Black Doctors Work to Make Coronavirus Testing More Equitable

Editor’s note: Find the latest COVID-19 news and guidance in Medscape’s Coronavirus Resource Center.

When the coronavirus arrived in Philadelphia in March, Dr. Ala Stanford hunkered down at home with her husband and kids. A pediatric surgeon with a private practice, she has staff privileges at a few suburban Philadelphia hospitals. For weeks, most of her usual procedures and patient visits were canceled. So she found herself, like a lot of people, spending the days in her pajamas, glued to the TV.

And then, at the beginning of April, she started seeing media reports indicating that Black people were contracting the coronavirus and dying from COVID-19 at greater rates than other demographic groups.

“It just hit me like, what is going on?” said Stanford.

At the same time, she started hearing from Black friends who couldn’t get tested because they didn’t have a doctor’s referral or didn’t meet the testing criteria. In April, there were shortages of coronavirus tests in numerous locations across the country, but Stanford decided to call around to the hospitals where she works to learn more about why people were being turned away.

One explanation she heard was that a doctor had to sign on to be the “physician of record” for anyone seeking a test. In a siloed health system, it could be complicated to sort out the logistics of who would communicate test results to patients. And, in an effort to protect health care workers from being exposed to the virus, some test sites wouldn’t let people without cars simply walk up to the test site.

Stanford knew African Americans were less likely to have primary care physicians than white Americans, and more likely to rely on public transportation. She just couldn’t square all that with the disproportionate infection rates for Black people she was seeing on the news.

“All these reasons in my mind were barriers and excuses,” she said. “And, in essence, I decided in that moment we were going to test the city of Philadelphia.”



Dr Ala Stanford and her staff on duty a coronavirus testing site in Pennsylvania. Stanford created the Black Doctors COVID-19 Consortium and sends mobile test units into neighborhoods.

Black Philadelphians contract the coronavirus at a rate nearly twice that of their white counterparts. They also are more likely to have severe cases of the virus: African Americans make up 44% of Philadelphians but 55% of those hospitalized for COVID-19.

Black Philadelphians are more likely to work jobs that can’t be performed at home, putting them at a greater risk of exposure. In the city’s jails, sanitation and transportation departments, workers are predominantly Black, and as the pandemic progressed they contracted COVID-19 at high rates.

The increased severity of illness among African Americans may also be due in part to underlying health conditions more prevalent among Black people, but Stanford maintains that unequal access to health care is the greatest driver of the disparity.

“When an elderly funeral home director in West Philly tries to get tested

The First Black Dentist in Texas

Marcellus Cooper was born into slavery, in Dallas, on February 12, 1862. His mother was Black, his father was White, and his owners were the Caruth family. He went to grade school in a freedman’s town in what is now Lake Highlands. He was the treasurer of a Black library association and worked in a Jewish-owned department store while saving money for dentistry school. He opened a practice in a sanitarium operated by Texas’ first Black surgeon before moving to a building designed by Texas’ first Black architect.

Now, 91 years after his death, Cooper is set to get a historical marker on land that once belonged to his former owners.    

In the 1860s, John Caruth and his Confederate veteran sons, William and Walter, were one of the largest slave-holding families in Dallas. Cooper was born a slave on their plantation to Sallie Lively, also a slave, and a White man, also named M.C. Cooper. Less than one year after Cooper’s birth, on January 1, 1863, slaves in Texas were freed de jure, but they wouldn’t be freed de facto until June 19, 1865. The Caruths’ former slaves spread out, forced by vagrancy laws to form freedman’s towns such as Upper White Rock, in present-day Addison, and the Fields Community, in present-day Merriman Park. Cooper commenced school in Little Egypt, a freedman’s town in present-day Lake Highlands, but moved with his father to Springfield, Missouri, where he completed high school.

Cooper returned to Dallas after high school and hired on at Sanger Brothers Department Store. By January 1888, Cooper was serving as the treasurer of the Lincoln Library Association. Although records of the association are sparse, a January 31, 1888, Dallas Morning News article reported that “the best element of the colored people [who attended its events] spoke highly of the enterprise, and said that if the colored people are to be elevated it must be through the means of those intellectual and financial levers which have served in elevating other races.”

