How to Advance Minority Health? Change the Look of Health Care.
To mark National Minority Health Month, the Human Capital Blog asked several Robert Wood Johnson Foundation (RWJF) scholars to blog about improving health care for all. Rashawn Ray, PhD, is an assistant professor of sociology at the University of Maryland and a former RWJF Health Policy Research Scholar at the University of California in Berkeley and San Francisco.
Some people assume that promoting diversity and combating health disparities means giving preferential treatment to minorities over Whites. However, these pursuits simply mean providing equitable opportunities and a health care system that is responsive to everyone. Education studies continuously show that promoting diversity and reducing discrimination benefits all students. Regarding health care, these pursuits may mean life or death.
The percentage of Black physicians has stayed roughly unchanged since the early 1900s. The percentage of Black and Latino professors at research-intensive university shows a similar pattern. I suggest that reducing health disparities and changing our current culture of health is contingent on more effectively integrating minorities into health professions and research positions.
First, integrating minorities into health fields is important because personal and professional trajectories affect the medical information queue—the prioritization and integration of medical knowledge. It also results in fresh ideas and approaches to combat health disparities. On a personal note, my boys have a rare condition called neonatal lupus. It occurs in 1 in 20,000 births and does not discriminate across racial lines. Despite my boys being seen by pediatricians, gynecologists, dermatologists, pathologists, and rheumatologists, no one could give my wife and me a firm diagnosis. That is, until a graduate from Meharry Medical College, a historically Black medical school in Nashville, heard of the case.
Laveil Allen, MD, who has worked at Vanderbilt and Harvard and is now a Tulane University hospital radiology resident, mentioned that he remembered reading about rare conditions that normally go undetected at child birth. Because of Dr. Allen, we were given information that we did not receive from other experts. I should also mention that my wife is a nurse practitioner and also suggested that our boys may have neonatal lupus. These health care professionals may have come to this correct diagnosis, not necessarily because they are Black, but because their personal experiences may have led them to recall different types of information that is vital for treating patients.
Second, integrating more minorities into health care professions may reduce treatment differentials related to perceived pain tolerance or the dissemination of information about weight loss. Race scholars assert these disparities are rooted in how stereotypical thinking about racial groups manifest during the patient-physician encounter.
Third, changing the look of health researchers may help to overcome trust issues in minority communities. This change may result in more useful data and a funneling of more minorities into research studies to more accurately test for physiological differences resulting from an exposure to environmental stressors.
Conducting community-based participatory research, coupled with volunteering in low income, minority communities, can provide a counter opportunity structure to the negative one children often encounter. For example, some colleagues and I are exploring the impact school gardens have on nutrition knowledge, aspirations for STEM professions, and civic engagement among students in 90 elementary schools in Washington DC. Serving in these communities also may lead researchers to see that gun violence among minority boys might be a signal for help as some may be committing suicide in a valiant effort to display honor like Greeks and Romans.
By research-intensive universities and medical schools working with historically Black colleges and universities and Hispanic-serving institutions to recruit the best and brightest students, changing the look of health care may offer promising benefits that lead to a culture of health with very different solutions to combat racial differences in mental and physical health.
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