Most Medical Professionals Aren’t Racist — But Our Medical System IsRoundup
tags: racism, public health, medical history
Ella St George Carey is a graduate student at the University of Oxford. She works on African American women’s and labor history with an emphasis on healthcare practitioners and practices.
Evidence has emerged that doctors are less likely to refer African Americans for testing for covid-19 when they exhibit symptoms. This reluctance to give black patients adequate care isn’t just a case of individual bias, or nefarious intent. Rather, it is a symptom of the broken system, over a century in the making, in which American hospitals operate and medical personnel are trained and educated.
The Crisis, the publication arm of the National Association for Advancement of Colored People, first raised the issue of racialized medical malfeasance in 1913 with its investigation into Harlem Hospital. The situation persisted at Harlem throughout the 1910s, exacerbated by staffing shortages brought about by the First World War and proved so dire that a popular saying arose among black Harlemites; “when any member of your family goes to Harlem Hospital, telephone the undertaker.” Eventually in 1922 the NAACP, along with others, were able to apply adequate pressure to New York Mayor James Hylan to commission hearings into the hospital’s conduct.
The findings from the Hylan Commission investigation make for difficult reading. In one particularly chilling account, which subsequently featured prominently in many black newspapers, a mother testified to finding maggots in Thomas, her 11-year-old son’s, open wounds, while he was a patient at Harlem Hospital. Thomas subsequently died there and Mrs. Miller testified that, before his death, “[My] boy was neglected in every way.”
The NAACP hoped the investigation would increase the hiring of more black doctors and nurses in Harlem so the hospital’s staff better reflected the makeup of its patients. They were at least somewhat successful. Partially as a result of damning testimony like Mrs. Miller’s, the Hylan hearings resulted in substantive changes at Harlem Hospital. Black Red Cross nurses were permitted to work at the hospital for the first time, the hospital’s Board of Managers promised to hire black graduate nurses and four new black doctors were appointed to the staff.
The implicit argument was that greater diversity among health-care workers would improve medical outcomes among communities of color, avoiding future instances of the neglect such as that suffered by Thomas Miller.
But there was a flaw in this thinking. These changes didn’t address the way in which racist ideas permeated medical training for how to treat black patients — even when those patients were fellow medical practitioners.
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