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Dome - The call continues

January 2012

The call continues

Date: January 10, 2012

Charm City Clinic
As an institution, Johns Hopkins Medicine is deeply invested in the health of its community, working to eliminate heath care inequality through education, community outreach and research. As a volunteer, Hopkins medical student Ramy El-Diwany helps uninsured or underinsured residents like Sallie Lovelist, Leona Johnson and Stephon Hand find health care resources and access at the Charm City Clinic, a free clinic and health resource center in East Baltimore.

Fifty years after the Rev. Dr. Martin Luther King Jr. spoke out against racial inequalities and inspired a generation to work to end institutionalized discrimination, health care disparities that he called “shocking and inhumane,” still persist.

In Baltimore, blacks account for 90 percent of new HIV infections. High school-educated mothers have an infant mortality rate twice that of women with at least some college experience. Poverty, unemployment and threats to basic needs such as food and housing are pervasive in many neighborhoods, including some just steps from Hopkins’ East Baltimore campus. Perhaps most striking of all is the 20-year life-expectancy gap between some of the city’s wealthiest and poorest residents, with the most impoverished facing a lifespan comparable to that of people living in a Third World country.

As an institution, Johns Hopkins Medicine already is deeply invested in the health of its community, contributing nearly $65 million in charitable care in fiscal year 2010. It also is working to eliminate inequality through education, community outreach and research. “Why not have an institution that’s as equally committed to addressing health disparities as it is to delivering health care?” says Brian Gibbs, the school of medicine’s associate dean of the Office of Diversity and Cultural Competence.

Thanks to Hopkins programs like the Access Partnership, many lower-income Baltimore residents who are uninsured or underinsured are receiving specialty care from some of the country’s leading medical experts for a one-time fee of $20.

The Johns Hopkins Urban Health Residency Program is providing access to primary care for inner city patients while training future physician leaders to tackle challenges facing the urban poor.

Hopkins experts are addressing substance abuse, violence, mental health and other issues facing underserved minorities through a weekly radio show aimed at improving health awareness.

Researchers here are also making headway into discovering and finding solutions to health care disparities. In the 1970s, Hopkins anesthesiologist Lawrence Egbert looked at the way patients were being assigned to surgeons based on race. He examined several common and standardized surgical cases, such as gallbladder operations, conducted during the 1950s and 1960s at The Johns Hopkins Hospital. Egbert found that black patients were two to four times more likely than white patients to be operated on by residents, rather than by attending surgeons. This disparity, he noted, exposed black patients to more risk for complications and adverse outcomes because surgeons in training were less skilled attending surgeons.

In the most recent decade, more and more Hopkins researchers from many disciplines are studying health disparities.

Today, epidemiologist Lisa Cooper is looking at racial inequalities in hypertension while trauma surgeon Adil Haider seeks to understand why minorities are more apt to experience poor outcomes following emergency surgery. Internist and pediatrician Gail Daumit is working to reduce disparities in patients with severe mental illness.

Now, the Armstrong Institute for Patient Safety and Quality is dedicated to finding ways to ensure the safety of Hopkins patients—regardless of ethnicity, gender or socioeconomic status.

In the following three stories, we’ll explore some examples of how Hopkins is using education, outreach and research to honor King’s time-tested clarion call to address racial injustice in health care.

—Shannon Swiger