Addressing the Challenge of Health Disparities: A Perspective — Allison Young
The COVID 19 pandemic has taught us many, many painful lessons. It has also laid bare some very unpleasant facts of being a person of color in America. Below is part 1 of my 3 part article, and today’s perspective examines some of the challenges facing healthcare in America, and how race is a key factor in outcomes (no surprise).
It has been convenient for the healthcare industry to assume that social determinants of health are largely responsible for the poor health outcomes in minority communities. Factors including diet, smoking, lack of health literacy, housing insecurity, food insecurity, and living in food deserts all contribute to the intractable issues that surround health outcomes. However, like most human issues — while they certainly contribute to the situation — social determinants simply “blame the victim.” What is left largely unspoken are the impacts of racial cultural biases carried by physicians who tend to be white and male. It should be noted that only 5% of physicians are African American and this number is significantly lower in the areas of specialization such as Cardiology, Endocrinology, and all surgical specialties. Moreover, most physicians come from upper class families with limited exposure to with minority culture. Therefore, there is distrust from minority patients, and a lack of empathy and untrue mythology (“e.g., African Americans feel less pain or are all drug seeking — therefore get less pain relief”) from providers — all contributing to delayed care and poor health outcomes.
If we ask the question — Why are there so few African American physicians? Most practicing African American physicians are trained at historically Black Colleges and Universities (HBCUs) or one of 5 or 6 medical schools. Those who graduate from majority white undergraduate institutions had significant additional hurdles to overcome. One little known factor that contributes to the limited number of African American physicians is the way in which the STEM courses are taught in majority white colleges and universities. Often these courses are taught in a way to discourage students and eliminate those who are not “worthy” of being physicians and scientists. This “separating the wheat from the chaff” approach includes tests with obscure tricks required for the correct answer that only those who have taken the course in an elite high-income suburban school or private preparatory school would know. Moreover, when African American students struggle with STEM courses, rather than being given support and encouragement — the are often told to “quit”, further reducing the number of candidates for the medical professions.
Racial bias compounds social determinants and accounts for many of the poor outcomes from African Americans. African Americans are disproportionately treated at health care facilities with the fewest technological resources, the most poorly trained professionals, and least experienced clinicians serve predominately black patient populations. For example, African American women are three times more likely to die of pregnancy-related causes than white women, and African American infant mortality rate is twice the rate for white infants.
These disturbing factors remain true even among middle and upper middle class African American women. Remember, even Serena Williams (world class tennis player and multi-millionaire) nearly died in childbirth when the medical and nursing staff ignored her requests. Luckily, she had other resources to call into action. This racial bias is well known in the African American community and accounts for the lack of trust of the medical establishment and a reluctance to seek care until the situation is critical. In the following discussions, we describe opportunities to address these issues.
Click to read the second and third parts of this article.
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Allison Young is a CEO with strategic acumen and excellent leadership skills who specializes in the healthcare industry. She is a results-oriented executive who utilizes a creative approach as a problem solver, developing innovative solutions to overcome challenges. She also has a strong background as an IT expert, having used her creative approach to improve methodologies and support clients in unique ways. Her diverse background has enabled her to become a dynamic leader today, and she is seeking new opportunities to serve on corporate boards to engage in strategy development focused on leadership and her other expertise.
