CNN
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When Charmain Jackman and her husband decided to see a couple’s counselor, they had a list of criteria. As a Black psychologist of Barbadian descent, Jackman knew she was looking for a therapist of color who had experience working with couples. The search, however, proved to be more challenging than she expected.
“We wanted someone who understood our culture,” Jackman told CNN. “We didn’t want to explain our family or immigrant experience.”
Ultimately, Jackman said their therapist ended up being a White, Jewish woman because they struggled to find a therapist of color.
Nationally, only about 4% of psychologists identify as Black or African American.
“We’re like a needle in the haystack,” Jackman said.
But she continued searching and after nine months, she finally found a Black therapist. Jackman said the long search became her impetus for starting a new company.
In 2020 she launched Innopsych, an online directory of therapists of color. The company aims to shift how people of color view therapy by making it easier for them to find a therapist who understands them.
Jackman said the company’s efforts highlight a broader issue within the health care system: a lack of diversity among medical professionals can impact patients and their outcomes.
“People are often coming in for therapy much later, when things are more severe, which means needing more intensive and invasive treatment options,” Jackman told CNN. “But I also know it could be deadly if people don’t get the care that they need.”
‘I just want to make sure I’m listened to’
In the United States, Black newborns die at three times the rate of White newborns, but a 2020 study published in the Proceedings of the National Academy of Sciences found that Black infants are more likely to survive if they are being treated by a Black physician, according to previous CNN reporting.
Black men and women are far more likely to die from HIV than their White counterparts, partly due to limited access to effective antiretroviral therapies, according to the US Department of Health and Human services. A study in the Journal of General Internal Medicine found that Black patients received HIV therapies significantly later when treated by White providers, compared to those treated by Black provider, or when White patients treated by White providers.
And 60% of Black adults in a recent survey said they prepare for medical visits by expecting insults from health care workers.
For Dr. Uché Blackstock, a physician and thought leader on racism in the health care industry, such disparities highlight the need to address systemic racism and to increase representation among physicians of color.
But only about 5.7% of medical physicians identify as Black or African American, according to the Association of American Medical Colleges.
To increase representation, Blackstock said we also must address the barriers that prevent people of color from becoming physicians in the first place, such as racism, microaggressions and access to education.
After 10 years in academic medicine, Blackstock told CNN she left her job in 2019 because she “felt so undervalued and underappreciated as a Black woman physician.” That same year she founded Advancing Health Equity with the goal of partnering with health care organizations to dismantle racism in health care and to close the gap in racial health inequities.
AHE performs racial equity assessments and evaluations for health care programs and organizations. The organization also offers coaching for health care leaders to ensure they incorporate a health equity lens in their work.
Blackstock later authored a bestselling book that explores the legacy of racism in America’s health care system. She said one of the issues exacerbating racial inequity in health care is the lasting impact of deep-rooted racism in medical education.
She estimates “between 25,000 and 30,000” Black physicians could have been trained at historically Black colleges, but a 1910 report that evaluated their programs against European standards forced most of the schools to close.
Blackstock said many of the schools failed to meet the criteria outlined in the report, which was commissioned by the American Medical Association, because of racism and years of inequality led to a lack of resources.
Although she founded AHE in 2019, Blackstock noted that interest in her company and its DEI work increased significantly in 2020.
“In 2020 when Black Lives Matter happened and the pandemic started, a lot of health care organizations were recognizing that they needed to increase their capacity to address racial health inequities,” said Dr. Blackstock.
The pandemic also exposed wider disparities in our health care system that made it more likely that communities of color would be impacted by Covid-19. According to a study published in the Annals of Internal Medicine, excess deaths by population were three to four times higher among Black and American Indian/Alaska Native men and women compared with White men and women early on in the pandemic.
Blackstock recalls a time when she walked into a patient’s room covered head to toe in PPE during the height of the pandemic.
Her patient was a young Black woman who had been diagnosed with Covid-19 a few weeks prior and was experiencing shortness of breath.
“At that time, there was so much we didn’t know,” Blackstock told CNN. “Literally almost every bit of myself was covered.”
After she introduced herself, Blackstock said the patient asked a question of the utmost importance: “Are you Black?”
“Yeah, of course I am,” she said she responded.
“She just let out this deep breath and said, ‘Thank you. I just want to make sure that I’m listened to.’”
Helping physicians thrive
When Jaines Andrades started working at Baystate Medical in Springfield, Massachusetts, she was a janitor. But she worked her way through nursing school, and ten years later she returned to the hospital as a nurse practitioner.
Now she advocates for increasing diversity in health care. In May, Andrades testified during a Senate committee hearing on the shortage of minority health care professionals and the maternal mortality crisis among minority women.
Andrades spoke about her own experiences and told the committee she feels “robust college and career planning is very critical” to improving diversity in health care.
“Letting students know it is within their reach and that there are resources available to them to embark on their journey to higher education is key,” Andrades said during the hearing.
On Tuesday, Bloomberg Philanthropies announced a historic $600 million gift to the endowments of four historically Black medical schools.
The donation, one of the largest ever to historically Black colleges and universities, includes $175 million each for Howard University College of Medicine, Meharry Medical College, and Morehouse School of Medicine.
Charles Drew University of Medicine & Science will receive $75 million, while Xavier University of Louisiana, which is opening a new medical school, will receive a $5 million grant, according to previous CNN reporting.
Without continued financial investment, Andrades told CNN these programs are unlikely to succeed.
“We can have all of the best intentions and we can develop all of these different programs, but if they’re not funded, they don’t go anywhere,” she said. “One of the main ways to bridge the gap is to make it financially feasible for people to go to school.”
That also includes ensuring that all students – but especially those from low-income backgrounds – have their basic needs met, Andrades said.
“If you don’t have shelter, food, water, getting an education is not on your list of priorities.”
Andrades recommends investing federal funds in mentorship and programs such as Baystate Springfield Educational Partnership (BSEP), which offers high school students with opportunities to explore different careers and prepare for potential internship or employment opportunities. Many former BSEP students now work as health care professionals at Baystate Health in Springfield, MA, Andrades said.
“I believe federal support for programs like this could lead to many more minority students embarking on prosperous careers in health care,” Andrades told the committee in May.
She later told CNN creating supportive environments is also critical for retention.
“There’s a sense of relief that you see in a patient’s face when they see someone who looks like them, or when you speak their language,” Andrades added. “It’s just a pure sense of relief.”
Although some lawmakers and critics have taken aim at programs to increase diversity in higher education and business in recent years, Blackstock said there’s still an interest in her organization’s work.
“Fortunately, even despite the backlash… we still have a lot of interest from organizations in health that want to do equity work,” she said.
Blackstock said “pathway” programs are just one piece of the larger puzzle.
“How do we make sure that in medical school, residency, and faculty positions, the leadership of these organizations are prioritizing environments where Black physicians and health professionals can thrive, not just survive?” she said.