COVID-19 has laid bare stark health care disparities between Black and Hispanics and their white counterparts. According to the CDC, these communities have borne the brunt of the pandemic, with cases and deaths nationally exceeding their share of the population.
Here in New York, as a physician working for Weill Cornell Medicine, I witnessed this firsthand. On the Upper East Side of Manhattan, where Weill Cornell Medicine is located, mortality rates from COVID-19 were lower than in other parts of the city, particularly upper Manhattan and the Bronx, historically under-resourced areas where the population is largely Black and Hispanic.
The impact of social determinants of health are no surprise to many of us in the medical community. According to the U.S. National Center for Health Statistics, the life expectancy of Black men in 2020 was 72.6 compared to 77.7 for white men. According to the U.S. Department of Health and Human Services, the infant mortality rate for Black babies is a staggering 10.8% per 1,000 live births compared to 4.6% for white babies. Tragically, although overall infant mortality in the U.S. has fallen for all racial/ethnic groups, the disparity between Black and white infant mortality has only worsened in the past 50 years. These are but two examples among countless others.
In order to change this, we must invest in diversifying the physician workforce. Research has shown the mortality rate for Black babies falls dramatically when Black doctors care for them after birth, and that cardiovascular mortality rates for Black men are improved when they see Black doctors. But there are too few physicians of color to treat the growing minority population.
The path forward requires New York State and the nation’s medical community to acknowledge systemic barriers that prevent students from backgrounds underrepresented in medicine from becoming physicians and adopt strategies to mitigate or eliminate these barriers.
Weill Cornell Medicine’s Travelers Summer Research Fellowship Program and the state-funded post-baccalaureate programs run by the Associated Medical Schools of New York (AMSNY) are valuable tools in this mission. These pipeline programs help level the playing field. They provide additional support to students from communities that lack the resources to adequately prepare one for matriculation and success in medical school.
AMSNY recently released its Medical School Enrollment Report for 2020-2021, which analyzes student enrollment at New York State’s 17 medical schools. It found that students who are defined as underrepresented in medicine increased by almost two percentage points, reaching 21.1%. This is the first time since these statistics have been tracked that the percentage has exceeded 20%, indicating that pipeline programs work.
But if we simply start at the collegiate level, it’s too late. According to the report, “Addressing the Challenges to a Diverse Physician Workforce,” published by AMSNY in 20202, “beginning with the zip code into which a child is born, the pathway to medical school is punctuated with significant obstacles that discourage and prevent students from pursuing careers in medicine.” To effectively address the attrition of these students from the pipeline into medicine, it is important to identify the junctures at which young people inspired by medicine abandon those plans and develop targeted solutions.
Last month, Gov. Hochul released her first executive budget. In it, she proposed a historic increase in funding for AMSNY’s Diversity in Medicine Program — adding an additional $1.2 million. While this is fantastic news, the increase is far from finalized. To ensure these programs receive this level of funding in the final budget, the state Legislature must approve the governor’s increase.
As the COVID-19 persists in disproportionately affecting minority populations, it is more critical than ever that we invest in and expand pipeline programs for students from underrepresented backgrounds from early education through career. These targeted solutions can help bring our city closer to truly achieving health equity for all New Yorkers.
Howell is assistant dean for diversity and student life, vice chair for diversity in pediatrics and associate professor of clinical pediatrics at Weill Cornell Medicine.
