Bill Frist, M.D. and Andre L. Churchwell, M.D., Guest Columnists Published 10:00 a.m. CT July 31, 2020
While to some, Confederate monuments are memorials to the dead, to many others they are glorifications of slavery, racism and oppression. Nashville Tennessean
No one should feel discriminated against when seeking care, and quality healthcare should be available to everyone.
As city and community leaders across the country wrestle with their own roles and responsibilities in addressing racial inequality, we believe specific attention to health equity and health disparities will lead to dismantling structural racism and a roadmap for a healthier future for all.
An example of how we are beginning that focus and journey can be found inNashville, Tennessee. But it could just as well be any town or city in the nation.
Weve known for years that minorities face health disparities nationally, and in our own experiences as physicians, weve seen first-hand how health inequities unfairly persist in communities of color when it comes to access and quality.
In Nashville, the simple zip code of your residence could lead to a six-year decrement to life expectancy, twice the rate of unemployment and five times difference in poverty.
The challenges of unconscious bias and racism that enable health inequities must be addressed to improve health outcomes.
Thanks to the recent Nashville Community Health and Well-Being Survey, we have a clearer picture of the challenges facing vulnerable populations, especially African Americans here in Davidson County, for the first time in 20 years.
Former Senate Majority Leader Bill Frist(Photo: Submitted)
The personal, pervasive stories of discrimination that have captured our nations attention are keenly present in our survey data.African American respondents were nearly five times more likely (14.6%) to report feeling discrimination when seeking healthcare in Metro Nashville compared to white respondents (3.1%). And nearly one in three (31.5%) African Americans felt discriminated against at work in the past year, compared to only 6% of white respondents.
Moreover, one third of African American respondents reported feeling emotionally upsetangry, sad, or frustratedin response to treatment based on race. Only 7% of white survey-takers reported similar emotions. For African Americans, such treatment was more likely to have physical manifestations: nearly 18% experienced headache or stomach ache, a pounding heart or muscle tension. Those symptoms were only felt by 3% of white respondents.
The chronic stress of being an African American has a clear, compounding effect on the chronic medical conditions they face and are part of the answer for the life-expectancy discrepancies seen between people of different races.
For example, white American males live on average 77 years while African Americans live on average 72 years. White females live on average 81 years compared to 78 years for African American women.
Hear more Tennessee Voices: Get the weekly opinion newsletter for insightful and thought provoking columns.
Tennessean Opinion Editor David Plazas spoke to Dr. Bill Frist, former U.S. Senate majority leader Nashville Tennessean
Our region is a national leader in health care services, with Middle Tennessee often referred to as the Silicon Valley of Health Services. We now need to do the hard work of figuring out how to lead the nation in health equity. And it starts by gathering data and understanding where inequities exist.
The Nashville Community Health and Well-being Survey was developed and implemented by NashvilleHealth and the Metro Public Health Department. It explored specific health conditions, access to care, and health behaviors across Davidson County residents between October 2018 and April 2019.
More than 1,800 responses were gathered online and by mail. The assessment was extensive, and while findings were not limited to comparisons between Black and white populations, we highlight thedata to emphasize the work we have ahead of us to ensure health equity for African American Nashvillians.
The survey found chronic conditions like diabetes, hypertension, respiratory conditions, and obesity were all much more common in African American than white residents. Of survey takers who self-identified as African American, 22.1% have diabetes. Only 8.3% of survey takers who self-identified as white, non-Hispanic have the condition.
Whereas 47.8% of the African American respondents are obese, 24% of white respondents are obese. 47.6% of African Americans reported hypertension; only 27% of white respondents reported hypertension. And 24.7% of African American registered respiratory conditions; 17.4% of white respondents reported the same.
Dr. Andre L. Churchwell, (Photo: Mary Donaldson)
No physician or nurse wakes up each day with the intention to treat patients differently the overwhelming majority of us called to healthcare genuinely want to help all people.
But unintentional, unconscious implicit bias in delivering clinical care has been demonstrated in numerous studies, with minorities more likely to receive lower quality care, regardless of income or insurance.
And when it comes to social supports, our Nashville communities of color disproportionately feel unsupported. In responding to the survey, 15% of African Americans reported that they rarely or never get needed social support, and a startling 23.1% of Hispanic respondents shared the same sentiment. Only 7.8% of white respondents said the same.
As physicians we know that to achieve true health equity we must also address systemic racism in our criminal justice system and create paths to improve public education, transportation, and many non-medical society challenges.
The change needs to start with us.In Nashville, but indeed in every community in America.
