al/Ek- Cal/Ek], MD/PHD Candidate, UC San Diego, Association of Native American Medical StudentsAshton Glover-Gatewood [Ash/ton-Glow/Ver-Gatewood], MPH, OMS-3, Oklahoma State University College of Osteopathic Medicine at Cherokee Nation Moderator: Aletha Maybank, MD, MPH, Chief Health Equity Officer, Senior Vice President, Center for Health Equity, American Medical Association - Twitter: @DrAlethaMaybank Subscribe to the Prioritizing Equity podcast: https://www.ama-assn.org/about/publications-newsletters/ama-podcasts#ama-prioritizing-equity Learn more: https://edhub.ama-assn.org/ama-center-health-equity The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

Advancing Equity Through Quality and Safety Peer Network

Advancing Equity Through Quality and Safety Peer Network

Learn more about the AMA Peer Network: https://ama-assn.org/peer-network In this week's edition of our Prioritizing Equity series, Karthik Sivashanker, MD, MPH, Vice President at the AMA Center for Health Equity speaks with participants from the Peer Network for Advancing Equity through Quality and Safety program on their strategies to start operationalizing equity into their quality and safety operations. Panel: Aderonke Akingbola, MD, MMM, AGAF, CPE Vice President, Medical Affairs, Ochsner Health Judy C. Washington, MD, Associate Chief Medical Officer, Atlantic Medical Group Moderator: Karthik Sivashanker, MD, MPH, Vice President, Equitable Health Systems, AMA Center for Health Equity Topics discussed in this episode: IntroductionIntroduction of the panelistsEquity at the intersection of health care quality and safetyAddressing inequities through quality and safety reportingPeer Network frameworkHarm event reportingCreating psychological safe spacesBuilding teams to improve safety and equityThe challenges of transforming the health care systemHarm event case studiesSuccessful outcomes from this workLessons for health systems from the Peer Network Subscribe to the Prioritizing Equity podcast: https://www.ama-assn.org/about/publications-newsletters/ama-podcasts#ama-prioritizing-equity Learn more: https://edhub.ama-assn.org/ama-center-health-equity The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

Reproductive Health Care as a Human Right

Reproductive Health Care as a Human Right

Reproductive health care is a human right. Learn how this connects to health equity and explore the impacts of the overturn of Roe v. Wade with a panel of experts. Panel: Lawrence Gostin, JD—Professor, Global Health Law at Georgetown University and Director, WHO Center on Global Health LawJamila Perritt, MD, MPH—President and CEO, Physicians for Reproductive HealthKrishna Upadhya, MD, MPH—Vice President, Quality Care and Health Equity, Planned Parenthood Federation of America Moderator: Aletha Maybank, MD, MPH—chief health equity officer, senior vice president, Center for Health Equity, American Medical Association Topics discussed in this episode: Introduction Introduction of the panelists Policing and criminalization of reproductive health care Abortion access and inequities in health care The end of Roe v Wade and a new legal frontier for abortion rights The impact of the overturning of Roe and access to abortions Substandard medical care being mandated by states How the legal system can provide rights & access to health services Abortion, reproductive justice, & human rights Finding hope in health care justice work The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

The Myth of Meritocracy in Medicine and Health Care

The Myth of Meritocracy in Medicine and Health Care

Earn CME credit for listening to this episode of Prioritizing Equity. Explore the myth of meritocracy, its presence in health care and how physicians can push past it to advance health equity. Daniel Markovits, JD, Melody S. Goodman, PhD, Tomás Diaz, MD and moderator Fernando De Maio, PhD discuss in this Prioritizing Equity panel. Panel: Daniel Markovits, JD—Guido Calabresi Professor of Law and Founding Director, Center for the Study of Private Law, Yale Law SchoolMelody S. Goodman, PhD—Associate Dean for Research/Associate Professor of Biostatistics, New York University School of Global Public HealthTomás Diaz, MD—Assistant Professor of Emergency Medicine and Medical Educator at Columbia University Medical Center Moderator: Fernando De Maio, PhD—Director, Health Equity Research and Data Use, Center for Health Equity, American Medical Association Resources: The Meritocracy Trap (book): https://www.themeritocracytrap.com/Advancing Health Equity: A Guide to Language, Narrative and Concepts: https://www.ama-assn.org/system/files/ama-aamc-equity-guide.pdfEducation from AMA Center for Health Equity: https://edhub.ama-assn.org/ama-center-health-equityThe AMA’s Organizational Strategic Plan to Embed Racial Justice and Advance Health Equity: https://www.ama-assn.org/system/files/2021-05/ama-equity-strategic-plan.pdf Originally aired: March 14th, 2021 The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

