By Dianne Anderson

Whatever the health equity category, the Black community continues at two to three times more likely to die than whites, which is prompting more research to show that it’s not by accident, but more by design.

Disparities across healthcare for Black patients over the decades is not an unfamiliar conversation for Dr. Candice Taylor Lucas, who strives to reach as many as she can as the system leaves Black patients behind.

“There is a community calling that I have in the practice and the work that I do,” she said. “Having representation, having Black physicians and physicians of color, having women physicians introduces an opportunity for us to really, truly see diversity for all the patients.”

Both Dr. Lucas, Health Sciences Associate Clinical Professor at UCI College of Medicine and Carol A. Major, MD, Assistant Dean for Student Inclusive Excellence are co-directors of the LEAD ABC project.

Much of their work with Leadership Education to Advance Diversity-African, Black and Caribbean, is about training doctors in areas that have long been ignored in the core curriculum, like racism, diversity, or even how poverty intersects with health outcomes.

“It wasn’t until the death and murder of George Floyd that we stepped into the space in academia of truly owning the structural influences of racism on health outcomes,” associate clinical professor of pediatrics at the School of Medicine, UCI. “Our medical students are scholars, they’re coming in with passion and ability.”

In her career, she has been asked more than once if she has experienced racism. She doesn’t have to think long.

Before George Floyd, she said many contended that racism doesn’t happen in California, or that they happen in the past, even despite research that shows otherwise. She said there is not enough attention to the intersectional ways that racism still lurks in the health sector, both at the patient and doctor level.

She is determined by a personal sense of responsibility to make sure that mentorship is available for the next generation of Black physicians.

“Now with UCI we have a discrimination policy, that if I come in as a provider and a patient says they don’t want to be treated by you, a Black doctor, now we have something to stand on,” she said. “There are experiences patients have, but there are also experiences that we have as doctors.”

Not long ago, she was excited to catch up with the GREEN Foundation through a partnership with the Center for Environmental Health Disparities Research. The GREEN Foundation works with anti-tobacco efforts, along with decades of providing resources to address all forms of cancer in the Black community.

Dr. Lucas said that kind of community engagement goes back to increasing scholarly opportunities, and helps amplify the fact that racism is a core structural determinant of health.

In JAMA, Journal of the American Medical Association, several studies in recent years shed light on the extent of anti-Black and structural racism in health care.

That publication is opening the topic up for discussion. On the JAMA website, the authors write that structural racism has deeply and adversely affected health and health care,  manifested in reduced life expectancy, and among other illnesses, higher infant and maternal mortality.

“This stark disparity has become further exacerbated during the COVID-19 pandemic. Black and Hispanic or Latinx populations have experienced rates of hospitalizations and deaths due to COVID-19 that are 3-fold higher than White populations,” they say of the JAMA Network Open, where they announced a commitment to expand studies and commentaries on how racism impacts healthcare.

Dr. Lucas said a general lack of Black physicians in medicine also places extra strain on those that go into the field to serve the community. For anyone, just becoming a doctor in itself requires a huge volume of work, but Black doctors often take on heavier content.

It’s a matter of life and death, and saving who they can.

“I often will feel that my identity as a Black physician is one that carries beyond the treatment that I may be able to provide, that I’m able to offer the humility in caring for the patients that I care for,” she said.

In yet another study, “Racism, COVID-19, and Health Inequity in the USA: a Call to Action,” several doctors expressed that the silence around racism in healthcare is destructive. They emphasized the need for research interventions, patient advocacy and dismantling racism to reduce health disparities, rather than simply reporting the existence of the disparities.

“One should be empowered to step outside of one’s comfort zones in advocating for and speaking up for the voiceless and disempowered; speaking truth to power when encountering instances of racial prejudice, implicit bias, or microaggressions without fear of repercussions or stigmatization; and supporting pathways for reporting such encounters while nurturing safe and inclusive institutional environments,” the doctors write.

To see Racism, COVID-19, and Health Inequity in the USA: a Call to Action,”
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7668281/

Resources

For more information, see the Center for Health Disparities Research at https://sites.uci.edu/cehdr/