Racial and ethnic minorities in the United States (U.S.) experience death, disease, and disability at a far greater rate than U.S. white majority. Minority populations suffer from health disparities with 2-fold – 3-fold greater cases than the majority population of chronic, infectious diseases and disabling conditions (asthma, COPD, emphysema, diabetes, hypertension, strokes, heart attacks). According to the Health Resources and Service Administration, Office of Minority Health and the National Medical Association:
- Infant Mortality
- Maternal Fetal Mortality
- Cancer
- Heart Disease
- HIV / AIDS
- Diabetes
- COVID-19
- Substance Abuse – Tobacco, Alcohol, and Illicit Drugs.
The root causes of racial and ethnic disparities are complex and warrant analyses of an array of issues that fall under the umbrella of both individual racism and societal insurance coverage, etc.) as well as cultural practices. Nonetheless, to close the racial gap in the U.S., in April 2000 the U.S. Department of Health and Human Services (DHHS) and the American Public Health Association (APHA) announced their plan to partner and launch a national campaign. The National Medical Association has also been at the vanguard of dealing with health disparities, improving minority health, and capitalizing on Equity, Inclusion, and Diversity. This campaign is unique in that it addressed diverse issues that impact health such as housing, education, faith, and workplace conditions. The partnership aimed to implement a detailed comprehensive plan, redirect resources where necessary, and conduct an evaluation of its efforts.
It should be noted that before DHHS and APHA forces, both agencies were already involved in eliminating racial and ethnic disparities. The hallmark of DHHS’ commitment has been through its coordination of Healthy People 2010 and Healthy People 2020 – a national prevention in the country every ten years. Despite the national effort to tackle racial and ethnic inequalities in health, there remains a strong need for local commitment to substantially alleviate, if not eliminate the nation’s racial health gap problem.
The Department of Health and Human Services (DHHS) – CMS – Centers for Medicare, Medicaid, and CHIP 2022 Strategic Plan is to – “Serve the public as a trusted partner and steward, dedicated to advancing health equity, expanding coverage, and improving health outcomes.” The Strategic Pillars of CMS’ Plan are (1) Advance equity – Eliminate health disparities. (2) Expand Access – Via the Affordable Care Act. (3) Protect programs – The sustainability of the value-based person-centered care. (4) Engage Partners and communities, and (5) Foster excellence in the workplace. CMS policy initiatives are the most advantageous opportunity that America has had in improving the health of Americans since the passage of the Affordable Care Act of March 2010. CMS provides coverage for 150,000,000 million Americans.
In June of 2023, the United States Supreme Court ruled against Affirmative Action in colleges. The effects of this ruling have not yet been manifested. In 1996, when affirmative action in public post-secondary and graduate schools was abolished in California by Proposition 209 and Louisiana, Mississippi, and Texas by Hopwood vs. State of Texas, it did not take long for the nation to feel a harmful effect. Immediately following those decisions, the number of minorities applying and accepted into public colleges and graduate schools across the school was particularly catastrophic. Dr. David J. Skorton, MD, Association of American Medical Colleges (AAMC), president and CEO, stated that “the AAMC has seen a steady increase in applications and enrollment over the last several years as students considering a career in medicine continue to answer the call to service.”
Race and Ethnicity:
In 2015, data released by the AAMC showed that more Black men were applying and matriculating to medical school in 1978 than in 2014. July 1978 was the year that I entered medical school and as mentioned the number of Black men applying and matriculating in medical school has greatly declined. However, the Association of American Medical Colleges reported that diversity in medical schools increased. Black or African American students comprised 10% of matriculants in 2022-23. Up from 9.5% in 2020-21. First-year Black or African American men increased by 5%. Matriculants who are Hispanic, Latino, or of Spanish origin increased by 4%. Individuals from this group made up 12% of the total matriculants. American Indian or Alaska Native matriculants declined by 9%, comprising 1% of total matriculants. These trends, although promising, have to be monitored in the wake of the Supreme Court’s decision. We must not continue to rely on public or private majority-white health professions schools to educate our children. Our doctors, dentists, pharmacists, nurses, and mid-levels must grow.
Gender:
Women continued to make gains in 2022-23, making up 57% of applicants, 56% of matriculants, and 54% of the total enrollment. This is the fourth year in a row that women have made up most of these three groups.
Socioeconomic Status:
The data shows increased diversity in the socioeconomic status of matriculants, and accepters. Matriculants with a parent whose highest level of education was less than a bachelor’s degree or any degree with an occupation categorized as “service, clerical, skilled and unskilled” Dr. Goeffrey Young, PhD at the AAMC states reports, “That recent studies have shown that diverse health care and research teams improve health outcomes and can better identify and solve complex scientific problems. Racial and ethnic diversity in medical schools and in the health professional workforce are critical components in our nation’s response to health inequities and play important roles in the development of competencies for all physicians.”
“The Black Bag” is not about sticking students into a program for a summer or giving them an hour of tutoring after school for a year and no guidance afterward. It’s about forming sustainable relationships with young people from the moment their potential is recognized until they receive their medical, dental, or nursing degree.” March 2001.
Dr. Robert E. Dawson
Founder of the Black Bag Medicine Foundation
The “Black Bag” serves minorities at all levels of education – K through 12th grade, college, and health professions schools. Because students’ needs vary significantly at each level, the Foundation works collaboratively with educational institutions to implement age-appropriate programs and services tailored to address students’ unique needs. Through this “Pipeline Scholars Approach,” the Foundation directly provides or coordinates:
- Science and mathematics tutorials:
- Standardized test preparation and taking.
- Academic and career counseling.
- Public health education.
- Summer science camps.
- Placement into enrichment programs, and
- Community service projects to promote healthy behaviors among at-risk populations.
The goal is not simply to get students into health professions schools but to provide resources that enhance their chances of successfully getting out of those schools. Although the Foundation’s primary focus is on growing doctors, students interested in other health professions are given comparable assistance to those who are in pursuit of a career as a physician (i.e., dentists, physician assistants, nurses, nurse practitioners, pharmacists, social workers). The “Black Bag” hopes to create a forum in which professionals representing multiple disciplines can form partnerships to address minority underrepresentation in health careers.
