Calling out racial disparities does not equate to neglecting progress made toward greater racial equity.
Yet, as it almost always seems to in conversations about institutional racism, that point of contention came up on Monday night during a roundtable discussion about medical mistrust and healthcare disparities hosted by Universal Health Aid of Cleveland. It’s a group of Case Western Reserve University students who brought in myself along with Karen Mulloy, a professor at Case’s school of medicine; Yvonka Hall, the executive director of the Northeast Ohio Black Health Coalition; Jessica Kelley, a sociology and public health professor at Case; and David Miller, the associate dean at Case’s school of applied social sciences.
One thing was clear by the end of the discussion: Glaring healthcare disparities still shape the medical experience for many people of color in Cleveland and nationwide, despite some progress toward greater racial equity in the industry. Those disparities and all the factors that shape them drive mistrust of medical institutions.
A study conducted by the University of California Los Angeles this year found that the proportion of Black physicians in the United States has barely changed in the past 120 years. This write-up by Enrique Rivero, a UCLA health sciences media relations officer, breaks it down best:
“In 1900, when 11.6% of the nation’s population was Black, 1.3% of physicians were Black. In 1940, when 9.7% of the total population was Black, 2.8% of physicians were Black — 2.7% were Black men and 0.1% were Black women. By 2018, when 12.8% of the total population was Black, 5.4% of U.S. physicians were Black — 2.6% Black men and 2.8% Black women.”
That same study also found, big surprise, a pretty substantial income gap between white men and Black men working as physicians. Adjusted for inflation, white men working as physicians made an average of $68,000 more than Black physicians in 1960, In 2018, they made $50,000 more, on average.
That’s just what the statistics say. That I even need to provide statistics to reinforce a fact that many people of color, particularly Black people, experience all the time in healthcare illustrates just how different the healthcare experience is for people of different races. That’s just one study, too. There are plenty more on healthcare disparities. And surely, for every study, there’s got to be like a dozen anecdotes detailing medical nightmares any person of color could tell you.
It was with one of those anecdotes that Yvonka Hall, the NEOBC executive director, responded when one attendee chimed in to say that the panelists had been ignoring progress toward racial equity in healthcare during the medical mistrust discussion on Monday.
Hall has cancer, and she battled with medical professionals for more than a decade just to get them to take her seriously, she said. She’d been telling doctors for more than a decade that something didn’t quite feel right, but so often they brushed off her concerns, she said. She finally got them to give her an ultrasound. Hall said she’d never seen someone type as quickly as the technician did as she typed up the report from her scan. She knew in that moment that they found something they should have known about for years.
That story isn’t unique. And the fact that I’m now, in 2021, writing about the simple existence of racial health disparities should be troubling. I haven’t even gotten into the local Cleveland issues, and I’m already 600 words in.
For one local example, Cleveland’s health disparities break down along both racial and geographic lines, said David Miller, the associate dean at Case’s school of applied social sciences. Cleveland’s east side has health centers, but no hospitals equipped to treat people with trauma I injuries (the most serious, life-threatening injuries like gunshots). The nearest trauma I centers to Cleveland’s east side are at UH Cleveland Medical Center in University Circle and the MetroHealth Medical Center in Clark-Fulton. Many east-side Clevelanders who find themselves in traumatic medical emergencies may as well be on a volcanic island, Miller said.
So as far as the topic of the discussion, medical mistrust, it’s a deep-rooted issue for the reasons I mentioned above and so many others I won’t be able to write about in the depth they warrant in this reflection. For many people of color, there’s good reason to mistrust healthcare institutions. And rebuilding the trust that centuries of institutional racism shattered takes time.
The reason I was on the panel is because many media entities, too, have long betrayed the trust of the communities they ought to serve. We aren’t immune to institutional racism; in fact, many among our ranks have proliferated it in the past and continue to do so to this day.
And with the Covid-19 pandemic, the media has become an inherent part of the world of medical misinformation, too. As Jessica Kelley of Case’s sociology and public health department noted during the discussion, too often, reporters covering medical findings about Covid-19 ended up oversimplifying or misunderstanding them and accidentally spreading false information. It was frustrating, she said, and rightfully so.
All that’s to say it’s going to take a whole lot more than a few thousand words to adequately shine light on all the different angles of health disparities and health equity here in Cleveland. My fellow panelists on Monday have devoted most of their careers and their lives to that cause. I may just be reporting on health equity, and I may be relatively new to reporting, but I strive to cover these issues with no less dedication than those panelists — researchers, teachers and community leaders — I was so lucky to speak alongside.
Michael Indriolo is a reporting fellow at The Land covering health equity.