The killing of George Floyd renewed the anthem “Black Lives Matter”. Anti-Black racism impacts every aspect of life in America. The trauma experienced by Blacks in this nation has resulted in poorer health outcomes due to a greater burden of disease caused by stress and reduced access to care due to systemic barriers and provider bias. These issues and more were outlined in a recent
journal article
explaining “Why Racial Justice Matters in Radiation Oncology”. For those unaware of how racism impacts health, a few suggested readings help close the knowledge gap. Concrete steps to reduce racism at the personal and institutional levels are provided.
A more diverse oncology workforce will help ensure access to high-quality care and greater opportunities to participate in life-extending clinical research for minority patients with cancer, both of which are needed to address the persistent disparities in treatment options and health outcomes. We need to be out in our communities talking about the work that we do and encouraging individuals, students and trainees to consider a career in oncology. But our institutions must first work to create an inclusive environment, one that condemns racism in all forms.
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Dr. William Blackstock, Chair of Radiation Oncology, attending his daughter Ansley’s class to educate diverse students about being a physician. Cultivating the pipeline for workforce diversity.
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Workforce Diversity in Medicine Matters
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As the subjects of racial equity and justice dominate the headlines, now more than ever, it is essential that the health care workforce is representative of the nation. Racial and ethnic minorities are projected to account for more than half of the US population by 2050. Current estimates for new cancer cases in the US will increase by 45% in the next ten years, likely affecting older adults and minority populations. The changing landscape in our country’s demographics and longstanding health disparities, which are exemplified in disproportionate infection rates of minorities with COVID-19, all highlight the need for the health care workforce to reflect the diversity of the population they serve.
Research shows that a more racially and ethnically diverse physician workforce is essential to improving the adverse health outcomes of minority populations, increasing patient satisfaction, and expanding the understanding of health disparities. Despite this data, although more than 25% of the US population is black and Hispanic but, they make up only 9% of the physician workforce. In oncology, the gap is even wider with only 2% of oncologists self-identifying as black or African-American and 3% as Hispanic. Workforce diversity also stresses gender equity. In 2018, the American Association of Medical Colleges revealed 64% of physicians were male and only 36% were women (US population: 51% women and 49% male). Heart disease is the number one killer of women yet, only 13% of physicians nationwide are cardiologists and 4.5% of practicing interventional cardiologists are women.
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As recent tragedies have highlighted, it is imperative we are committed to inclusion, racial equity, and embracing diversity
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Black, Hispanic and Asian physicians play a pivotal role in providing health care for the underserved. They care for 54% of minority or underserved patients and 70% of non-English speaking patients. They are also 1.5 to 2 times as likely to care for low-income patients and 2 to 4 times more likely to treat patients on Medicaid. Recent studies show that patient satisfaction and health outcomes are improved when health providers and their patients are culturally and linguistically concordant. Diversity in the physician workforce engenders trust and comfort in patients which can translate to improved clinical oncology care in underserved communities.
Cultural sensitivity, or having respect and awareness of the cultural difference and similarities that exist between people, is essential in health care systems and its workforce. Cultural sensitivity requires a set of skills that allows an individual to understand and learn about people whose cultural background differs from theirs. These skills allow medical professionals to provide quality patient care that is rooted in trust. A diverse workforce and culturally sensitive care from all providers can truly facilitate understanding, enhance communication, improve quality of care, and ultimately improve health outcomes. Providing a career path for those currently underrepresented in medicine, educating the current workforce about implicit bias, and promoting culturally competent care can all serve as effective strategies in the fight for equity.
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Student National Medical Association
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In oncology, individuals from populations historically underrepresented in medicine overall are even more underrepresented within this specialty. Organizations like the Student Medical Association (SNMA) and others across the medical community are working to increase workforce diversity. The SNMA exists to:
- Support current and future underrepresented minority medical students, with a focus on black/African American students.
- Address the needs of underserved communities.
- Increase the number of clinically excellent, culturally competent and socially conscious physicians.
The Wake Forest School of Medicine’s (WFSM) SNMA Chapter is dedicated to the fulfillment of this mission through educational events, networking opportunities and hands-on exposure to medicine. Importantly, WFSM’s chapter is committed to promoting diversity within the medical school and works with admissions to promote a favorable and welcoming atmosphere for potential students, and to recognize underrepresented graduates. For more information on the SNMA, visit
https://snma.org/
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Training for Health Professionals to Integrate Racial Equity into Practice
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The Public Health Foundation, an independent non-profit organization based in Washington, DC, recognizes the impacts that institutionalized racism has on health outcomes. Since health professionals have the power to impact, pursue, and achieve health equity, they have made the following trainings (1 hour each) available for free through their TRAIN Learning Network:
https://bit.ly/2zB0hoS
- Achieving Health Equity- Tools for a National Campaign Against Racism
- Health Equity and Environmental Justice 101 Training
- Segregation Stress Syndrome: From Emmett Till to Trayvon Martin
- Working Across Government to Advance Health and Racial Equity
- #NYCHealthEquity- Advancing Racial and Social Justice
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Meet Our Population Health Navigator:
Alexis Daniels, MS
Alexis Daniels is a Population Health Navigator in the Office of Cancer Health Equity. In her role, Alexis helps African American cancer patients navigate through the medical system in a culturally competent manner, providing individualized assistance to patients, their families, and caregivers. She also serves as a community liaison and works closely with community-based organizations and churches to address community and educational needs. Alexis has 15 years of experience in human services which includes mental health, law enforcement, counseling, case management and advocacy. She received her MS and BS in Criminal Justice from Grambling State University. Together with the Hispanic and Rural Population Health Navigators, they form a team that exemplifies providing culturally sensitive and linguistically concordant care.
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Follow us on social media!
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The Office of Cancer Health Equity Team
Director: Karen Winkfield, MD, PhD
Assistant Director: Kathryn Weaver, PhD, MPH
Program Manager: Carla Strom, MLA
Hispanic Patient Navigator: Maria Alejandra Combs, JD, OPN-CG
Rural Patient Navigator: Emily Britt, MSW
African American Navigator: Alexis Daniels, MS
Community Health Educator: Aeriel Diaz, BA, CHES
Community Research Coordinator: Kelsey Shore, CCRC
Community Outreach Coordinator:Elias Berhanu, MPH
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E:CancerEquity@wakehealth.edu
P: 336-713-3665
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