“Of all the forms of inequality, injustice in health care is the most shocking and inhumane.”  ~ Dr. Martin Luther King, Jr.

As a nation, we recently celebrated the life and vision of Dr. Martin Luther King, Jr. Some of us had a day off work, some engaged in a day of service, others attended interfaith services, while many—myself included—reflected on his words of racial and economic justice. I looked inward asking myself what does this mean for us today. Is the struggle for equality and justice over?

The short answer is no.  Actually, we are far from it.

I recently read an article, “Black arthritis patients get fewer potent drugs,” (http://www.reuters.com/article/2012/08/02/us-arthiritis-drugs-idUSBRE8711E520120802). The reporter indicated that people of color were prescribed less powerful arthritis medications (biologics) than their white peers.  We are talking about revolutionary drugs that can ease pain and suffering.  One wonders whose pain we value more.

Why is this the case? I suggest the culprit is institutional racism and classism. And I’m not talking about the Klan or Neo-Nazis. I’m talking about a system where seemingly nice and well-intentioned doctors who took the Hippocratic Oath to do no harm often unconsciously privilege some folks while marginalizing others.

But, please do not read this as an indictment against those who dedicate their professional life to medicine. It’s not about individual doctors. It’s about the way medical schools and CME (Continuing Medical Education) courses largely miss a critical part of proper medical training by not exposing doctors to a patient centered focus.

Medical training fails to highlight the intersecting identities of patients and how they are treated based on these identities. By not making this focus a priority, it is harder for doctors to grasp that patients are impacted by a healthcare system that is essentially biased.  We know from study after study that medicine cannot be practiced in a void because as we tragically see it is not “color blind”.

It is essential that doctors are taught about the racism and economic injustice that affects healthcare delivery. Unless medical schools and CME providers consciously think about these issues, Dr. King’s struggle for equality and justice will never be over.

Noam Gerber, MPH, and CreakyJoints Data Scientist provides important insight:  “The healthcare industry should use human rights as the framework and vocabulary to analyze and respond to societal determinants of health.”

Noam continues: “Racial and financial inequality in this country are the main factors driving health disparities. Biological factors alone cannot, and do not, account for the worse health states of people of color and people living in low socio-economic communities. Unfortunately, the old adage is true, that money does buy healthiness.”

Too often we talk about healthcare issues without including the voices of those who are most impacted by them. I recently had the opportunity to speak with two of Seth’s 50 State Network Super Advocates, Sylvia from Kentucky, and Rachelle from Michigan.  Here are their perspectives.  Please listen up. 

Sylvia speaks to the importance of assertive communication and knowing what resources are out there: “To me it is about the lack of education on the part of doctor as well as the patient. Most doctors who work for these clinics aren’t always on the cutting edge and stick to cheaper generic drugs and the patients are not aware of the alternatives that they have, especially when confronted with the cost. I had a doctor write a prescription for me and then told me I wouldn’t be able to afford it but I could try.”

Fortunately for Sylvia, she did something about it: “I took it upon myself to contact the manufacturer’s patient access program and I now receive a medication that would have cost me $1,800.00 a month for free. When I told the doctor at my next visit he was shocked and I replaced him with another doctor and I am happy to say, I am much better!”

Rachelle also calls us to action: “One of the reasons I joined the Global Healthy Living Foundation as a Super Advocate is because of its mission to increase access to care for anyone living with chronic illness.  When this particular article (“Black arthritis patients get fewer potent drugs”) was shared with me, my aching, arthritic jaw hit the ground.”

Even with aching jaw, Rachelle refuses to be silent about this injustice:  “We all know that there are inequalities in healthcare and society, but the idea that an entire race of people are being denied access to medications that can save their joints and keep them from experiencing permanent, irreversible disability, this is something of which the entire community should take note. The mission of the GHLF to increase access to care for all of us is an important one; we all need to take note to help one another.”

This folks, is just the tip of the healthberg. I will work hard so we can have a continued dialogue about these issues to ensure that our healthcare system becomes more aligned with Dr. King’s vision of equity.  So Rachelle, Sylvia and all those out there—let’s change the system! It’s time.

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