“Of all the forms of inequality, injustice in health is the most shocking and the most inhuman because it often results in physical death.”
— Martin Luther King Jr., 1966
More than a half century after King uttered those famous words prior to a convention of the Medical Committee for Human Rights, we continue to see injustices in health care and inequality in health outcomes. We have long witnessed disproportionate burdens among minority populations for diseases and conditions such as cancer and diabetes.
Now the COVID-19 pandemic is continuing to shine a light on health care disparities as Black and brown individuals disproportionally die due to complications from COVID-19.
During 2020, we saw the impact of systemic racism as we witnessed the killings of Ahmaud Arbery and George Floyd and also mourned — and questioned — the deaths of Breonna Taylor, Rayshard Brooks and others. We have seen Black men targeted because of perceived potential to inflict harm by their mere presence as they bird watch or wait for their dad at a hotel gift shop.
Black women are often labeled as “angry” when they speak up. Black physician Susan Moore, M.D., alleged in a video on social media that white doctors and nurses undertreated her pain and ignored her symptoms while she was hospitalized with COVID-19. After the hospital discharged her on Dec. 7, she had to be taken to a different facility 12 hours later.
Moore, a 52-year-old family physician from Carmel, Ind., died due to complications from COVID-19 less than two weeks later.
The hospital system that initially treated Moore pledged to address racial equity in its facilities after her death but also faced significant backlash for a portion of the same statement that said its nursing staff “may have been intimidated by a knowledgeable patient who was using social media to voice her concerns and critique the care they were delivering.”
Black women face systemic racism in many facets of our lives. Tragically, the U.S. health system Moore was so proud to be a part of failed her in the end.
Research has shown that Black Americans like Moore are undertreated for pain compared to white patients. Unfortunately, that is just one example of the health disparities that continue to affect patient care across the country.
As family physicians, we are uniquely positioned to raise awareness about health disparities and help address the social determinants of health for our patients. The AAFP is dedicated to addressing both health disparities and systemic racism. Our work on these important issues predate the public health emergency of COVID-19 and the killing of George Floyd. Our Center for Diversity and Health Equity launched in 2017, and its success has been the gold standard that many other organizations are using as a guide. The Academy is committed to eliminating institutional racism, and we are putting our words into action through tools such as the EveryONE Project’s Implicit Bias Training Guide and Neighborhood Navigator. These and other tools provided through the AAFP can help us recognize and address our unconscious biases, identify our patients’ social needs and connect them to resources, and raise awareness of underlying drivers of health disparities.
We must continue to fight for our patients and our colleagues. COVID-19 continues to plague our communities, but we now have a dim light at the end of the tunnel that needs to turn bright as each and every one of our patients receive their COVID-19 vaccine. We must continue to make sure that Black and brown communities no longer fear the health care system that for too long treated them differently. We must advocate for those who are in pain and request pain medication. We have to continue to fight for birth equity for Black and brown mothers and babies. We have to continue to be a voice to fight for health equity for all.
The tragic death of one of our own reinforces that we can’t be patient and wait for society to change. Dr. Moore was not an “angry black woman.” She was a physician and a patient. If Black physicians cannot use our medical knowledge to effectively advocate for our own care, what does that say about the chances of the average minority patient being able to receive fair and equal treatment? We must act now!
Ada Stewart, M.D., is president of the AAFP.