By 1891, after working for 11 years in the Sanger Brothers wholesale department, Cooper had saved sufficient funds to study dentistry at Meharry Medical College, in Nashville, Tennessee, the first medical school in the South for Blacks. A lack of records leaves us imagining why he chose that field and why he left what was presumably a good job where he was beloved. But news of his move was big enough that the paper covered it. “On the eve of his departure for Nashville,” the News reported on September 29, 1891, Sanger Brothers’ Black employees presented him with a gold-headed cane “in token of their appreciation.”

Dr. Cooper returned to Dallas in 1896, after finishing dental school, and opened an office on Commerce Street.


It is startling to think about what Cooper was able to accomplish, given the fierce racism he faced during the three decades he lived in Dallas after earning his doctorate. In addition to the use of vagrancy laws to force Black people into isolated

Personal resilience plays big part in heart health for Black Americans

Black people who have a strong sense of psychological well-being may have better heart health, a new study indicates.

It suggests that feelings of optimism and a sense of purpose and control — hallmarks of psychosocial resilience — are more important to heart health than where people live, researchers said.

Lead researcher Tené Lewis, an associate professor at Emory University’s Rollins School of Public Health in Atlanta, noted that differences in heart health between Black and White Americans have been documented for decades. But individual factors affecting Black Americans have not been well understood.

“Almost everything we know about Black Americans and their health focuses on deficits, yet we really need to begin to identify strengths,” she said. “Understanding which strengths matter most for Black Americans — and under which contexts — will allow us to develop the most appropriate and applicable public health interventions for this group.”

For the study, the researchers recruited nearly 400 Black volunteers between the ages of 30 and 70. They investigated whether the American Heart Association’s Life’s Simple 7 metrics were linked to better heart health among them. The seven measures include smoking, physical activity, diet, weight, blood sugar, cholesterol and blood pressure.

Participants also completed standard questionnaires gauging their psychosocial health.

This information was then compared with neighborhood data on heart disease and stroke and death rates.

In neighborhoods with high rates of heart disease and stroke, Black adults with higher psychosocial resilience had a 12.5% lower risk of heart disease than those who were less resilient, the researchers found.
The findings were published Oct. 7 in the journal Circulation: Cardiovascular Quality and Outcomes.

“We assumed that being both high on psychosocial resilience and living in a resilient neighborhood would be the most beneficial for cardiovascular health, yet what we found was that psychosocial resilience demonstrated the most robust association regardless of the neighborhood resilience measure,” Lewis said in a journal news release.

She said more studies like this one are needed to fully understand and respond to factors that promote better health for Black Americans.

More information

For more on mental health and heart health, head to the American Heart Association.

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Black children twice as likely to die after surgery than White children

Black children are more than twice as likely as White kids to die from surgical complications, and minority children are about half as likely to even have surgery as white children, two new studies show.

In one study, researchers found that of nearly 277,000 children who had inpatient surgery between 2012 and 2017, 10,425 suffered a complication that required follow-up surgery and 209 subsequently died.

Of those deaths, 135 patients were White — 1.6% of all White children who suffered a complication — and 74 were Black — 3.7% of all Black children who suffered a complication.

“We don’t fully understand all of the issues that place a Black child at greater risk and how all of these issues interact with each other,” said study author Dr. Brittany Willer, a pediatric anesthesiologist at Nationwide Children’s Hospital, in Columbus, Ohio.

“Our study gives physician anesthesiologists and surgeons insight into those at highest risk, to heighten their awareness of the most vulnerable patients during the early postoperative period, which may have the biggest immediate impact on easing racial disparities,” Willer added.

In the second study, researchers analyzed U.S. National Health Interview Survey data on more than 227,000 children aged 18 or younger, including more than 11,000 who had inpatient or outpatient surgery in the previous 12 months.

After adjusting for factors such as the health of the child, poverty, insurance and the parents’ level of education, the researchers found that Black, Asian and Hispanic children were about half as likely as White children to have surgery.

The findings were presented Saturday at the virtual annual meeting of the American Society of Anesthesiologists. Such research is considered preliminary until published in a peer-reviewed journal.

