CUNY Med’s mission fits in Black History Month

Every day, I board the M101 bus on the East Side for my five-mile, half-hour commute to the CUNY School of Medicine in Harlem, where I am dean. The neighborhoods connected by this bus line offer a striking illustration of the health disparities that persist in our city and country.

On the Upper East Side, a person can expect to live 87 years — nine years more than the citywide average — while a person in Central Harlem can expect to live 77 years. Babies born on the Upper East Side are five times more likely than their Harlem neighbors to survive birth. It is unconscionable that Black women statewide die in childbirth about three times the rate of white women and an indictment of the health care ecosystem.

Black History Month recognizes and celebrates the many ways African-Americans have enriched and advanced the U.S. It is also an occasion to take stock of health disparities while taking action to improve the health of all neighborhoods on the M101 circuit.

At the heart of these entrenched inequities is a vast and growing shortage of primary care and diverse physicians. Without access to excellent, compassionate primary care, people often go untreated or turn to high-cost hospital emergency departments for conditions that could be managed or cured at the doctor’s office.

In Central Harlem, for example, children 4 years and younger are five times more likely than their Upper East Side peers to be hospitalized for illnesses that are avoidable with early care. In Central Harlem kids aged 5 to 17 years are 12 times more likely to need emergency care to breathe than those on the Upper East Side. Conditions such as asthma worsen without care and can be deadly.

I use these two M101 connected neighborhoods, although the same stark comparisons exist across New York City revealing an unequal burden of disease. These growing disparities are all symptoms of the social determinants of health — a concept famously promoted by Dr. H. Jack Geiger, a physician and founding faculty member of what is now the CUNY School of Medicine.

Poverty, hunger, poor education, and other socio-economic factors, Geiger asserted, are the primary drivers of the social determinants of health. They play out across the city’s five boroughs and worsen alongside the severe and growing shortage of primary-care physicians in minority communities and widening gap in health in these communities. Two million New Yorkers — about 25% of the city’s population — and 8 million people statewide live in federally designated Health Professional Shortage Areas (HPSAs).

Similarly, social determinants play a decisive role in medical education, effectively deciding at birth who can dream of becoming a doctor and who can’t. The disconnect is real when 52% of New Yorkers are Black or Latinx but only 16% of NYC’s doctors are. Nationally, only 10% of medical students are Black and 12% are Latinx while nearly 80% of medical students come from the top two quintiles of household income.

CUNY Medicine is working to change that. For the last century, most medical schools have been guided by a three-part mission: education, research, and clinical care. CUNY Medicine took a broader view to incorporate a fourth pillar: social responsibility focused on communities needing health care the most.

Starting with a commitment to inclusive excellence, our holistic admissions process considers the whole person. While most medical schools require the Medical College Admission Test (MCAT), we never have. In alignment with racial, ethnic, and economic disparities, we recognize students may need to work and carry additional responsibilities at home.

Many minority and first-gen students have an unequal burden of debt and difficulty paying for academic enrichments including MCAT prep. We acknowledge academics are important but so are an applicant’s innate talent, lived experiences, and challenges overcome. Our process is designed to illuminate promise and commitment to serve, and it has allowed more diverse students to realize their dream of becoming physicians.

Today, nearly 40% of our current students are Black and 22% are Latinx. A small school with an outsized impact, we train one out of every four Black MD students in NYC and we are fifth nationally in producing Black doctors. I am proud CUNY Medicine MD graduates add value and commit to our four-part mission: More than half practice primary care, three-quarters stay in NYC, a rate almost double other New York medical schools, and nearly 40% practice in HPSAs, compared to 15% of MD graduates statewide.

CUNY Medicine continues to make history by ensuring NYC’s health care workforce looks like the patients and population served, making NYC healthier. During Black History month, and every month our dream is to eliminate health care disparities in our time.