The former secretary of the U.S. Department of Health and Human Services says the often bumpy road to health equality included his own return to a newly desegregated South to help organize the first four-year, African-American medical school in the U.S. in the 20th century.
Dr. Louis Sullivan, president emeritus of the Morehouse School of Medicine, said while there have been advances in public health and medical education over the past century, there is still work to be done to improve health disparities and the surge of chronic diseases are leading killers of all Americans.
Sullivan was one of the keynote speakers during a three-day health symposium held Nov. 6-8 on the campuses of South Carolina State and Claflin universities. Dr. Monnie Singleton of Singleton Health Center presented the “Healthy Moves” symposium to help residents of Orangeburg County and surrounding areas take better charge of their health.
Sullivan spoke Thursday afternoon at the Fine Arts Building on the S.C. State campus on “The American Journey to Health Equity.”
While the death rate from infectious disease and malnutrition was improved over the course of the 20th century, Sullivan said the nation is seeing chronic diseases such as heart disease, cancer and stroke becoming prominent as leading causes of death among Americans.
“The health of all of us is influenced by a number of factors so we need to work to improve the conditions in which we live” to improve health outcomes and live more fulfilling lives, Sullivan said.
The passage of the federal Affordable Care Act is serving to improve health care access, but work remains, he said.
“When I went to Washington in 1989, we were concerned that we had 37 million Americans without health insurance. Well, that number today is 48 million in spite of the fact that we had an economic boon during the decade of the ’90s. So that tells us that simply having economic boon by itself doesn’t guarantee that we will have greater access to health insurance.” Sullivan said.
More focus needs to be put on preventive care, especially as it pertains to curbing obesity and diabetes rates, with individuals needing to make lifestyle changes to help the process, he said.
“How active are we in exercising? What kind of diets do we consume? Do we use tobacco or not? Are we living in an area where the air is polluted with chemicals? That has an influence,” Sullivan said. “It’s not simply the incidence of chronic disease, but how well it is controlled” that influences minorities as well.
He said the nation’s health system is shifting from a culture of treating sick people to maintaining people’s health and wellness.
“That means that we have to have more of a collaboration between our citizens and our health professionals. This is because of the nature of the conditions that we face now and the fact that if we are to bring costs under control as well as improve the health of our citizens, our citizens must participate in maintaining their health or successfully treating their conditions,” Sullivan said.
Conscious and unconscious bias among physicians is another area of concern, he said.
“In our health system, we also have to be concerned about ... the assumptions we make about individuals when they enter our (doctors’) offices. And these are often things that we’re not aware of,” said Sullivan, who cited a study conducted by Dr. Augustus White, an African-American orthopedist, which illustrated how differently minorities were treated for such issues as acute cardiac symptoms.
“When I was secretary, we established the Office of Research on Women’s Health and also noted in a survey that women in post-menopausal ages do have significant incidences of heart attack and other vascular conditions. So we need to be sure that we don’t have our biases influence the decisions we make to the detriment of the patient,” Sullivan said.
He said biases point to a need for more racial and ethnic diversity among the nation’s health professions.
“Up through the 1950s, only 2 percent of the nation’s medical students were African-Americans. So it was my privilege to be recruited back to my college alma mater, Morehouse College, in 1975 to organize the Morehouse School of Medicine. We admitted our first class there in 1978,” Sullivan said.
Sullivan, who has written a book, “Breaking Ground,” which will be published in February 2014, said it will include his experience of having to leave Georgia’s segregated higher education system to attend medical school at Boston University. He said his return to the South 21 years later to organize the Morehouse School of Medicine, however, was supported by both black and white physicians.
Dr. Regina Benjamin, a former U.S. surgeon general, and Dr. Wayne Riley, former president of Meharry Medical College in Nashville, Tenn., are among the school’s alumni.
“While we’re a young school, our graduates have done remarkable things, in addition to having a percentage of our students going into medical education to serve rural and inner city community as primary care physicians,” he said.
He credits the Civil Rights Movement with opening doors for many African-American medical school graduates, with some 1,100 to 1,200 black students nationwide entering medical school every year.
“And we need more because today virtually one third of Americans is either a Latino, African-American or Native American. But when you look at the health professions, the percentage of these population groups within (these professions) is around 10 percent or less,” he said, noting that the U.S. Census Bureau projects there will be no majority population by 2043.
Benjamin said a healthy minority population will consequently be key in keeping the nation’s competitive economic advantage in the world as well as “from a humanitarian perspective.”
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