GUEST EDITORIAL: Act locally to demand health care equity in Sarasota

Posted Jun 16, 2020 at 12:01 AM Sarasota Herald Tribune

Washington Hill▲

We are in a cultural moment because of moral outrage by people of all colors.

Reverend Al Sharpton said it well at George Floyd's eulogy: that "what happened to Floyd happens every day in this country, in education, in health services, and in every area of American life, it's time for us to stand up in George's name and say get your knee off our necks."

Here in Sarasota, it's time to provide better and improved health care for all — not just for the haves, but for the vulnerable in our community as well.

There are numerous health care disparities in Sarasota as a result of longstanding racism that is interpersonal, systemic, institutional, structural and founded on racial bias. Physicians and health care workers see this every day.

We know racial bias and racism when we encounter it, and we know that over the years it leads to poorer health status and outcomes. The COVID-19 pandemic disproportionately affects and targets black and brown people more than whites because of racism. This is no surprise to us in health care. The coronavirus has placed a bright spotlight on the different care patients receive due to racism, and worse disease and higher mortality rates in minorities because of it.

Clearly, there are demonstrated disparities in health care and outcomes based solely on implicit bias and racism. A midwife said to me this week that there is no reason for a black or brown pregnant women to die or be very sick more so than her white counterpart — other than longstanding and present racism. Think about that. She is right.

There is no genetic or biological reason for this tragedy. Racism is an insidious cultural disease with many manifestations. It has to be admitted that unfair privilege is one. Access to health care and health care injustice are others. Not getting a deserved promotion is another. And so on.

On June 6, medical students, physicians, nurses and their families knelt in remembrance of George Floyd's death in the pouring rain to say "yes," we know there is racism in the provision of health care services; and "yes," we admit it; and "yes," now let's do something about it.

The rain has stopped, but the systemic racism continues. All of us providing health care services and those of you receiving those services have a role and must speak out.

What should empower you to speak out? To start with, your taxes pay for some of these services. More importantly, we will all collectively benefit.

So where do we go from here? Everyone is asking that question. Here is how you can help:

If you are in a clinic or office, observe to see whether providers and staff are really diverse. Who is at the front desk, and who are doing the procedures? When you see diversity, acknowledge it. When you don't, speak up.

Use your ears, and listen to what is going on around you when you are receiving health services. Use your platform, and speak out wherever and whenever you can. Remember, equality is not equity. The service may be equally available to all, but are all really able to access it?

Use your voice and your contacts in advocating for a more accountable, diverse and inclusive health care system. Compliment when you see something done well, and hold people accountable when it needs to improve.

Sarasota's organizations providing health care services should have real, open conversations about racism, its local effects and their own policies. Providers should encourage their leaders and employees to use their influence and push forward with diversity and inclusion initiatives. Those in charge must be accountable.

Look at diversity metrics over time. Encourage partnering with community organizations, suppliers, businesses and the diverse communities —not just other organizations that that look the same. We can no longer remain silent and not speak up. That's complicity.

This is not easy work. There will be lots of resistance and lots of words. It will take a lot of energy — but do not become dismayed or give up. We have come a ways but still have a very long way to go in really being diverse in health care.

In the past 30 years since I have been, in Sarasota, progress has been made but we still have so much more to do. Those 100 healthcare workers gathered in front of the Sarasota Memorial Hospital Internal Medicine Practice in Newtown — kneeling in the rain to remember George Floyd and support the Black Lives Matter movement — will make sure of that.

They are not going away; nor is the community. We are not going back.

An Associated Press wire story, dated March 26, 1966, contains the first known published reference to Dr. Martin Luther King's famous quotation regarding injustice in health care: "Of all the forms of inequality, injustice in health is the most shocking and inhuman."

Dr. King's remarks were made at a Chicago press conference held the day before, in connection with the annual meeting of Medical Committee for Human Rights. These words still hold true today. Systematic and institutional racism result in many of the health disparities and poorer outcomes that we see — whether in the death of pregnant mothers or infants, or rates of cancer, heart disease or COVID-19 in those of color.

Diversity addresses health disparities.

After graduating from medical school in 1965, I remember marching a year later for racial equity. It is now 2020 and people of color are still marching for racial equity. There is something wrong with that pic and many of you have pointed that out. Far too little has changed.

Regardless of your race or ethnicity, or where you get your care, or whether you are receiving or providing health care, we must do, expect and demand better of ourselves and those with the power to provide these services. We have a lot of work to do and a long way to go, to let the knee up and improve health care services for all. But we can do it if we really want to.

A change has to come!

Washington Hill, M.D., a maternal-fetal medicine specialist with CenterPlace Health and Sarasota Memorial Hospital, has been an obstetrician-gynecologist for 55 years, almost 30 at Sarasota Memorial Hospital. He can be reached at dr.washingtonhill@gmail.com.