There’s no evidence to suggest that White children are more likely to require surgery or to have cosmetic procedures — factors that might have helped explain the large difference, according to the researchers at UT Southwestern Medical Center in Dallas.

“All parents want the best medical care for their children, and ensuring that quality surgical care is available for minority as well as White children will require a multifaceted solution,” lead author Dr. Ethan Sanford, an assistant professor of anesthesiology and pain management, said in a meeting news release. “Clearly, we have a lot of work to do.”

More information

The Children’s Hospital of Philadelphia explains how to prepare your child for surgery.

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These Orgs Are Making Sure the Future Has Black Doctors

Only 5 percent of doctors in the U.S. identify as Black.

This is Race and Medicine, a series dedicated to unearthing the uncomfortable and sometimes life-threatening truth about racism in healthcare. By highlighting the experiences of Black people and honoring their health journeys, we look to a future where medical racism is a thing of the past.


Thanks to the Black Lives Matter movement, racism and anti-Blackness are being examined in many American industries: healthcare is one of them.

In addition, the way in which COVID-19 has specifically impacted Black Americans now makes the inherent racism within healthcare very clear.

The current pandemic is exposing the consequences of racial discrimination within healthcare industries at every level. However, anti-Blackness in medicine and other related health disparities is nothing new for Black people.

The medical field has historically been an industry that perpetuates neglect and prejudice towards Black patients. There is also a notable lack of Black representation in active doctors and physicians in the United States.

According to the Association of American Medical Colleges (AAMC), in 2018 only 5 percent of all active physicians in the United States identify as Black or African American compared to 56.2 percent of active physicians in America who are white.

The lack of Black doctors and medical staff who have the ability to recognize health concerns in Black patients may have life threatening consequences.

Misogynoir, a term coined by Moya Bailey that means hatred of Black women, continues to perpetuate medical harm.

For example, according to the Centers for Disease Control and Prevention (CDC), an average of 700 women die each year in the United States from pregnancy-related complications. However, Black women are two to six times more likely to die due to pregnancy complications than white women.

To combat the effects of racism and lack of Black representation in the medical field, there are a number of organizations advocating for Black, Indigenous, and People of Color (BIPOC) students and doctors with the goal of breaking barriers and diversifying the healthcare industry.

Here are some of the organizations doing the work to make sure the future has more Black doctors and healthcare professionals.

The Society of Black Academic Surgeons (SBAS) has been advocating to “improve health, advance science, and foster careers of African American and other underrepresented minority surgeons” for over three decades.

In addition to diversifying faculty in academic surgery, SBAS seeks to promote their members into leadership positions as well as eliminate health disparities against BIPOC patients.

SBAS values mentoring its members in fellowship programs to achieve the goals stated in the organization’s mission statement.

Membership benefits for students within SBAS include access to the organization’s resources for the opportunity to enter their chosen medical profession and prepare for residencies.

They also offer access to a network of like-minded colleagues within the organization, opportunities to save money through SBAS student members-only programs, and more.

The Association of Black Women Physicians (ABWP) is a nonprofit organization networked by Black women to support BIPOC

This is What it’s Like to Navigate Healthcare While Black

We still have a long way to go before Black people receive the medical care they need.

This is Race and Medicine, a series dedicated to unearthing the uncomfortable and sometimes life-threatening truth about racism in healthcare. By highlighting the experiences of Black people and honoring their health journeys, we look to a future where medical racism is a thing of the past.


As a dark-skinned and sometimes sensitive little Black girl, I could never shake the feeling from my bones that my pain might be viewed as inconsequential to the very people who were supposed to provide medical care to me. It’s still something I have trouble reconciling.

With the legacy of medical racism dating back to antebellum America, it’s no surprise that Black patients seeking treatment today are still mistrustful, cautious, and protective.

As a child, I remember watching movies about how the U.S. Department of Public Health experimented on Black war veterans by withholding syphilis treatment without informed consent.

Later, I learned about white doctors testing the first gynecological instruments on enslaved Black women without anesthesia and using Black cells for groundbreaking HeLa cancer research without consent.

I sat down to talk to Black patients of all ages about their racist experiences in healthcare. Some of them wish to remain anonymous due to the stigma of openly discussing mental health, while others work in the healthcare industry and fear professional backlash.

