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Systemic Racism in Healthcare to Meet its Match with Interdisciplinary Health Equity Champions–Local and Abroad

This article is a part of our CTSC Event Recap series.

On Saturday, September 24, 2022, 45 health equity champions from across Northeast Ohio convened at the Cleveland History Center to watch documentary and participate in an interactive panel discussion featuring: Drs. Debora Bruno (University Hospitals), (Cleveland Clinic) and (Louis Stokes Veterans Administration Cleveland Medical Center).

(Left to right - Drs. Bruno, Singh, and Jehi) Dr. Bruno, Assistant Professor, School of Medicine at �ǿմ�ý, member of the Population and Prevention Program at Case Comprehensive Cancer Center, thoracic oncologist at University Hospitals, and manager of the Dahms Clinical Research Unit, fields an audience member’s question.

The , a , partnered with the Clinical and Translational Collaborative of Cleveland (CTSC) to co-host the event, made possible by the . The Color of Care is a documentary that provides firsthand and historical accounts demonstrating how racism permeates healthcare in America and perpetuates the existence of health disparities–using the COVID-19 pandemic as an example of systemic negligence that costs lives. 

“In the healthcare system, what is changing is that we need to be culturally humble. We need to speak less, listen more, ask more questions, understand what patients and families bring with them when you work with them in order to establish effective communication,” Dr. Bruno explained. 

Most attendees work in healthcare at one of our local healthcare institutions or academia while others were representatives from foundations or the community. The passion for eliminating health disparities was palpable during lunch conversations in a rotunda surrounded by a motorcycle exhibit with a view of the Euclid Beach carousel.

Attendees enjoy lunch and conversation with new and old acquaintances in the rotunda at the Cleveland History Center.

The Color of Care acknowledges key points that paint the current picture of health equity in America. Throughout the film, viewers learned about examples of how zip code determines life expectancy–illustrating the connection between systemic inequity and environmental injustice (read for local context). 

“We’re moving away from the thought that disease is a product of biology. The social determinants of health play a very important role in determining our health.” Dr. Bruno said. 

Another piece of food for thought is that, “All of our math…how we predict how people are going to do…are based on the past. And if the past circumstances are based on racism or things that are not right or things that could be improved, what we end up doing with those algorithms is perpetuating those differences.” This statement, from a clinical expert, in the film explains the gravity of responsibility that the biomedical research industry has in helping to eradicate current practices, through health equity research, with limited to no scientific basis and disproportionate negative impact on health outcomes for racial and ethnic minorities. 

“Race is a social construct. There shouldn’t be that much of a difference […] when 99.9% of the genome is the same. Why are we thinking about things differently in terms of treatment?” Dr. Singh declared. She added, “The students are the ones who will come back after watching something like this and say, ‘Wait a minute, why is this the way it is? Why am I calculating this GFR [glomerular filtration rate - a blood test that checks how well your kidneys are working] the way I’m calculating it? Biologically there is no difference. […] We, as researchers and scientists, better have an answer.”

A recent example of a local physician doing the work comes from UH Harrington Heart & Vascular Institute physician, Dr. Sadeer Al-Kindi. Dr. Al-Kindi who found that there is a link between 1930s redlining and an increase in contemporary cardiometabolic health risk factors, including heart disease, kidney failure, and diabetes (read the article in full ). 

A somber energy took over the room as Black and Brown families recounted deceased loved ones’ healthcare interactions during one of the most anxiety-inducing, uncertain, and chaotic times in recent public health history.

Question topics from audience members ranged from required training and best ways to engage students (at all levels) to understand the importance of trust, empathy, lived experience, cultural humility, and relationships to patient self-advocacy (e.g., what to do if you believe you’ve been discriminated against or otherwise mistreated in a healthcare setting).

Mary Louise Tatum, Behavioral Health Advanced Practice Nurse, Cleveland Clinic, asks the panel for insights about encouraging acknowledgement of racial and ethnic fragility and privilege to change rigidity in thinking.

“All folks need to work together without any one of us thinking we know more than another. Documentaries like this are starting the conversation,” Dr. Jehi proclaimed.

Interested in viewing the film? Cleveland Clinic, Louis Stokes Veterans Administration Cleveland Medical Center, and University Hospitals are expected to host institutional virtual screenings before the end of the year. 

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