Narratives and Language

Narratives and Language

Earn CME credit for listening to this episode of Prioritizing Equity. This week's edition of our Prioritizing Equity series focuses on the power of narratives and language in health care. It explores how dominant narratives perpetuate harm, and offers examples of how these narratives can be challenged and disrupted, moving towards equity-focused and person-first alternatives. Read the guide: https://www.ama-assn.org/system/files/ama-aamc-equity-guide.pdf Panel: Philip M. Alberti, PhD—Founding Director, AAMC Center for Health Justice and Senior Director, Health Equity Research and Policy at Association of American Medical CollegesDavid A. Ansell, MD, MPH—Senior Vice President and Associate Provost, Community Health Equity, Rush University Medical CenterRenee Canady, PhD, MPA—Chief Executive Officer of MI Public Health InstituteMalika Fair, MD, MPH, FACEP—Senior Director, Equity and Social Accountability, Association of American Medical Colleges (AAMC); Assistant Clinical Professor, Emergency Medicine at The George Washington University School of Medicine and Health Services Moderator: Fernando De Maio, PhD—Director, Health Equity Research and Data Use, Center for Health Equity, American Medical Association Originally aired: February 14th, 2022 The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

Redistributive Justice

Redistributive Justice

The January 24, 2022 edition of the AMA's Prioritizing Equity series focuses on redistributive justice and its impact on the health of patients and communities that have been socially and economically marginalized and minoritized. Panel: Ivelyse Andino—Founder and CEO of Radical HealthWilliam A. (“Sandy”) Darity Jr., PhD—Professor of Public Policy, African and African American Studies, and Economics and the director of the Samuel DuBois Cook Center on Social Equity at Duke UniversityEugene Richardson, MD, PhD—Assistant Professor of Global Health and Social Medicine at Harvard Medical School Moderator: Aletha Maybank, MD, MPH—chief health equity officer, senior vice president, Center for Health Equity, American Medical Association Originally aired: January 24, 2022 The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

Critical Race Theory and Intersectionality

Critical Race Theory and Intersectionality

Earn CME credit for listening to this episode of Prioritizing Equity. In this October 4, 2021, Prioritizing Equity discussion, AMA Chief Health Equity Officer, Aletha Maybank, MD, MPH, and leaders across a continuum of disciplines discuss critical race theory and its applications to the field of health equity. Panel: Dennis C. Chin—Vice president of Narrative, Arts, and Culture, Race ForwardMalika Sharma, MD, MEd—Division of Infectious Diseases, Department of Medicine, St. Michael’s Hospital; assistant professor, University of TorontoBram Wispelwey, MD, MS, MPH—Senior fellow at Atlantic Fellows for Health Equity, associate physician, Division of Global Health Equity Brigham & Women's HospitalRahel Zewude, MD—Black Physicians of British Columbia, Black Physicians of Canada, Department of Medicine, University of British Columbia Moderator: Aletha Maybank, MD, MPH—Chief health equity officer, senior vice president, Center for Health Equity, American Medical Association Originally aired: October 4th, 2021 The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

Accomplices and Co-Conspirators

Accomplices and Co-Conspirators

Earn CME credit for listening to this episode of Prioritizing Equity. In this July 12, 2021 Prioritizing Equity discussion AMA Chief Health Equity Officer, Aletha Maybank, MD, MPH, is joined by a panel of experts to examine the ways that white physicians can get actively involved in the fight for racial justice. Learn how doctors can become accomplices to advance equity. Panel: David A. Ansell, MD, MPH—Senior vice president and associate provost in community health equity at Rush University Medical CenterEsther K. Choo, MD, MPH—Professor at the Center for Policy and Research in Emergency Medicine in the department of emergency medicine at Oregon Health and Science UniversityBay Love, MBA, MPP—Partner at the Groundwater Institute and organizer at the Racial Equity InstituteKimberly D. Manning, MD, FACP, FAAP—Professor of medicine and associate vice chair of diversity, equity and inclusion at the department of medicine at Emory University School of Medicine Moderator: Aletha Maybank, MD, MPH—Chief health equity officer, senior vice president, Center for Health Equity, American Medical Association Originally aired: July 12th, 2021 The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

Celebrating and Reflecting During PRIDE Month

Celebrating and Reflecting During PRIDE Month

Earn CME credit for listening to this episode of Prioritizing Equity. This Pride Month, Kameryn Lee, MD, joins Aletha Maybank, MD, MPH for a special Prioritizing Equity discussion on what physicians can do to best support and center the voices of LGBTQ patients while continuing to advance health equity. Originally aired: June 14th, 2021 The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

Getting to Justice in Education

Getting to Justice in Education

Earn CME credit for listening to this episode of Prioritizing Equity. How can equity be further integrated into medical education? In this May 31, 2021 edition of the AMA's Prioritizing Equity series, leaders in medical education discuss the importance of embedding equity in health care education and envision new paths towards justice. Panel: Candice Chen, MD, MPH—Associate professor, Fitzhugh Mullan Institute for Health Workforce Equity at the George Washington UniversityUtibe R. Essien, MD, MPH—Assistant professor of medicine, University of Pittsburgh School of Medicine Moderator: Aletha Maybank, MD, MPH—Chief health equity officer, senior vice president, Center for Health Equity, American Medical Association Originally aired: May 31st, 2021 The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