We want to add our voices to the collective call-to-action to city leaders across America and those of us in medicine and healthcare, to fully engage, and honestly and openly address the issues that continually lead to disparate health outcomes for so many.
Accountability in these matters, like free speech, is to be shared amongst allof us.
Autoplay
Show Thumbnails
Show Captions
Senator Bill Frist, M.D. is a heart transplant surgeon, founder of the Vanderbilt Transplant Center, and former U.S. Senate Majority Leader.
Andre L. Churchwell, M.D. is the Vice Chancellor of Equity, Diversity & Inclusion and Chief Diversity Officer at Vanderbilt University. He also serves as a Professor of Medicine (Cardiology) and the Chief Diversity Officer at Vanderbilt University Medical Center.
Read or Share this story: https://www.tennessean.com/story/opinion/2020/07/31/examination-racial-inequality-nashvilles-healthcare/5540680002/
Read more:
- How good is fish for your diet? - November 8th, 2009 [November 8th, 2009]
- What foods have both fiber and protein? - November 8th, 2009 [November 8th, 2009]
- Is There Evidence That Acupuncture Works? - November 8th, 2009 [November 8th, 2009]
- What are some good fiber foods? - November 8th, 2009 [November 8th, 2009]
- Can Green Tea fight HIV infection? - November 8th, 2009 [November 8th, 2009]
- Quality of GNC Supplements - November 8th, 2009 [November 8th, 2009]
- The Gene Smart Diet - November 8th, 2009 [November 8th, 2009]
- Tips for eating in a vegetarian lifestyle - November 8th, 2009 [November 8th, 2009]
- Regarding the Starting of a new diet regimen - November 8th, 2009 [November 8th, 2009]
- Thoughts on Dropping Weight - November 8th, 2009 [November 8th, 2009]
- What do doctors think about vitamin E supplements? - November 8th, 2009 [November 8th, 2009]
- What herbs or supplements are commonly used for depression? - November 8th, 2009 [November 8th, 2009]
- Is there a safe way to lose a lot of weight? - November 8th, 2009 [November 8th, 2009]
- Diets that promise you will lose weight - November 8th, 2009 [November 8th, 2009]
- Are Fish Toxins Linked to Diabetes? - November 8th, 2009 [November 8th, 2009]
- Can Plastic Surgery Help Migraines? - November 8th, 2009 [November 8th, 2009]
- Weight Loss Surgery Eradicates Diabetes Symptoms - November 8th, 2009 [November 8th, 2009]
- Found: A Gene That Controls Fat Cells - November 8th, 2009 [November 8th, 2009]
- Sugars and Starches, what's the difference? - November 8th, 2009 [November 8th, 2009]
- Improving your health with a serving of nuts? - November 8th, 2009 [November 8th, 2009]
- Is Your Diet Causing You To Be Depressed? - December 13th, 2009 [December 13th, 2009]
- Placebo Effect: Magnetic Bracelet Therapy - December 13th, 2009 [December 13th, 2009]
- Does serotonin promote sleep? - December 13th, 2009 [December 13th, 2009]
- Decreased energy levels - Overeating, Sleep, Nutrition - February 1st, 2010 [February 1st, 2010]
- When will the body begin to cannibalize muscle tissue? - February 7th, 2010 [February 7th, 2010]
- Foods that are high in antioxidants - February 7th, 2010 [February 7th, 2010]
- Editorial: Reduce health care costs by cutting administrative overhead - April 1st, 2012 [April 1st, 2012]
- Health Care Winners: Centene, Onyxx - April 25th, 2012 [April 25th, 2012]
- Dan Morain: Nurses union puts politics ahead of health - April 25th, 2012 [April 25th, 2012]
- What's next if Obamacare falls? - April 25th, 2012 [April 25th, 2012]
- Global Managed Health Care Services Industry - April 25th, 2012 [April 25th, 2012]
- Immigration Fight Echoes Health-Care Case at High Court - April 25th, 2012 [April 25th, 2012]
- Medical Centers Lead Workplace Wellness Effort - April 25th, 2012 [April 25th, 2012]
- The next health care overhaul? Look to employers - April 25th, 2012 [April 25th, 2012]
- Capital BlueCross Hosts Community Health Care Forums Focused on Managing Costs While Maintaining Quality - April 25th, 2012 [April 25th, 2012]
- County committee to look at area health care - April 25th, 2012 [April 25th, 2012]
