As a medical student at Duke, I was very active in the local branch of the SNMA, so I was thrilled to be invited to participate in the regional conference here in Boston. Now, I must admit that I was not their first choice for speaker. Who knows, I might not have even been their second or third choice. That being said, no words can express how pleased I was to be a stand-in for the honorable Dr. Louis Sullivan, former US Secretary of Health and Human Services under President George HW Bush.
The SNMA Region VII Conference included a community service event (bravo!) and had separate programs for high-school, pre-med and medical/professional students. The entire conference was chock-full of amazing speakers, Including Dr. Ronald Dunlap, President-elect of the Massachusetts Medical Society and Dr. Christopher Lathan, Faculty Director for Cancer Care Equity and medical oncologist extraordinaire at the Dana Farber Cancer Institute. And then there was me.
Instead of focusing on how on earth I ended up as keynote for this event, I decided to focus my remarks on the conference theme: Healing and Transforming Our Communities. The title clearly implies that there are problems that need to be solved; wounds that need to be healed; a transformation or change that is due – in short, something is wrong with "the community". How does one begin to diagnose an illness that affects an entire community? And more importantly, how does one develop strategies to begin the healing process?
Step one of problem solving is to identify and clearly articulate the problem. I like to use the analogy of those dreaded word problems in algebra – you know, where you are given a few sentences and tasked with developing an equation that succinctly and uniquely describes the word problem. Developing the equation is only the first step; you then must develop a strategy to actually solve the problem. However, if the written equation does not adequately describe the problem, then, irrespective of the elegance of the technique used to solve the equation, the answer derived will still be incorrect.
So it goes with the issue of healthcare disparities. The black community in the US is plagued by multiple health inequities, including higher rates of infant mortality, childhood asthma, obesity, heart disease, and cancer – just to name a few. How can we solve a problem that is of such epidemic proportion?
Any mountain is climed by taking one step at a time.
STEP#1: Identify the variables - all black peoples are not the same.
In the US, approximately 13% of the US population considers themselves part of the black race, yet among those ~40 million individuals, there is abundant diversity. Although the majority of black Americans are descendants of slaves (African-Americans) that were brought to these shores hundreds of years ago against their wishes, the black race in the US has become more ethnically diverse. Since the 1970s the US population has been bolstered by a growing number of West Indian immigrants hailing from a variety of countries including Jamaica, Haiti, Trinidad and Tobago, Barbados, etc. More recently, there has been an influx of sub-Saharan African immigrants to the US.
So when writing the "equation" that outlines healthcare disparities in the black community it is critically important to keep the diverse nature of the population in mind. To develop an appropriate solution to the problem, ALL of the variables must be included in the equation.
One drop of knowledge can ripple through an entire community ~