Year: 2023
Type: article
Abstract: Persistence of racial segregation makes equitable health care impossible for African Americans, as does the supra-geographic segregation perpetuated by enduring racial medical mythologies that remain unchallenged in health professions education.This article canvasses how these mythologies exacerbate myopia in health professions practice and education, maintain barriers, and perpetuate racial health inequity.Codifying Racial Segregation In 1870, the American Medical Association (AMA) twice excluded 1 the racially integrated delegation from Washington, DC, to the AMA's national meetings while admitting a White one.2 Between 1846 and 1910, the AMA developed a state-based organizational structure that excluded most African American physicians even as the association shaped medical education.2 Schools commonly rejected Black medical aspirants like James McCune Smith, who moved to Glasgow, Scotland, where he earned his medical degree in 1837, 3 and Daniel Laing, Isaac Snowden, and Martin Delaney, who were admitted to Harvard Medical School in 1850 but were expelled when White students protested.4 African American physicians responded by founding their own societies 2,4,5 and medical schools because the relatively few Black patients admitted to White hospitals were typically pressed into service as "teaching material" and research subjects.6 When the AMA decided to elevate medical education by creating the Council on Medical Education in 1904, it did not essay to treat the 9 million underserved African Americans in the South. 2 Instead, the AMA Council commissioned the Carnegie Foundation for the Advancement of Teaching to evaluate American medical education and produce the 1910 Flexner Report, which recommended closing all but 2 of 7 African American medical schools-Howard and Meharry.7 Moreover, the report castigated African American physicians-already denigrated as purveyors of drugs, alcohol, and abortion 8,9 -as "limited," declaring: "A well-taught negro sanitarian will be immensely useful; an essentially untrained negro wearing an M.D. degree is dangerous."7 Five of the 7 schools closed, and the number of African American physicians plummeted, ensuring that Black patients' needs remained unmet.A lingering consequence today is that only 5% of US physicians are Black.10 And though African American men, who have
Source: The AMA Journal of Ethic
Author: Harriet A. Washington
Institution: Columbia University
Language: English
Subfield: Gender Studies
Field: Social Sciences
Domain: Social Sciences
SDG: Reduced inequalities
Open Access status: diamond
OpenAlex ID: W4313837446