Here are their stories.

“Maya,” 38, works as a doctor and has experienced racism among her colleagues and as a patient. Due to the professional risk of speaking out, she asked that her name be changed.

Maya’s experiences with racism in healthcare began as she looked for a job after her residency ended. Maya asked for a recommendation from the lead doctor she had worked with for 3 years and got a yes.

Once Maya got the job, which was a per diem temporary position, the woman who hired her let her know that her reference might not be ideal.

The lead doctor had said, “Well, Maya is not a go-getter.”

The woman hiring asked, “What do you mean? Is she smart? Does she know what she’s doing? Does she work hard?”

The lead doctor said yes, and Maya was hired.

The second doctor in the residency, a Black male, applied for a per diem job at the same clinic where the residency took place. The lead doctor wanted him to interview, even though she worked side by side with him for 3 years.

While she reluctantly recommended Maya and required the other Black doctor to interview, the same doctor went out of her way to create a job for the third resident, a white male medical student.

Per diem jobs are temporary, have no guaranteed hours, and benefits are rarely provided. It’s difficult to secure stable income, and many providers have to work multiple jobs just to make ends meet.

Like Maya, Black residents and doctors already exist at the margins of their field.

In

How Racism Slowly Chips Away at Black People’s Health

Enduring is all I have. It’s what my ancestors passed on.

This is Race and Medicine, a series dedicated to unearthing the uncomfortable and sometimes life-threatening truth about racism in healthcare. By highlighting the experiences of Black people and honoring their health journeys, we look to a future where medical racism is a thing of the past.


A close relative asked if I watched the full videos of the most recent series of “open season” on Black life: the violence against Jacob Blake, Breonna Taylor, and George Floyd, to name a few.

The truth is, I don’t have the mental or emotional capacity to endure watching these videos.

I’m just trying to stay well so I don’t compromise my immune system and catch a life threatening virus that’s attacking people’s respiratory systems. Meanwhile, the resurgence of the Black Lives Matter Movement is ironically echoed by the slogan “I can’t breathe.”

I want to watch these videos to shake off my numbness, even go out and protest. Unfortunately, maintaining my health won’t allow me to show up in this way.

I sometimes find myself in bed trying to sleep long enough to miss the endless terrorizing news cycle with no trigger warnings. I’m overwhelmed and angry, and there’s no justice in sight.

With each shooting, life gets put on hold while I try to reckon again. I conjure up coping mechanisms for now. Running, cooking, and listening to music tend to divert my attention just long enough before the next news story.

However, I still feel burdened by this cycle, like there’s truly no escaping this racist society. Enduring is all I have. It’s what my ancestors passed on.

We are all focusing on protecting both our physical and our mental health during this pandemic; however, navigating this crisis is especially difficult for African Americans.

COVID-19 is disproportionately impacting the Black community. Black people are more likely to be essential workers in frontline jobs and are at a higher risk for hospitalization and death from COVID-19.

On top of that, Black people are still fighting and marching to end systemic injustice. It all serves to reinforce how trivial Black life is considered in America. The weight of this reality is more than exhausting — it’s deteriorating.

Arline Geronimus, a Professor of Health Behavior and Health Education at the University of Michigan, developed the term weathering in 1992 to best describe what’s taking place.

Geronimus’ study found racial inequalities in health across a range of biological systems among adults. The study also found that these inequalities can’t be explained by racial differences in poverty.

Geronimus spoke with Healthline about her work.

“Weathering is… what happens to your body in a racist society. I named it weathering because I saw it as a way of capturing what it does,” Geronimus says. “Weathering happens when Black people have to demonstrate…resiliency in a racist society.”

There are numerous ways weathering can take place, from passing on trauma from one generation to the next, to workplace

The Cost of Medical Bias When You’re Sick, Black, and Female

This is Race and Medicine, a series dedicated to unearthing the uncomfortable and sometimes life-threatening truth about racism in healthcare. By highlighting the experiences of Black people and honoring their health journeys, we look to a future where medical racism is a thing of the past.


Being a doctor is a unique role. It involves knowing some of the most intimate things about a person, but not really knowing them as a person at all.

