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More Black Physicians Could Improve Life Expectancy Of Black Patients: Researchers
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Weeks of shoulder pain landed a reluctant Whitney Nichols in urgent care. As a previously healthy 24-year-old Black woman, she pleaded for additional testing to uncover the cause of her pain. As a last resort, the doctor ordered a CT scan of her chest. The result, blood clots in both of her lungs.
Even after this seemingly scary diagnosis and after being transferred to a hospital, Nichols said she felt dismissed when a doctor told her she would be fine.
Nichols, now 29 and a graduating medical student, reflected that these interactions with dismissive doctors made her feel "so alone in that space" and unsafe.
MORE: 'I felt powerless': Black Americans suffering from long COVID say they have trouble accessing careBut Nichols said that night, everything changed when a Black physician, Dr. Erika Walker, walked into the room. Walker explained the blood clots were serious but treatable. Walker advised Nichols to stop taking her estrogen-based birth control, which can increase the risk of blood clots, and prescribed medication that would break up the clots.
She said it was great " ... Just seeing somebody that I felt like I could be comfortable with."
Black people make up 13% of the U.S. Population, but Black doctors are not equally represented. For example, only 7% of primary care physicians are Black, according to a study from the Journal of the American Medical Association. Amid a growing recognition that Black Americans experience disparities in health and medical care, new research suggests that Black patients are more likely to live longer and healthier lives when their primary care doctors are also Black.
© Courtesy Wilson Hayes Black medical students and physicians gather at The Student National Medical Association's 59th Annual Medical Education Conference, in Hartford Conn. Michael Dill, director of Workforce Studies at the Association of American Medical Colleges team, analyzed the relationship of Black primary care physicians and the health outcome of the people who lived in those same areas, evaluating 1,600 U.S. Counties. Dill and his colleagues found that a 10% increase in Black primary care doctor representation was associated with an extra month of life expectancy for Black patients.
The higher the representation of black physicians in the workforce per county was associated less death of any cause for county residents, Black and White patients. Thus, even people not actively being treated by Black physicians benefitted from their presence like the results published in the Journal of the American Medical Association in April of 2023.
"We found that diversifying the physician workforce ... Is important for improving public health," Dill told ABC News.
MORE: Should racism and discrimination be viewed as public health threats? A new study argues they shouldDr. Bobby Mukkamala, past chair of the American Medical Association Board of Trustees, said the data was "shocking" but "in a motivational way." Mukkamala said this data can be used to advocate for equitable hiring practices at hospitals and health care systems so that doctors and staff look like the communities they serve.
Researchers said when doctors have similar cultures and lived experiences to the patients, they may be more likely to take their concerns seriously, which results in better life expectancy.
For over 150 years ago, Historically Black Colleges and Universities (HBCU) were established to provide Black students the opportunities to advance their education when they were unwelcome at existing public and private institutions of higher education. Traditionally HBCUs are a large producer of Black physicians.
© Courtesy Olubunmi Ajao Erika Walker, M.D Internist and Whitney Nichols, incoming Internal Medicine and Pediatrics Resident. Dr. Erica Sutton, associate dean at Morehouse School of Medicine said, "feeling heard, perhaps listening as well, and then translating that into patient centered care patient driven treatment plans," is the essence of why Black physicians can impact their patients' health.
Dill said there is no shortcut to increasing workforce diversity. "This is not a problem we can fix in a couple of years," Dill said. "This is the work of generations."
Mukkamala, Sutton, and Whitney are involved in programs that aim to increase and inspire young children of diverse backgrounds to pursue careers in science, education, technology and math, including The American Medical Association's Back to School Program, Morehouse's health careers programs and Student National Medical Association.
"This isn't something that you can tell somebody in college to convince them to [pursue medicine]," Mukkamala told ABC News. "Those seeds get planted early on in grade school."
© Courtesy Oluwatosin Ibrahim The organizers of The Student National Medical Association's 59th Annual Conference, Olubunmi Ajao, MS incoming Obstetrics and Gynecology Resident Physician and Whitney Nichols, incoming Internal Medicine and Pediatrics Resident Physician. Sutton is hopeful for the future.
"I think that one of the things that we've seen recently in this country is a renewed interest in inclusivity belongingness ... We definitely try to teach at HBCUs is that these [less diverse] communities do include you," Sutton told ABC News. "It's not us and them...That community is enriched by your presence."
Danielle Craigg, MD is a senior General Preventive Medicine & Public Health Resident at Renaissance School of Medicine at Stony Brook University and a member of the ABC News Medical Unit.
