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On MLK Day, Striving to Understand Deep-Seated Racism in Healthcare

News January 31, 2023

Linda Villarosa speaking at a podiumMartin Luther King Jr. Day has long been an opportunity at the Lewis Katz School of Medicine to pause and reflect on Dr. King’s profound impact. But in many ways, the school’s faculty and students pay homage to his legacy every day.

“Throughout the year, every year, our students and faculty are in the community providing services, from tutoring our youngest community members to providing healthcare services to those most vulnerable,” said Amy J. Goldberg, MD, FACS, the Marjorie Joy Katz Dean of the Katz School of Medicine, the George S. Peters, MD, and Louise C. Peters Chair and Professor of Surgery, and Surgeon-in-Chief of the Temple University Health System.

“Diversity, equity, and inclusion are important to us at Temple,” Dr. Goldberg said. “We recognize that an environment enriched with people from varied backgrounds working to address health disparities enhances scholarly work and the development of a culturally aware and responsive healthcare workforce.

“But even with all the work we’ve done, we know there is far more still to do,” she continued. “Sadly, injustices still exist within healthcare. We see it every day here in North Philadelphia.”

Dr. Goldberg spoke on January 16 at the Temple Performing Arts Center, where the medical school hosted Linda Villarosa, a contributing writer on race, inequity, and health for The New York Times Magazine. The Student Government Association Community Service Board and the Center for Urban Bioethics organized the event.

Villarosa’s essay on medical myths about Black people is featured in the magazine’s Pulitzer Prize-winning 1619 Project, an ongoing initiative that “aims to reframe the country’s history by placing the consequences of slavery and the contributions of Black Americans at the very center of our national narrative.”

Her third book, Under the Skin: The Hidden Toll of Racism on American Lives and on the Health of Our Nation, was published last June. In it, Villarosa explores the forces in the American healthcare system and American society that have long caused Black people to have poorer health outcomes than their white counterparts.

At the MLK Day event, Villarosa shared insights from both publications, as well as personal experiences that helped to inspire her research.

“Even though we spend so much [on healthcare] and we have innovative healthcare, it doesn’t add up to good health,” she said.

The seed for Under the Skin was a 2018 article she wrote for The New York Times Magazine about Black maternal and infant mortality in America. While the U.S. lags behind many of the world’s richest countries in several health categories, its maternal mortality rate, Villarosa said, is worse than that of many developing nations. And among Black women, the problem is particularly acute. They are three to four times more likely than other American women to die from pregnancy or labor and delivery complications, according to Villarosa.

“Obviously, healthcare should be a human right,” she said, “and we don’t have that right now. But even if we had universal access to healthcare, it still would not entirely correct the inequalities that exist in our country as far as health outcomes.”

Though health systems recently have focused on improving accessibility to care among traditionally neglected neighborhoods, Villarosa said the feedback she has received from members of such communities across the country is that accessibility is often not the issue. What’s deterring many, she said, is disturbing experiences within the health systems.

“I certainly don’t think anybody becomes a physician, nurse, PA, or an administrator to harm people,” she said. “But something is happening in the healthcare system to cause that kind of treatment.”

Villarosa said she encountered it firsthand when her father was a patient in a veteran’s hospital in Denver in 1999. He’d become so agitated that he was restrained. Villarosa showed pictures of her normally dapper father to his providers and told them he was a scientist. She told them he’d be fine if he were treated humanely. They did, and he quickly improved. But she still questions why it needed to come to that.

Linda Villarosa and Dr. Amy J. Goldberg posing with a group of four young women and one young manOne of the student organizers, Kristine Chin, MD '26, said Villarosa helped personalize the work she and her classmates have done, and continue to do, in the surrounding community.

“During my time here at the Lewis Katz School of Medicine, I’ve been involved in a lot of community service programs and events,” Chin said. “But being a part of the day’s planning, as well as witnessing the day itself, allowed me to step back and reflect on the service I’ve done; how the service we do impacts the community, and how we must continue to work together to build and support the North Philadelphia community.”

Chin said she asked Melanie A. Cosby, PhD, Director of Diversity and Inclusion at the Lewis Katz School of Medicine Office of Health Equity, Diversity, and Inclusion, about how she could contribute to “community engagement and increase service opportunities for students.” In the course of that conversation, Dr. Cosby referenced the MLK Day program, “so I hopped aboard,” said Chin, who is the Student Government Association’s first-year community service representative.

She said helping with the day’s preparations and execution brought her into contact not only with Villarosa but also with many other like-minded faculty, physicians, and students, which was empowering in and of itself.

At the conclusion of the morning’s program, Chin, who delivered the closing remarks, said, “Service without reflection can run the risk of being nothing more than a performative exercise that centers around how we feel and what we think is best for the community, rather than focusing on what the community needs and wants and how we can work together with them to achieve this.”

With that, she encouraged her classmates to participate in one of the service projects undertaken in Dr. King’s memory. Through the end of the month, the school’s medical students, in collaboration with the Temple University Hospital Patient Experience Department, are conducting a warm clothing drive for students at the nearby Mary McLeod Bethune School. And physician assistant students prepared “blessing bags,” which they shared with the school’s unsheltered neighbors.