You’d think, given the past few years’ surge in calls for racial justice in American society, that we’re on our way to true equity. There’s still a long way to go on that front in the medical field, as three Black brothers who are prominent health care and social justice leaders made clear during a conversation at Coins2Day’s virtual 2021 Brainstorm Health conference on Tuesday. One major problem? Communities of color have more trust for the medical system when their doctors look like they do—and the ranks of Black medical professionals isn’t heading in the right direction.
“The African American, Hispanic, Native American, Pacific Islander workforce [in medicine] has not changed that much over the last 10, 15, 20 years,” said André Churchwell, a physician who serves as the vice chancellor for equity, diversity, and inclusion and as the chief diversity officer of Vanderbilt University. “In 2020, there were fewer African American men applying to medical school and being accepted than there were 10, 15 years ago.”
This is part of a legacy of racism and socioeconomic inequities that feed a vicious cycle. If you don’t have wealth, access to education, or proper means to achieve success due to the institutional barriers rampant in the United States, the result is less talent from diverse communities and the rippling effects thereafter. There is a legacy of mistrust among the Black community with the medical system, as outlined by surveys by think tanks such as the Commonwealth Group. Without a more diverse health care industry, that problem is exacerbated by a global pandemic such as COVID, which has consistently affected communities of color disproportionately and may be fueling vaccine skepticism among certain groups.
As with drug development, the work must begin early. Building out infrastructure for underserved communities will fuel the future, according to Churchwell. “And so we have a lot of work to do on what’s a more robust set of resources to build our inner-city schools, to support the education and mission of education,” he said.
André Churchwell’s brothers, Keith Churchwell and Kevin Churchwell (respectively the president of Yale New Haven Hospital and CEO of Boston Children’s Hospital), expounded on the impact of these social determinants of health. These aren’t the kinds of things you may automatically link with medicine, but they are foundational to our biologies. That includes everything from lack of access to education, to lack of income, to social isolation, to being trapped in food deserts with little recourse for healthy foods, to living in metropolitan areas with crowded transportation systems that may fuel the spread of a pathogen like the coronavirus. In medicine, our daily actions and the way society chooses to treat different groups of people have just as much of an impact as a vaccine during a pandemic.