Greenwich YWCA hosts frank, ‘critical’ conversation about race

GREENWICH — The long history of obstetric racism in the United States dates back to 1619, with the arrival of enslaved Black women, who labored to provide as many children as possible to further enrich their American slave owners.

Genital trauma and disease as a result of rape and sexual abuse impacted an enslaved woman’s fertility and value, and thus, her ability to contribute to the workforce, Dr. Juliet Mushi, an OB/GYN and expert in maternal and fetal health, said during a virtual discussion hosted by the Greenwich YWCA to honor the legacy of the Rev. Martin Luther King Jr.

The abuse of enslaved Black women continued for centuries. From 1846 to 1849, Dr. Marion Sims, an American surgeon, performed gynecological experiments on 11 enslaved women with obstetric fistulas, without using anesthesia or antiseptic, said Mushi, who is affiliated with the Yale School of Medicine and Greenwich Hospital.

His goal was to perfect the technique of repairing obstetric fistulas, “which he was able to do,” and he was credited and hailed as the father of American gynecology, Mushi added.

Sims later treated rich white women using the technique, “and by his account, he became the second wealthiest physician of his time,” Mushi said.

A statue of Sims stood in Central Park until 2018. “The impact on Black women’s bodies was the beginning of a legacy of dehumanization and traumatization in the medical space,” she said.

Mushi spoke virtually on a panel with three others Thursday night, during a frank but “critical” conversation on racial health disparities.

“Our purpose tonight, and every January, is to lift up and examine a contemporary issue that Dr. King would have cared about and fought for — were he still with us,” said Mary Lee Kiernan, president and CEO of the Greenwich YWCA.

The discussion came just after the Greenwich YWCA hired Erin O. Crosby as its first director of women’s empowerment and racial justice and to lead the nonprofit’s new Center for Equity and Justice.

The conversation gave historical context to health disparities by race, as a backdrop to explain why people of color have been so disproportionately affected during the COVID-19 pandemic.

Moderator Tiffany Donelson, president and CEO of the Connecticut Health Foundation, said many people ask her why the organization focuses on health equity when Connecticut is deemed the fourth healthiest state in the country.

But it ranks 41st in the nation for disparities by race, as it relates to life expectancy, diabetes, asthma and cardiovascular disease, Donelson said, caused by a lack of transportation, unaffordable housing and disparate treatment of people of color when they enter the health care system.

“And it is not often conscious,” she said. “Nobody goes into health care thinking that they are going to treat any patient differently. ... But because of unconscious biases, because of the structures in our country, it often yields to people of color having different treatment than others.”

Racism and microaggressions create a significant health cost to people of color, she said. Research has linked racism to physical and mental health issues, including depression, anxiety, hypertension, breast cancer and preterm birth, Donelson said.

Maternal health and mortality dominated the Zoom conversation. Over the years, Black women have consistently reported experiencing neglect, dismissiveness or disrespect when they enter the reproductive health care space, Mushi said.

In a study of more than 1,000 women who had a cesarean section, Black women had the highest pain scores, yet they received fewer pain assessments from doctors. And despite their higher pain scores, Black women received less in terms of painkillers than white women, Mushi said.

National statistics show that a Black woman with a college degree or higher is still 1.6 times more likely to die from pregnancy-related causes than a white woman without a high school diploma, Donelson said.

“Disparities exist across the spectrum in medicine. There’s not one field that’s not impacted,” said Dr. Irene Blanco, a rheumatologist and associate professor of clinical medicine at the Albert Einstein College of Medicine Medical Center.

“Racist structures were implemented in order to segregate people by the color of their skin and it subsequently led to poor housing, poor education, poor (health) outcomes,” she said.

Of the 32 highest-income countries, the United States ranks “dead last,” with the highest expenses for its health care system, said Dr. Sten Vermund, dean and professor of public health and professor of pediatrics at the Yale School of Medicine.

“We’ll pay any amount of money for curative medicine,” he said.

“But to find a home for the homeless, to find a job for the jobless, to find a substance abuse treatment opportunity for someone with an addiction problem who wants to do something about it, that we underinvest,” he said. “And the Europeans do it the other way around. They realize that the social needs are spectacular and can trump the medical needs.”

Asked whether she could also offer just one solution in the complex problem of health inequities, Mushi said physicians should allow Black and brown patients to voice their concerns about racism.

One of few Black physicians in Greenwich, Mushi said she sees a number of Black and Latino patients, who are relieved when they meet her and see that she is a doctor of color.

“This is the first time that they can share their concerns about, will they be seen during their labor process, will their requests be honored?” Mushi said. “And just even having those conversations and creating that space to acknowledging that fear goes a long way.”

Blanco agreed. “We need to train every doctor of color to have those discussions, to be fearless and courageous,” she as the conversation ended.

“And finally, you’ll see the patients exhale, because finally, somebody is addressing the elephant in the room,” she said.