Race, Medicine, & Society
February 8, 2018
Guest Speaker: Mario Browne
Director of the Office of Health Sciences Diversity at University of Pittsburgh
Public Housing in Pittsburgh
- Pitt wanted to eliminate public housing
- Some people were dependent upon public housing programs
- These people needed help with education, training (for jobs), and finding opportunities
to acquire better housing
Often we think about what people need, but don't talk to them ourselves to find out
what they really need
Public Health Story:
- Pregnant woman with two kids who had been smoking
- The woman wanted daycare for the kids, education, and housing help
- In return, she would try to quit smoking
- Smoking had curbed her stress
- Different groups feel different levels of stress
Browne was in pre-health, but didn't want to go to medical school
- He was part of the football team and a fraternity
- He wanted to pursue Nursing, however this occupation was thought of to be a woman's job
- Hence, why there aren't many men in Nursing
- He looked into Medical Technology
- Did research with communities and worked to build trust with them
Pittsburgh
- Mainly black and white
- Not a large amount of representation by other non-white groups
- Health disparities in Pittsburgh
In the Public Health field, Browne liked to mix intervention with research. This was different from
the common Public Health worker that usually regulated places (ex: inspecting health standards in a restaurant).
Not many minorities in medical (research and technology)
Cultural Competency:
- Understanding and appropriately responding to cultural variables and diversity in an interaction
(ex: physician and patient)
- How do you know where a person is from? What do you know of their values?
- Find out a person's community and traditions
- Doctoring Hierarchy
- Empowering a patient vs just telling them what to do
- Have an awareness that one size doesn't fit all
- Golden Rule: Treat others how you want to be treated
- Platinum Rule: Treat others how they want to be treated
Health Care providers should ask themselves if they have bias against different kinds of people
- They need practice talking to different kinds of people
( For anyone really interested in the topic of the relationship between physician and patient, check out
Medicine in Translation: Journeys with My Patients by Danielle Ofri. Ofri (MD, PhD) works at
Bellevue Hospital in New York. In her book, she works with a variety of patients from all over the
world. Patients from places such as China, Bangladesh, Guatemala, Nigeria, and more. She gives her perspective about working with these patients and the complications that arise with language barriers
and cultural differences. )
Social Deterrents to Health
- Who has access to certain things?
- Policies that assign value to people: hierarchy
- GI Bill: WWII housing & benefits bill for veterans
- Some given benefits, some denied
Dr. Camara P. Jones (M.D., M.P.H., Ph.D)
- Research Director on Social Determinants of Health and Equity
- Looking at Structural Racism
Three Levels of Racism:
1. Interpersonal
2. Personal
3. Internalized
(Didn't quite hear him so correct me if I'm wrong)
Medical Schools
- Academies need to look at themselves internally
Health Care System
- Heal sick people or make money
- Baltimore Patient Dumping: Insurance probably didn't cover the person anymore so the
patient was ejected from the hospital onto the street in cold weather.
Public Health
- Increasing need for multilingual workers
- Urban Planning Tables: need to make Upstream decisions that effect people's lives
Upstream Care = Primary Care
Ambulance = Tertiary Care
Intersection of Race and Class
- Structural factors such as no good High School = no good Medical School
Implicit Bias
- Affirmative Action, Token Figure
- Holding bags for people
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