[1]Debra Groones was only 14 when racism was hitting her hard in Boston.
She recalls looking out of the bus window during daily trips to school, seeing white kids - and their parents - holding signs that read: "N-- [expletive], go home."
On other class days, she recounts, white students would intentionally pull the fire alarm so that when the black kids left the building, they would throw rocks and bricks at them.
Her past of 33 years ago is part of history books. But she still copes with a disguised form of racism when seeking health treatment.
Groones was diagnosed with breast cancer in 2004.
But before her diagnosis, she said, "I told the doctor I could feel it [a lump], I had something in my breast. All she said was: ‘Oh, this is probably nothing."
"I had to literally put [the doctor's] fingers where the lump was," Groones says.
Today, Groones serves as one of 11 ambassadors selected by Boston Mayor Tom Menino for Pink and Black, an advocacy project of the Boston Public Health Commission.
According to a Kaiser Foundation survey, 30 percent of African American and 35 percent of Latino patients have said they've been treated unfairly by a health provider. The number contrasts with that of white patients: only 1 in every 20 have the same complaint.
Last week, the MetroWest Community Health Care Foundation, a sponsor of EthnicNewz.org's health beat, held a health disparities forum to talk about why more African American infants die before reaching their first birthday.
The forum, held in Framingham, Mass., was based on a PBS series of seven documentaries titled "Unnatural Causes." Doctors and producers followed Kim Anderson, a pregnant Atlanta lawyer, who gave birth to her first child two-and-a-half months before the baby's due date despite being healthy, educated and having received medical care.
In Boston, a study shows that for African American households with an income of more than $35,000, infant mortality is 16.6 percent, compared with 11.2 for white households earning less than $10,000 a year.
"Here in Boston, we have more medical facilities than any other urban center in the country. But when life expectancy for a black man is six years less than for his white counterpart, and four years less for a black woman, something is wrong," says Barbara Ferrer, executive director of Boston Public Health Commission and the author of study, "Understanding Health Inequities in Boston."
Ferrer's study also looked into smoking habits of pregnant mothers, and the findings are stark, too. The infant mortality rate among babies born of African American non-smoker mothers is 13.2 percent, and 9.2 percent among babies of white smoker mothers.
Considering income levels, education and habits of their mothers, why are African American babies still more at risk of dying before 1 year of age than whites?
Here's the answer of the Boston Public Health Commission and the MetroWest Community Health Care Foundation: racism.
"Black people experience insults related to the color of their skin on a daily bases, small or major insults, but regularly. Think about racism as a chronic stressor," says Dr. Joseph R. Betancourt, director of the Disparities Solutions Center at the Massachusetts General Hospital.
"This is real. It's not something in someone's head. I am 56 years old, with a doctoral degree, and every time I go to Macy's there's a security guard following me," says Dr. Linda Bishop Hudson, vice president of community health for the New England division of the American Cancer Society.
As Dr. Hudson illustrated, racism targets patients as well as physicians. Dr. Anita Nartey is a physician born in Ghana, but trained at the MetroWest Medical Center.
She recalls a day when a patient called to make an appointment and was offered to be treated by her or by a white physician, and the patient chose the latter. But that doctor was not available on the day the patient needed, and Dr. Nartey was.
"Well, I saw the doctors' pictures in the newspaper. I don't want [Dr. Nartey] to know this, but I am prejudiced," the patient was reported as saying.
"I thought about it all day long. All that the Civil Rights movement seemed to have done is take segregation away. It didn't change the attitudes so much," Dr. Nartey says.
The Public Health Commission study also reveals that low birth weight is more predominant in babies of African Americans mothers born in the U.S. (15.1 percent) than in those of black mothers born in poor countries like Haiti (12.5) and Jamaica (10).
"We're talking about little things that happen every day, micro aggressions. Whether it's institutional racism, interpersonal racism or internal racism, each of those affect the issue of pregnancy outcomes," says Dr. Kermit Anthony Crawford, director of the Center for Multicultural Mental Health at Boston University.
"When you say racism, don't think of a major aspect. Because, while you can't address racism, you can tackle prejudice, oppression or violence," says Dr. Crawford, a North Carolina clinical psychologist.
For many in the medical field, one of the possible answers to combatting racism would be providing better training for students in medical school.
For Dr. Alice Coombs, an anesthesiologist at South Shore Hospital in Weymouth, the term cultural competency is still unknown for too many of the future generation of doctors.
She was on a panel that interviewed eight medical school applicants for scholarships. The question was: "Do you feel that your institutions give you enough training about cultural competency?"
"One said we should address plastic surgery needs for transvestites. Another talked about getting all religions more involved in health care. Not one mentioned racial and health disparities," said Dr. Coombs.
While there's no remedy for a past of oppression shared by patients and doctors, providers know that hospitals can't ignore the issue of health inequalities. In the PBS video, Dr. David Williams, a Harvard physician, said that "health is more than health care. It's education, housing and employment as well."
Dr. Edna Smith, chair of the MetroWest Workgroup to Eliminate Racial and Ethnic Health Disparities, knows too well that education plays a huge role in bridging the gap between the privileged and the underserved.
Even as a straight-A student she was rejected at the Nursing School of Children's Hospital in Boston.
"I picked the one college for me, and someone was telling me I should be a secretary," Dr. Smith says.
She graduated from Boston University but says she still has to worry about her grandchildren experiencing the same things.
"We have to work it out community by community, and the schools need to incorporate cultural competency in their curricula. There's a way to talk about race relations, and education is that way," she says.
Dr. Anita Nartey agrees that the conversation about race in this country has to be expanded.
"The only cure for racism starts in childhood. What your grandfather tells you, your parents, it all affects you. Whatever color we are in this room, we should start teaching our kids about cultural competency," concludes Dr. Nartey.
source: EthnicNewz.org
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