“We need to reckon with who we are as a country,” Wellesley’s President Paula A. Johnson said during The Atlantic’s Health Equity Summit, an event exploring the U.S. health care system and what it is doing to improve health outcomes across race, age, gender, and sexual orientation. “Are we going to invest in equity and the infrastructure that’s necessary?”
She joined leaders such as Xavier Becerra, U.S.secretary of health and human services, and Nadine Burke Harris, surgeon general of California, to discuss issues of racial and gender disparities in health care that the pandemic has exposed and exacerbated.
Johnson, a cardiologist, has more than 30 years of experience in academic medicine. She has studied sex, gender, health, and disease and how they intersect with race and ethnicity.
Johnson spoke with AtlanticLIVE contributor Jeanne Meserve about how men and women are treated in the health care system, implicit bias in practitioners, and whether digital health will improve health care access.
Meserve asked Johnson about the importance of a diverse health care workforce. Johnson said creating diversity is critical. “When we have a significant number of physicians of color, we change the conversation,” she said. “We have studies that show when there’s concordance between a patient and physician, that, actually, those patients are listened to differently. There’s more attentiveness to understanding the context of their disease.”
Johnson noted that the maternal mortality rate for Black women in the U.S. is double that of white women, but that a study in Florida showed a decrease in maternal mortality when the physician and patient are the same race.
Meserve also asked Johnson about the prevalence of implicit bias among health care practitioners. Johnson said implicit bias is a problem across the country, and that studies have shown that everyone has it, including health care providers. At this moment, when people are focusing on these issues, she said, we have an opportunity to start rethinking medical education “so that our young health care professionals understand that race is a social construct. That it’s not a biologic differentiator. We need them to understand that when they see these differences in rates of disease…that there are many determinants, including so many of the social determinants, in health. This is where a lot of these early implicit biases become cemented.”
The next generation of scientists and physicians, she said, need to think critically about how they design their studies: “Are they thinking about issues of social justice? Are they thinking about issues of equity, both as it pertains to race and ethnicity, but also as it pertains to sex and gender? These are all things that, I think, we, today, understand from an educational standpoint, can change. We just must have the will to do it.”
Meserve wondered if digital health care might help “close the gap” on some of these issues. “As we think about equity, are we going to ensure that every American has access to the internet?” Johnson asked. “Are we going to ensure that there’s a strong public health system? I think unless we do those things, we will see many of the same inequities that we see in one-on-one health care, marched out to digital health care.”
The recorded conversation between Johnson and Meserve is available here.