Local examines racism in health care

The seeds of national change to combat racism may be growing in a cozy dwelling on Pendleton Street.

While racism has been, and continues to be, a pressing issue in New Haven and beyond, local documentary filmmaker Crystal Emery said there are underlying elements of racism in everyday life. Emery is currently filming “Disparities in American Health Care: The Audacity of Hope” — a firsthand look into the realities of racism in health care.

The issue is of national importance, but it has effects on a local level here on Yale’s campus, especially given the diversity of the student population, Emery said.

Emery set out to create the documentary in respone to her own experiences, she said. As a black woman confined to a wheelchair, Emery said people make assumptions about her even before she has a chance to speak.

“I face disparities in health care everyday,” she said. “I’m a black woman in a wheelchair with a chronic disease. I have to fight for my Medicare prescriptions. I have to fight for the right to exist.”

But Emery’s personal notion of discrimination in health care is not a unique experience — research shows that differential treatment along racial and ethnic lines is commonplace throughout the United States.

Patricia Baker, president and CEO of the Connecticut Health Foundation, said a growing body of research indicates the prevalence of unequal treatment for people of color in the healthcare system.

“This is true when you control for economics, education and insurance coverage,” Baker said. “That means that the Yale student that happens to be a person of color that presents at the Emergency Room — they’re African-American or Latino — very possibly could be treated in a fundamentally different way than their white roommate.”

Baker emphasized the relevance of racism and its numerous implications for the Yale community. As a leading institution responsible for producing the next generation of doctors, the Yale School of Medicine has a significant responsibility in helping counteract unequal treatment in health care, Baker said.

“How do you promote cultural confidence and linguistic confidence, not only in terms of the healthcare delivery system, but in our institutions?” Baker said. “Yale produces that workforce, Yale produces those leaders … In the medical school, how are they embedding that sensitivity and cultural awareness in the right workforce for the future?”

But Yale’s diverse course offerings may have a unique advantage in preparing future doctors to combat inadvertent racism.

The School of Management’s MD/MBA program combines clinical experience and managerial expertise in its curriculum. Howard Forman, director of the program, said the additional dimension of management training adds to any doctor’s ability to deal with problems like those in the healthcare system.

“At first, you might only see [racism in health care] as an issue of social justice or … an issue of sociology,” Forman said. “I think that by bringing in additional training in management, the students identify the fact that there are deeper issues at work … Sometimes when you consider things from a different perspective, from a manager and leader, you can root out additional causes for these disparities and this lack of high quality healthcare delivery and access.”

Forman said the School of Management is perfectly positioned to provide the skills needed to “root out the inefficiencies that exist,” helping doctors effect change in the healthcare enterprise from a fresh perspective.

Consciously increasing the presence of underrepresented minorities — such as Native Americans and Latinos — in the faculty is another way for Yale to combat racism’s perversion of health care, Baker said.

The core issue, Emery said, is Americans’ entrenched view of race, which filters down to the individual level. Even Yale students are not immune, she said.

“There’s a lot of intellectual masturbation around the issues of disparities,” Emery said. “People don’t want to look at the real cause, which really is racism. They utilize the color of someone’s skin to define that pecking order. Everybody, I believe, is a racist — you have to be to live in America.”

The February 24, 1999 edition of ABC’s Nightline news program covered a New England Journal of Medicine study that found a consistent, racial bias in doctors. Controlling for other factors, the study suggested, white patients were consistently offered better treatment options than their black counterparts.

In 2002, the Institute of Medicine released a congressionally sponsored report entitled “Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care.” The results confirm those of the 1999 study and the personal experiences of individuals like Emery.

Alan Nelson, former president of the American Medical Association, chaired the committee that wrote up the 2002 study.

“Disparities in the health care delivered to racial and ethnic minorities are real and are associated with worse outcomes in many cases, which is unacceptable,” Nelson said in a press release. “The real challenge lies not in debating whether disparities exist, because the evidence is overwhelming, but in developing and implementing strategies to reduce and eliminate them.”

The committee agreed that increasing awareness was the key first step in combating the racial bias ingrained in the health care-delivery system. In pursuit of this goal, Emery started work on her documentary in April 2007 and, most recently, hosted open discussion forums last month in New Haven and Hartford.

“This documentary is to give voice to people and experiences that usually do not get heard,” Emery said. “Even in the debate among public speakers, academics, it is very rare that you see a black person, that you hear a Hispanic’s voice. It’s even rarer to see an Asian.”

But Emery said the impact of her documentary will not stop with health care. Emery said she decided to use these issues as a vehicle to breach the topic of racism on other fronts as well, such as in education and housing.

“This documentary is part of a wave of energies that will eventually eliminate racism, not just in health care, but in the world,” she said. “As the wave builds, it moves forward: I’m not the only person out there on the front line in this battle on health care. There are many wonderful doctors who are on the frontline everyday, and they no longer turn the cheek or other eye.”

Once it is finished, Emery plans to present the documentary at film festivals nationwide, she said.

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