Sotonye Douglas, MS is a graduating medical student from Quinnipiac University, Frank H Netter Medical School, beginning General Surgery Residency in June 2023, and a member of the ABC News Medical Unit.
A Single Black Doctor Can Increase Life Expectancy For Black Patients
Having even one Black doctor within a county resulted in a higher life expectancy among Black patients, according to a study published on JAMA Network Open.
The authors of the longitudinal cohort study wanted to determine whether there is an association between the number of Black county-level primary care physicians and the number of mortality-related outcomes.
And they did, in fact, find there was an association.
The U.S. Department of Health and Human Services and the Association of American Medical Colleges looked at over 3,700 counties across the U.S. In 2009, 2014 and 2019. Then, they narrowed those numbers down to a combined sample of 1,618 U.S. Counties, based on whether at least one Black primary care physician operated within a county during one or more of those three years. The study did not consider counties where there were no Black physicians.
The data showed that counties with more Black physicians resulted in higher life expectancy for Black patients, while Black mortality rates and mortality rate disparities between Black and White patients increased with fewer Black physicians within a county. In addition, patients had an increase in life expectancy of 30.61 days in association with a 10% increase in Black physician representation, when considering an adjusted mixed-effects growth model.
The front-line fight against racial disparities in health care Northwestern Memorial's Dr. Khalilah Gates helps write medical curriculum, including ways to counter implicit bias and health disparity impacts.
LEARN MOREWhile the study did not show a cause-and-effect relationship, the findings underscore the racial health disparities across America and highlight the systemic issue of minorities being underrepresented in the health care field. Authors said the study shows the "need to expand the structural diversity of the health workforce."
Monica Peek is one of the authors, as well as a primary care physician and health equity researcher at UChicago Medicine. She wrote an article on the findings.
"This study has brought to light the importance of Black PCP representation to public health outcomes among Black populations across the U.S.," she wrote. "Increasing this representation must become a multifaceted national strategy to improve health and increase equity among Black populations in the U.S."
Life Expectancy Improves For Black People Who Live Near Black Doctors, New Study Finds
Advocates working to address racial health disparities say a new study about Black physicians is a groundbreaking wake-up call.
The study finds that Black people who live in counties with more Black primary care doctors live longer. The research, led by the U.S. Department of Health and Human Services, helps make the case that diversity in medicine matters.
Researchers found life expectancy increased by about one month for every 10% increase in Black primary care physicians.
The study looked at the entire population of these areas. The whole population living one month longer than people otherwise would is significant, says Usha Lee McFarling, a national science correspondent fo STAT.
Researchers also found death of all causes were reduced in Black populations with more Black physicians, McFarling says.
"The discrepancies in how long people live between Black and white people in counties was reduced," she says. "So the health of Black populations really improved on a number of levels when there were more Black physicians available."
At the onset of the study, researchers wanted to look at the more than 3,100 counties in the U.S. — but they had to exclude half for not having any Black physicians, McFarling says.
Black doctors — who are more likely to see the poorest, sickest patients such as people on Medicaid — aren't superheroes, but their presence in a county helps improve outcomes, she says.
"Maybe a county that supports Black doctors — where they can work and thrive — supports Black lives in general. Maybe those doctors are advocating more doing more health in the community," McFarling says. "One thing that was really clear: the counties with more poverty had greater life expectancy with Black doctors."
Only 6% of doctors in the U.S. Are Black, she says, compared to the 13.6% of the population that's Black.
This disparity goes back for decades: Doctors were largely white men, then many white women as well as Asian men and women started becoming physicians. But few doctors exist among Black, Latino and Indigenous populations.
The results of the study surprised some folks on social media — but not among the Black community.
Researchers know there aren't enough Black doctors and about the massive health disparities in the Black population — but something did surprise the team, she says.
"I think they were shocked that the presence of even just a handful of Black physicians in a county could help health on an entire population level," McFarling says. "I think that's what really raised eyebrows and said we have to just double and triple and quadruple our efforts to get more diversity within medicine."
Many people in the health equity world are saying it's time to stop studying and take action to address the problem of diversity in medicine. Medical schools are working to increase diversity in their classes — but since it takes more than a decade to train a doctor, change won't come overnight, McFarling says.
"What people are worried about is an upcoming Supreme Court ruling that may rule out the ability to use race as a factor in admissions in medical schools and universities," she says. "And that could really set this even further back."
Ashley Locke produced and edited this interview for broadcast with Gabe Bullard. Allison Hagan adapted it for the web.
This segment aired on April 21, 2023.
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