As a young woman navigating my way through college, I hung out with some folks who today are practicing as expert medical and health professionals. As I observed them, it was pretty clear that I too wanted to help people improve their health and address health disparity, but not as a clinician. Professors like Ruth Faye Davis, Ph.D. and Lily Lindsay, Ph.D, RD helped me hone a gift and interest in nutrition. Emerson Cooper, Ph.D., helped me to overcome a fear of chemistry. So, by the time I got to Nutritional Biochemistry with Ephraim Gwebu,Ph.D. I was thrilled to study and do research about what happens when we eat.
During my senior year, my BFF Joann Dickson-Smith and I concluded that we were to have careers in public health. We confirmed our decision when we enrolled in an elective health education class our final quarter taught by Luetilla Montgomery-Carter, Ed.S. After finishing Oakwood University, Joann and I completed our master of public health degrees and began our careers.
Along the way, we witnessed the glaring disparity in minority health compared to the majority population. I worked to teach people how to make better choices, access health care, navigate their way through false health information. Joann researched best information and practices that had the greatest impact on health outcomes. But, no matter how much hard data Joann researched that I could convert to health interventions, nothing could clearly, consistently and directly address and change the “system of racial bias and inequity” that permeated the health care system and fed disparity.
That was nearly 40 years ago. So, imagine my disgust last week when I saw an article that clearly documented bias in the care of African-Americans. Researchers at the University of Virginia discovered as they questioned white medical students and residents, that they actually believed that Black folks blood coagulates more quickly; that Black people had less sensitive nerve endings than white people – which suggests Black folk can endure more pain. “Forty percent of first-year medical students and one in four residents answered that they thought Black patients had thicker skin than white patients.” There. Are. No. Words.
We don’t have to look far to see how African-Americans have been mistreated in health care. Mention the Tuskegee Syphilis Experiment and you will get all kinds of responses. When I discovered it, I was stunned to learn that I was a child living in Alabama while this government approved experiment was conducted. Descendants of the 623 men who were “studied” for 40 years, were recently granted access to their loved ones health records via efforts of the Voices for Our Fathers Legacy Foundation. Members say, this will help them to continue to heal and move forward with forgiving hearts. I’m not sure about trust though.
I get that a lot has been done to grant greater access to health care. The Affordable Care Act is one of the pieces that has literally opened the door to health care for many who have never had it; especially those who are poor and/or minority. But one thing is for sure, once you get in the door if you sense that you are not being treated fairly or equally, odds are you’re not coming back.
I can remember clearly after my son was born, I dressed down and went to the public health clinic in follow-up for a birth certificate and to apply for WIC. By the time I finished clearly explaining my training and experience, the woman who helped me was certain she had been checked for disparate care. A few years ago before he left home, we took our son to the ER with searing chest pain. They let him sit and wait, until I spoke for him. I let them know he used absolutely no drugs and his heart was beating irregularly. Only then was he placed on a monitor. My heart ached for the countless others whose voice was not respected.
One positive fact I read several years ago however is this: “A George Washington University study of 141 U.S. medical schools found that historically Black medical schools had the highest social mission rankings. In a Top 20 list of medical schools with the highest social mission rankings, Morehouse School of Medicine, Meharry Medical College and Howard University College of Medicine ranking first, second and third respectively. “ (Annals of Internal Medicine, 2010). Graduates of these schools, many of whom become primary care physicians aren’t just talking about it, they are being about it.
And, patients can tell the difference. It doesn’t take much to stop and listen, offer compassion, research the culture of the people you serve, and just be fair. See, patients know when they can trust you. And, no matter how much research is done, how many doors are opened or how much insurance a patient may have, if the health care system and its providers treat you based on your appearance, they are contributing to the disparity. And, you are no longer trusted!
I was a lot more hopeful for the medical system years ago. I’m bothered now because we all have way more access to factual information, yet biases guide us and shortchange those who need good health care most. Being a person of color should not be a risk factor for poorer medical care/treatment of disease and other health conditions. It’s National Minority Health Awareness Month. It’s time for patients to demand better. It’s time for health professionals to do better. And, it’s way past time for America’s health care system to Accelerate Health Equity for the Nation. Kudos to those African-American doctors and other health care professionals who are leading the way in culturally sensitive, compassionate care and the HBCU institutions who trained them.