How the Past Informs the Present in Healthcare

How the Past Informs the Present in Healthcare

Earn CME credit for listening to this episode of Prioritizing Equity. As our AMA Equity Plan reveals, achieving health equity and embedding racial justice requires action and accountability. In this May 17, 2021, Prioritizing Equity panel, leaders in health and higher education discuss why acknowledging historical harms is critical to bringing lasting change to health care. Panel: Robert E. Fullilove, EdD—Associate dean, Community and Minority Affairs and professor, Clinical Sociomedical Sciences, Columbia University Irving Medical CenterClarence C. Gravlee, PhD—Associate professor, Department of Anthropology, University of Florida Moderator: Aletha Maybank, MD, MPH—Chief health equity officer, senior vice president, Center for Health Equity, American Medical Association Learn more about the details of the AMA Equity Plan. Originally aired: May 17th, 2021 The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

Building Alliance & Sharing Power to Achieve Health Equity

Building Alliance & Sharing Power to Achieve Health Equity

Earn CME credit for listening to this episode of Prioritizing Equity. How can we work to establish a more equitable future? In this May 3, 2021, Prioritizing Equity panel, health leaders discuss why advancing health equity must require sharing power through effective alliances with those who have experienced marginalization and injustice across generations. Panel: jewel bush—Chief of external affairs, Girl TrekLeseliey Welch, MPH, MBA—Co-founder and executive director, Birth Detroit; co-founder and co-director, Birth Center Equity Guest moderator: Diana Derige, DrPH—Director, health equity strategy & development, Center for Health Equity, American Medical Association Originally aired: May 3rd, 2021 The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

Advancing Equity through Quality and Safety during COVID-19

Advancing Equity through Quality and Safety during COVID-19

Earn CME credit for listening to this episode of Prioritizing Equity. COVID-19 has highlighted the persistent health inequities that exist in the U.S. In this April 19, 2021, edition of the AMA's Prioritizing Equity series, health leaders use the pandemic as a lens to examine how quality and safety can drive equitable health care and outcomes moving forward. Panel: Louis H. Hart, MD—Director of equity, quality & safety, Office of Quality & Safety at NYC Health + HospitalsKedar Mate, MD—President and CEO, Institute for Healthcare Improvement Guest Moderator: Karthik Sivashanker, MD, MPH, CPPS—Vice president of equitable health systems and innovation, Center for Health Equity, American Medical Association; medical director for quality safety and equity, Brigham Health Originally aired: April 19th, 2021 The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

COVID-19 and Employer Vaccine Equity

COVID-19 and Employer Vaccine Equity

Earn CME credit for listening to this episode of Prioritizing Equity. COVID-19 has changed the nature of work for many Americans. The April 5, 2021 installment of the AMA's Prioritizing Equity series explores why employers must be as equally invested as the government and health care community in ensuring equitable access to COVID-19 vaccines for their workforce. Panel: Marina Del Rios, MD, MS—Associate professor of clinical emergency medicine, director of social emergency medicine and emergency ultrasound research director at the University of Illinois College of Medicine in ChicagoKyu Rhee, MD, MPP—Chief medical officer, Aetna; senior vice president, CVS Health Moderator: Aletha Maybank, MD, MPH—Chief health equity officer, senior vice president, Center for Health Equity, American Medical Association Originally aired: April 1st, 2021 The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct

COVID-19 & Minoritized Physicians

COVID-19 & Minoritized Physicians

AMA's Prioritizing Equity series brings together revered voices to discuss how a year of the pandemic has impacted minoritized and marginalized physicians, in this March 18, 2021 webinar. In a conversation moderated by AMA Group Vice President and Chief Health Equity Officer Aletha Maybank, MD, MPH, experts illuminate the effect COVID-19 has had on communities that historically and contemporarily experienced inequities. Panel: Leon McDougle, MD, MPH—121st President, National Medical Association; Professor of Family Medicine, The Ohio State University College of Medicine; Chief Diversity Officer, The OSU Wexner Medical CenterMary Owen, MD—Director of the Center of American Indian and Minority Health, University of Minnesota Medical School; President of the Association of American Indian PhysiciansElena Rios, MD, MSPH—President and CEO, National Hispanic Medical AssociationHector Vargas, JD—Executive director of GLMA: Health Professionals Advancing LGBTQ EqualityWinston F. Wong, MD, MS, FAAFP—Chairman, National Council of Asian Pacific Islander Physicians Moderator: Aletha Maybank, MD, MPH—Chief health equity officer, group vice president, Center for Health Equity, American Medical Association Originally aired March 18, 2021. The AMA's Digital Code of Conduct: https://www.ama-assn.org/code-conduct