The Impact of Racism on the Health Status of African Americans
Carnage of Racism
The Beginning
Palaeonto-logical Evolution Evidence
Origin of All Languages
Genetic Evolution Evidence In 1987 geneticists at UC Berkeley (Cann/Wilson) analyzed partial mitochondrial DNA (mtDNA) sequence (less than 7%) of different people worldwide and found more genetic mutations among indigenous Africans than any other people. Max Ingman, et. al., at the University of Uppsala in Sweden recently described global mtDNA diversity in humans based on analyses of the complete mtDNA sequence of 53 humans of diverse origins. Nature: Mitochondrial Genome Variation and the Origin of Modern Man, Dec. 7, 2000.
The Migration of Man
“The African Eve” The UC Berkeley geneticists postulated that the entire population of the modern world was descended from a relatively small group of people that left Africa 100,000 years ago. This group postulated the “African Eve” theory (Newsweek), that every human being alive today carries the mtDNA of just one African woman (Lucy’s cousin) or a small number of female African ancestors who lived more than 10,000 generations ago.
Imhotep the Physician This great African physician was deified in approximately 2850 B.C. Imhotep was the first person known as a doctor throughout the world and acknowledged as the god of medicine 5000 years ago. Some 2500 years before a Greek laid claim to this same title.
Cesarean Section performed by a Banyoro surgeon in Uganda in 1879 with the use of aseptic technique, sutures and hot cautery irons.
Human Genome Project
A Portrait in Diversity
Human World Clans The Seven Daughters of Eve “Whose Your Mama?”
“LAYLA” Rodney’s Mama
Conclusion of Evidence Thus, we have Fossil, Linguistic and Genetic evidence that persuasively point to the conclusion that every person alive today is descended from modern humans (Homo Sapiens) that existed only in Africa until approximately 100,000 years ago. The origins of humanity, civilization, intelligence and modern medicine (Imhotep) have evolved from Africa.
The Evolution of Racism in Medicine Racism has roots in medicine over 2500 years
Race and Ancient Scientific Precursors
Early Forefathers of Racial Bias
The Roman-Greek Contributions to Racism in Medicine The teachings of Galen (c. 130-201), a famous second century Roman physician of Greek origin, were accepted as sacrosanct by teachers of Western medicine for 1500 years.Galen promoted the racist concepts of Black physical and psychological inferiority in his teachings and writings. Bernal M.Black Athena/ The Fabrication of Ancient Greece 1785-1985, Rutger Univ. Press, 1987.
European Contribution: Racism in Medicine Many European physician-scientists during the 16th, 17th, 18th and 19th centuries contributed racist teachings into the medical corpus of knowledge. A few notables:- Paracelsus: A famous Swiss physician and philosopher.
- Anton van Leeuwenhoek: Father of Microscopy.
- Marcello Malphighi: Father of Histology
Hottentot Venus Lady - Exploitation of Saartjie Baartman by Baron Georges Cuvier
The Round Up Period
The Slave Ship
Living Africans Thrown Overboard The Slave Ship Zong in 1781
Transatlantic Slave Period
The Assault on Black Humanity Continues
American Health Professional Contribution to Racism in Medicine
Benjamin Rush, M.D.
The Beginning of Women’s Health
First Black Health Reconstruction Period
Organized Medicine’s Race-Based Policies Three periods of AMA official rejection of Black physicians:1. June 1869 — the Medical Society of the District of Columbia.2. May 1870 — at the 21st AMA National Convention in Washington, D.D.3. In 1872 — the AMA Convention again rejected a similar biracial delegation.
Nineteenth-Century Academic Thinking on Race Nathaniel Southgate Shaler (1841-1906)Joseph LeConte (1823-1901)Edward Drinker Cope (1840-1897)
National Medical Association Birth
The Civil Rights Era The Second Black Health Reconstruction Period The 1964 Civil Rights Act, hospital desegregation court rulings, passage of Medicare and Medicaid and the health centers movement, all created a “Civil Rights Era” in health care for Blacks.This initiated the Second Black Health Reconstruction Period from 1965 - 1985.
“The Slave Health Deficit” A National Crisis 35% more Blacks than the general population die from cancer each year.40% more Blacks than the general population die from heart disease each year.35% of Black men suffer with hypertension compared to the national average of 25%.Diabetes Mellitus is 70% higher among Blacks.Blacks suffer much higher rates of ESRD but Whites are twice as likely to receive a life saving kidney transplant.The impact of HIV/AIDS, violence, substance abuse, unintentional injuries, infant mortality & many other preventable conditions is greater for Blacks.
Causes for the Ethnic Health Disparities Inadequate AccessSocioeconomicCultural DifferencesGenetic DifferencesEnvironmental ExposuresDietary HabitsUnhealthy Life Styles
Modern Racism in Health Care An Unspoken “Risk Factor” for the African American Health Deficit and Ethnic Health Disparities in the United States
“Of All Forms of Inequity, Injustice in Healthcare is the Most Shocking and Inhumane.” - Martin Luther King
Assault on the Black Intellect Centuries ago scientists taught Blacks were inferior both physically and intellectually 20th Century Scientific Accusers: Sir Francis Galton, Arthur Jensen, William Shockley, Richard Herrnstein and Charles Murray 20th Century Scientific Defenders: Stephen Jay Gould, Alvin Poussaint and Richard Atkinson
The Evidence for Modern Racism in Medicine “Health Care Racial Profiling”
Racial Bias in Medicine “Health Care Racial Profiling” JAMA, 1994: A study in Los Angeles revealed : “Hispanic patients were twice as likely as white patients to receive no analgesia when presenting to the ER with a fresh bone fractures.”The Annals of Emergency Medicine, Jan. 2000 (Emory University School of Medicine) concluded that “Black patients with broken arms and legs were less likely than white patients to receive painkillers when presenting to an Atlanta ER.”
