When the initial data began to come in about the populations most impacted by COVID-19, Dr. Thea James says she wasn’t surprised to see that Black Americans were suffering from higher rates of infection and death. “I remember before the data came out, feeling so anxious about it because I knew what it was going to show. It was textbook. The majority of patients came from communities that were historically behind red lines, with a high school education or less, with comorbidities – these were people in their mid-40s, so much pointed to so many other things like people with lower income and lower education having lower health status,” said Dr. James at our Community Meeting, Health Care Disparities: What Can We Do About It?, on February 16, 2021.
The meeting, led by Father Peter Gyves, SJ MD, welcomed:
• Margarita Alegría, PhD, the Chief of the Disparities Research Unit at the Massachusetts General Hospital
• Dr. Thea L. James, Associate Professor of Emergency Medicine at Boston Medical Center/Boston University School of Medicine
• María Rosario González Albuixech, the Director of Communications and Immigrant Health at Health Care For All
The panelists talked about the stark realities of systemic racism in our health care system, how it evolved, and what can be done about it. The panelists encouraged attendees to look deeper than the disparities we see in the data today to understand the systemic failures that have caused them. “Disparities are the flowers, not the roots,” said Dr. James. The conversation began with a discussion about how disparities have evolved from deep-seated racism over time, referencing redlining policies that continue to impact Black homeownership and wealth accumulation today.
“I won’t use terms like vulnerable and weak. They are neither. They are underserved and underrepresented,” said Albuixech, in a conversation about how to talk about disparities. “Health outcomes are a result of the racism we’ve seen, but we have the power to change social determinants of health.”
To achieve change, the panelists talked about individual and collective action. They focused on changing the narrative to ask why these disparities exist and work towards fixing the root cause and encouraged attendees to become involved in holding their communities to a higher standard.
“It is the importance of civic engagement and civic leadership. We let ourselves down by not engaging in what is happening in our communities,” said Alegría. “We need to engage in more of a social movement if we want organizational change. Healthcare, criminal justice, education, housing. They are all part of the equation as to why we are doing so poorly.”
Each panelist offered advice as to what we can each do as individuals:
“I am a big believer in social cohesion and social interaction, I believe in talking not to the choir but talking to people with opposite positions and having a dialogue that shares ideas both ways. Fear is modifiable. Dialogue is important. Socialize, change the narrative. Visit people in other communities. Interact by making that human connection.” – Margarita Alegría, PhD
“Look inside and ask ‘what is your narrative and what about that are you willing to change?’ Even if you see something you don’t like. Then I would say, I’m biased towards alternating life course trajectory. Focus on economic mobility. If you are a person who can do that, if you are a business owner – what are your hiring practices, what are your policies, what can you do that will give a person an opportunity to alter their life course? Offer mentoring and don’t set low bars. When you set the bar low it is a self-fulfilling prophecy. I tell my medical students – ask yourself what you’d do for yourself and your family, then choose the right thing.” – Dr. Thea L. James
“We have the power to change things. Prescription drugs are out of touch, people can’t afford their medical bills, they don’t have access to mental health. We can change the system long term. Advocate, call your religious leaders. Your voice is your power.” – María Rosario González Albuixech
Father Peter closed the discussion with a reminder that our country has a ways to go on healthcare and social issues, and that to end racism in our country will require the elimination of white privilege.
To learn more about what you can do to change the course of health disparities in America, attend our workshop, Be an Agent of Change: Achieve Health Justice, on March 23, 2021. To watch the Community Meeting discussion in full, visit our YouTube page.