Addressing racism can reduce health inequities
Being Black or Latinx in parts of Connecticut means a shorter life.
In Westport, a predominantly white community, life expectancy is 89.1 years. In Northeast Hartford, a community of color, residents live 68.9 years on average — a 20-year difference. Race is not the distinguishing feature of these data; it is racism.
Racism is a system of discrimination and injustice that provides or denies access, safety, resources and power based on race categories, and it produces and reproduces race-based inequities. The health care system is struggling to overcome a legacy of racism that is yielding present-day consequences. Medical racism surfaced in gynecologic surgical experimentation performed on enslaved Black women by Dr. J. Marion Sims. It haunts Black people who remember the Tuskegee Syphilis Study, and it reared its head recently when migrant women spoke of coercive procedures during ICE detention.
Communities of color have long been sounding an alarm about disparate treatment, access, and healthcare quality. However, the devastating effects of COVID-19 on Black, Indigenous, and Latinx people has brought new energy to the conversation about racial health disparities. Last week, YWCA Greenwich convened a panel of health care experts to explore this topic during its annual Dr. Martin Luther King Jr. event. Panelists delved into the history of racism in health care, COVID-19 vaccine hesitancy, maternal and infant care, diversification of the health care pipeline and other solutions.
Research tells us that doing nothing to resolve health inequities will cost us all.
A recent report from the Connecticut Health Foundation linked disparities to an estimated $505 million in excess hospital costs for Connecticut’s Black and Latinx residents. While doing nothing may not always be immediately fatal, a consequence Dr. King called shocking and inhuman, it strains resources within our health system. It ensures other systems like education and housing bear the brunt. It alters the quality of life of our neighbors and children. All results the current pandemic has illuminated.
Most sobering is that racism begins in the womb. Dr. Juliet Mushi, an expert in maternal and fetal medicine at Greenwich Hospital and a panelist at the YWCA Greenwich event, shared that Black women often experience diagnostic lapses; neglect, dismissiveness, or disrespect; no acknowledgement of pain; and coercion from reproductive health care providers. It is no wonder, when coupled with lack of access to quality health care options, that babies born to Black mothers in Connecticut are more than four times as likely to die before their first birthday than babies born to white mothers, regardless of income and education levels. Even tennis star Serena Williams played doctor and patient following her labor and delivery. She likely saved her own life.
Many of the answers to overcoming racial health disparities lie in the training and development of health care professionals. Institutions like Albert Einstein College of Medicine are making strides in this area. Its Office of Diversity Enhancement, led by associate dean Irene Blanco, MD, focuses on diversifying the pipeline of health care professionals beginning in high school. While 31.9 percent of the U.S. population identifies as Black or Latinx, only 10.8 percent of active physicians reflect these populations. Representation matters. What clinicians, researchers and educators learn matters too. Integrating content about implicit bias and racism into the curriculum across disciplines means every student will be exposed to these topics. From family physicians to surgeons, patients must be seen and heard, and their geographic and socioeconomic context understood to deliver equitable and responsive health care.
There will be questions about how we can move toward change. Whether its healthcare, public education or housing, co-creating antiracist institutions can feel like an insurmountable task. State Sen. Saud Anwar (DSouth Windsor) is calling on our state to declare racism as a public health emergency. He is not alone. By the end of 2020, 184 cities, counties, state legislatures, and other governmental leaders had declared the same, according to Michigan cartographer Alex B. Hill. Doing so means we have to keep telling the truth about how we got here. It allows us to cast a vision for health equity that can be realized. People of color — those most affected by these decisions — must serve as leaders and partners in such work, and we must appropriately fund the vision we cast.
These are steps we can and should take.