Racial Bias in Medicine “Health Care Racial Profiling” “Race, quality of care and prescribing practices in psychiatric emergency services”, Psychiatry Service: March, 1996. Conclusion – “Clinicians, mostly Caucasian, prescribed more psychiatric medications to African Americans than to other patients and devoted significantly less time to their psychiatric evaluations.”
“Health Care Racial Profiling” The Schulman// Georgetown Cardiovascular Study (NEJM:Feb. 1999).The Lung Cancer Sloan-Kettering Study (NEJM:Oct.1999). The Renal Transplant Harvard Study (NEJM: Nov. 1999).
Health Care Racial Profiling Brigham & Women’s Hospital and Harvard Medical School Study, “Quality of Care by Race & Gender for CHF and Pneumonia”, by Ayanian, et al (Medical Care Dec. 1999, 37(12):1260-9)The Michelle van Ryn Study, “Effects of Race and SES on Physicians Perception of Patients” (J. Social Science and Medicine: March 2000)Yale University Cooperative Cardiovascular Project, “Racial Differences in the Use of Cardiac Catherization after Acute Myocardial Infarction”, by J. Chen, et al (NEJM, May 2001, Vol.344)
Defining Racism Camara Phyllis Jones gives a theoretical framework for understanding and defining racism. - Internalized Racism
- Personally Mediated Racism
- Institutionalized Racism
National Medical Association Consensus Panel Racism in Medicine Health Parity for African Americans
NMA Consensus Panel Racism in Medicine & Health Parity for African Americans Rodney G. Hood, MD - ChairW. Michael Byrd, MD, MPH- Harvard School of Public Health
L. Natalie Carroll, MDLinda A. Clayton, MD, MPH- Harvard School of Public Health
Gary C. Dennis, MDMichael A. LeNoir, MD
“Desperate Diseases Must Have Desperate Remedies.” -Shakespeare
Health Care Solutions 5 Principles to Address Disparities - Health Disparities — Quality Problem.
- Data Collection is Inadequate.
- Stratified Clinical Performance Measures.
- Population-wide Monitoring.
- Race/Ethnicity Payment Strategies.
Kevin Fiscella, et al.,”Inequality in Quality”, (JAMA 2000 May 17; 283(19):2579-84)
Health Policy and Research Institute Health Institute Centers - African American Health Center Think Tank
- Health Policy and Advocacy Center
- Research, Surveillance and Educational Center
- Community/Public Media Information Center
- Mobilization and Participation Action Center
Racial bias and racism to be considered as a risk factor toward poor health for African Americans.Healthy People 2010 must address the impact of racial bias and racism in medicine to achieve health parity for all Americans.Emphasize healthy lifestyles and alternative health modalities such as prayer, meditation, and other holistic approaches.Culturally competent and diverse health care workforceCongressional Hearings on Racism in MedicineCongressional/Presidential Advisory CommitteeComprehensive Universal Health Insurance Program
Health Parity Recommendations EducationSupport UC President Atkinson’s recommendation to eliminate the SAT I scores as undergraduate admission criteria. Further support a moratorium or de-emphasis on the MCAT and other similar standardized test proposed to measure aptitude.Cultural competency education to incorporate the ethical issue of racial bias and racism in medicine.American public should be educated around the positive benefits that come with the elimination of all health disparities.Health education must emphasize responsibility for good health practices with healthy lifestyles and the unique considerations imposed by their cultural experiences.Initiate innovative programs to increase the number of underrepresented minorities in health sciences and combat anti-affirmative action.
Understanding Racism through Jazz
A Question to Explore Is there a correlation between the centuries-old racist theories taught by the western medical profession and the current studies that reveal persistent race-associated differential health status and outcomes based upon the degree of melanin in the population?
Health Disparities the Vision for the Future
The Hope and The Future We will, We can, and We must stop the insanity of racism! “Insanity is when we keep doing the same thing and expecting a different result.” by Albert Einstein
Linguistic Evolution Evidence Afro-Asiatic languages in Ethiopia & North Africa have the oldest linguistic roots and are heard today in East Africa close to the sites where the oldest fossils have been found. J.Reader: Biography of the Continent Africa, 1997, pg. 109-110
“He Who Has Health, Has Hope; and He Who Has Hope Has Everything.” - Arabian Proverb
African American Health Crisis The 1998 Age-Adjusted Death Rates: Black Americans suffered overall mortality rates 53 percent higher than for Whites.Stroke death rates for Blacks were 78 percent higher than Whites.Heart disease death rates were 50 percent higher for Blacks.Cancer death rates were 33 percent higher for Blacks.And - HIV death rates for Blacks were almost 700 percent higher than for Whites. Health, United States, 2000, DHHS, Center for Disease Control and Prevention, National Center for Health Statistics, July 2000 (Table 30).
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