The patient’s job is to be transparent about their health, and the doctor’s job is to listen objectively to symptoms and fears to choose the most logical diagnosis. 

Racial bias in the medical field disrupts the trust needed for this relationship to function. 

A biased doctor might disbelieve symptoms or their severity and misdiagnose a condition.

A patient may come to mistrust the doctor, not attend appointments, not follow instructions, or stop sharing key information because history tells them they aren’t taken seriously. 

Reducing bias is critical to eliminating health disparities, especially for Black women.

My run-in with bias

Several years ago, I experienced medical bias when I started having headaches multiple times per week. I had had migraine before, but this was different. 

I felt like I was dragging my body through heavy resistance, like encountering an undertow. I was losing weight. No matter how much water I drank, I was always thirsty and rushing to the bathroom around the clock. 

It seemed I could never eat enough to feel full. When I tried to avoid overeating, I became fatigued, my vision blurred, and I had so much trouble focusing it was hard to drive.

My primary care physician (PCP) cut me off when I tried to explain.

She congratulated me for losing weight and said I just needed to let my brain adjust to food deprivation. When I explained I wasn’t dieting, she sent me to a headache specialist. 

The headache specialist prescribed a medication that didn’t help. I knew they weren’t migraine headaches, but no one listened, even as my fatigue and disorientation increased. 

Once, I even had trouble finding my own house.

By my sixth visit, the symptoms were massively disrupting my life. I wondered if I had type 2 diabetes because of family history. My symptoms seemed to match. 

I knew of a test called HbA1c that provides a snapshot of blood sugar levels. I insisted on being tested. My doctor said she would order labs based on my demographics. 

I thought I was finally getting somewhere — but when the receptionist at the lab printed the list of tests, HbA1c wasn’t present. Instead, it was tests for common STDs. 

I was humiliated, overwhelmed, and no closer to having answers. In the parking lot, I broke down and cried. 

Subtle racism

When Black people share instances of racism, it’s often disregarded as playing the ‘race card’ or as an isolated incident. It’s much more difficult to explain subtle racism than it is to explain blatant acts like burning crosses and

Black Executives Face Greater Obstacles on Career Ladder

Just four of the chief executives running America’s top 500 companies are Black, yet the pool of highly educated, experienced Black professionals has never been greater. Black professionals who make it to the C-Suite are rarely given the profit-and-loss positions that serve as stepping stones to the top job. Here are some of the reasons why.

KEY TAKEAWAYS
1. Black employees face more obstacles earlier in their careers.

A substantial body of research shows that people tend to view Black professionals more negatively, regardless of their qualifications or actual work performed. “We don’t get a presumption of competence,” says Orlando Richmond Sr., a Jackson, Miss.-based partner at law firm Butler Snow. A 2019 study of racial bias in hiring for postdoctoral positions revealed Black applicants were rated less hirable, likable, and competent than white, Latino or Asian applicants. A 2017 study examining callback rates for Black job applicants found discrimination levels haven’t improved in the past 25 years.

2. Diversity efforts are often focused on recruitment rather than retention.

Many companies tend to emphasize diversity in recruitment but overlook retention and advancement, researchers and executives say. Michael Hyter, chief diversity officer at recruiting firm

Korn Ferry,

says that by the time companies are trying to promote people at the managerial level, they have often already lost key talent. Among all U.S. companies with 100 or more employees, Black people hold just 3% of executive or senior-level roles, according to Equal Employment Opportunity Commission data. More than a third of Black professionals say they intend to leave their company within the next two years, with many mentioning isolation and workplace hostility, compared with 27% of their white peers, according to Coqual, a think tank focused on workplace diversity.

3. Many Black professionals lack access to senior managers.

Relationships play a large role in career-building. A 2019 Korn Ferry survey of Black executives holding profit-and-loss roles found that 86% said having a sponsor—someone who supported and helped advocate for them when opportunities came up—was indispensable to their career progression. But CEOs, recruiters and senior executives say that Black professionals often don’t have the relationships that are pivotal to advancement. Fewer Black professionals have access to senior leaders at work than their white peers, according to the Coqual study. The same study also found that fewer Black professionals have managers who give them growth opportunities than their white peers.

Read the original article by Te-Ping Chen here.

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