- President Obama Calls on Students to Tell Congress: #DontDoubleMyRate - Video - April 25th, 2012 [April 25th, 2012]
- Sen. Coburn: Competition in Health Care to Allocate Resources - Video - April 25th, 2012 [April 25th, 2012]
- Jesse Kelly health care - Video - April 25th, 2012 [April 25th, 2012]
- PHC Vision Statement (short version) - Video - April 30th, 2012 [April 30th, 2012]
- The Bioeconomy Blueprint Panel - Video - April 30th, 2012 [April 30th, 2012]
- Providence Health Care's Vision Statement - Video - April 30th, 2012 [April 30th, 2012]
- Department of Health and Human Services: Minority Health Blogger Townhall - Video - April 30th, 2012 [April 30th, 2012]
- Health care worker accused of stealing identities of brain i - Video - April 30th, 2012 [April 30th, 2012]
- Health Care Reform, Part 1 of 3 | KYVE Insiders Roundtable - Video - April 30th, 2012 [April 30th, 2012]
- Health Care Reform: The ACA and Beyond - Video - April 30th, 2012 [April 30th, 2012]
- Is Broccoli Like Health Insurance? - Video - April 30th, 2012 [April 30th, 2012]
- Did Obama make a mistake on health care? - Video - April 30th, 2012 [April 30th, 2012]
- How Democrats Lie About Health Care - Video - April 30th, 2012 [April 30th, 2012]
- Toobin on Health Care: This was a "judicial hissy-fit" - Video - April 30th, 2012 [April 30th, 2012]
- President Obama says health care law will stand - Video - April 30th, 2012 [April 30th, 2012]
- Obama Defends Health Care Law From 'Judicial Activism' - Video - April 30th, 2012 [April 30th, 2012]
- Obama Healthcare Individual Mandate - Video - April 30th, 2012 [April 30th, 2012]
- President Obama attacks Supreme Court on health care - Video - April 30th, 2012 [April 30th, 2012]
- Raw Audio: High Court Dissects Health Care Act - Video - April 30th, 2012 [April 30th, 2012]
- Health care on trial - Video - April 30th, 2012 [April 30th, 2012]
- Final Day of Health Care Law Arguments Before Supreme Court - Video - April 30th, 2012 [April 30th, 2012]
- Feds to put up $1.9B for Oregon health overhaul - May 4th, 2012 [May 4th, 2012]
- Scuttling health care act will freeze Medicare, White House warns - May 4th, 2012 [May 4th, 2012]
- U.S. Health Care Spending High, But Quality Lags: Report - May 4th, 2012 [May 4th, 2012]
- Yes, the Health-Care Mandate Is About Liberty - May 4th, 2012 [May 4th, 2012]
- Health center gets $1M federal grant - May 4th, 2012 [May 4th, 2012]
- Health-care reform panel considers exchange options for Va. - May 4th, 2012 [May 4th, 2012]
- Hmong health care gap focus of Healthy House dinner - May 4th, 2012 [May 4th, 2012]
- Walsh-led health bill to be unveiled - May 4th, 2012 [May 4th, 2012]
- Ontario health system confusing for ailing seniors, study finds - May 4th, 2012 [May 4th, 2012]
- 'Health Care Deserts' More Common in Black Neighborhoods - May 5th, 2012 [May 5th, 2012]
- With federal money, Oregon kicks health care reform into high gear - May 5th, 2012 [May 5th, 2012]
- Nurse practitioners tackling more 'doctor' tasks - May 5th, 2012 [May 5th, 2012]
- Konza Prairie Health Center Receives $4.5 Million Grant - May 5th, 2012 [May 5th, 2012]
- Alberta wages hurting Sask. health care - May 5th, 2012 [May 5th, 2012]
- House releases plan to cut growth of Massachusetts health spending in half - May 5th, 2012 [May 5th, 2012]
- Mass. House Will Unveil Bill Seeking To Rein In Health Costs - May 5th, 2012 [May 5th, 2012]
- President Obama Welcomes the Kentucky Wildcats - Video - May 5th, 2012 [May 5th, 2012]
- President Obama Speaks on College Affordability - Video - May 5th, 2012 [May 5th, 2012]
- My First Job: Gene Sperling - Video - May 5th, 2012 [May 5th, 2012]
- Health-care costs worry near-retirees - May 7th, 2012 [May 7th, 2012]
- Massachusetts Institutes Health-Care Price Controls. Is America Next? - May 7th, 2012 [May 7th, 2012]
- Massachusetts Moves Toward Health-Care Price Controls. Is America Next? - May 7th, 2012 [May 7th, 2012]
- GOP plan boosts Pentagon, cuts social programs - May 7th, 2012 [May 7th, 2012]