Hopkins medical providers, students and community advocates talk frankly about health disparities and how to combat them.
This feels very familiar, Charlotte Humphrey remembers thinking as the white doctor in the film spoke dismissively to the parent of a sick black child. This is why I’ve always felt I’ve had to protect and speak out for black folks who come to the hospital for care.
The Hopkins research nurse was among 300 health care workers, faculty, students and community advocates who gathered in January at the school of medicine to learn more about, and discuss, inequalities in medical treatment. The Deadliest Disease in America, the film that supplied the fuel for a series of workshops, highlighted differences in white providers’ attitudes towards black, white and Hispanic patients.
These portrayals triggered Humphrey’s memories of an episode that occurred in Baltimore when she was a child. After undergoing a tonsillectomy at the old Presbyterian Eye, Ear and Throat Hospital in 1962, she awoke to find herself in a dingy basement, unattended, with several other neglected black patients. What had happened to the bright, toy-filled pediatric ward she toured before her surgery?
“My first thought was that I had died and gone to hell, and I didn’t know why,” she says. Even more haunting was her realization that her mother and uncle were powerless to do anything about her situation.
After the film, Humphrey and others discussed similar episodes from the past, as well as forms of discrimination that persist—such as white providers who seem reluctant to touch people of color or who talk to them as if they were less intelligent than white patients.
Initiating such frank discussions was a goal of the program, says Brian Gibbs, associate dean for diversity and cultural competence. Like other events organized by his office, this presentation brought members of the East Baltimore neighborhood together with various groups on campus to ponder ways to improve health equity and access to care.
The Deadliest Disease in America was produced and directed by artist and filmmaker Crystal Emery. A documentary that explores the history of racism in health care, it illustrates today’s more subtle biases and classism through dramatizations of encounters between providers and patients. Developed by the nonprofit organization URU, The Right to Be Inc., the film has already aired at Yale University School of Medicine and will travel to other medical schools and community forums.
Cathy Handy, a third-year Hopkins medical student, praised a workshop that illustrated how difficult it can be for health care providers and patients to communicate effectively. She joined in an exercise in which participants closed their eyes and followed a facilitator’s instructions on folding and tearing a small sheet of paper.
“When we opened our eyes, we saw that everyone had different pieces of paper based on the same exact instructions,” Handy says. Moreover, when participants paired off to give and receive instructions one on one, the outcome was similar.
“It demonstrated how you’re not always as effective a communicator as you think — and that you don’t always understand someone when you assume that you do,” she says. “People in medical school often say they don’t know what they can do on a personal level to help change health disparities. One thing is to learn how effectively you communicate and how that impacts your patients.”
Other workshop topics included how to identify and report racism, and how community advocates can persuade legislators to address their concerns in health care reform. Participating groups from East Baltimore were the Esperanza Center, The Men’s Center, and The Transformation Team, a neighborhood-improvement group.
“Bringing in the community and responding to their concerns is one of several essential activities for this office,” Gibbs says. “We’re leveraging, leveraging, leveraging. Hopkins has tremendous resources that we haven’t figured out how to make as available to the community, and the community has tremendous resources that we often overlook.”
Another participating organization was the Black Mental Health Alliance for Education and Consultation Inc., a nonprofit in Baltimore that holds school-based programs on such topics as learning disorders and domestic violence, and also offers referrals to mental health providers.
Tracee Bryant, executive director of the Alliance, says the film increased awareness and sensitivity in providers of all backgrounds, expertise and cultures. “It’s a wonderful foundation for a rich, meaningful discourse.”
Humphrey also applauds such public conversations. She says that racial disparities in health care were seldom acknowledged, much less discussed, when she began work at Hopkins in 1992.
“These conversations are hard for everyone, but the dialogue has to happen,” she says. “As small as something like this event may seem, it is actually very big.”
Gibbs is working with colleagues at Johns Hopkins Bayview Medical Center to hold a similar program in the spring.
- Linell Smith