By Vernon A. Williams
Myriad factors contribute to the Black and White health chasm in America. Preventative care, early diagnoses, options for treatment of illness and, of course, the insurance factor are among impediments that influence Black health.
Major elements of health in the Black community include stress, weight, diet, exercise and an environment often permeated by obstacles to optimum health.
The inordinate concentration of alcohol and drugs in too much of the Black community increases the risks. Consequently, for young African American males, both addiction and an astronomical homicide rate places the health of citizens in jeopardy.
Another glaring shortcoming is the lack of medical research that takes into consideration different ways in which Black Americans’ bodies react to medical treatment in contrast to white patients. Without proper numbers of African Americans involved in the trial stages of research, the prognosis for Black patients becomes less reliable.
The health landscape for Black America is not all doom and gloom. Significant progress is being made across the board. There is reason for encouragement in a number of areas.
One that is increasingly critical is attracting Black scholars into the medical profession. If sustainable change is going to ever come, it will rely on those with a vested interest being at the table when decisions are made, and not on the outside looking in, after the fact.
In 2009, a body that accredits medical schools issued a new requirement that all medical schools must implement policies that help them attract and retain more diverse students. Failure to do so can lead to citations from this body, the Liaison Committee on Medical Education, and can affect their status as accredited institutions.
While the impact has not turned the entire situation around, there is documentable evidence that this effort appears to be working. In research published in the Journal of the American Medical Association, JAMA, there were significant changes in demographics of medical students from 2002 to 2017. They found an increase in diversity in enrollment, especially since 2012, which the researchers think may be the first year new standards could be expected to have an effect.
But the rate of change, some medical educators say, is too slow. Student bodies at medical schools were still almost 60 percent white in 2017.
“We see the trend going up, but it’s going up very slowly,” says Dr. Dowin Boatright, an assistant professor of emergency medicine at Yale University and coauthor of the study. “If we’re trying to get some degree of representation that matches the proportion of Black people in the population as a whole…..we’re talking 20 to 50 years.
The pattern of change over the period studied is noteworthy, Boatright says. Between 2002 and 2012, the proportion of female and Black students decreased each year.
In that same time period, the percentage of Latino and Asian students increased. White students were the majority of medical school enrollees throughout that time period.
In 2012, the percentage of female and Black students starting medical school began a steady, albeit slow, increase. By 2017, 7.3 percent of new medical students identified as Black, up from 6.8 percent in 2002. Students identifying as female made up 50.4 of those enrolled – up from 49 percent in 2002. Hispanics represented 8.9 percent of medical students, up from 5.4 percent in 2002 and Asian students were 24.6 percent of students, up from 20.8 percent.
Boatright hypothesizes that the improved numbers reflect the new requirement that schools have formal programs to attract diverse students. He said, “I think there’s a strong incentive now to have at least some kind of benchmark to promote diversity. Programs actually are being held accountable.”
Most people probably thought this was something being done in higher education all along – particularly since the initial push for affirmative action was almost 50 years ago. But it has only been recently that many medical schools have hired dean-level administrators who focus on attracting and retaining minority students.
Designated administrators addressing the issue is critical, according to Dr. John Paul Sanchez, an associate dean for diversity and inclusion at Rutgers New Jersey Medical School. He says, when you tell people they “should” do something, the response is usually casual. When you tell them the expectations are part of their responsibilities for which they will be held accountable, those who can make a difference take diversity and inclusion far more seriously.
According to the most recent data of the Association of Medical Colleges, in 2018, 8.6 percent of first-year medical students are Black. The number of Black men enrolling in medical school in 2018 — a group that has been significantly underrepresented compared to the general population — increased by 7.3 percent – 3.4 percent of first-year medical students this year. “Pipeline” and mentorship programs help.
Much more is needed and of course, it begins with the kind of dialogue that can be created by media – Black, and so-called mainstream – and enlightened citizens of all races. We should strive to make that a more prevalent conversation in 2019.
CIRCLE CITY CONNECTION by Vernon A. Williams is a series of essays on myriad topics that include social issues, human interest, entertainment and profiles of difference-makers who are forging change in a constantly evolving society.Williams is a 40-year veteran journalist based in Indianapolis, IN – commonly referred to as The Circle City. Send comments or questions to: [email protected].