There are turning points in every life. But for people from poor and minority communities, turning points are often devastating downward spirals. Mine came when I was just 11 and growing up in 1960s rural Arkansas. Like many Americans raised in poverty, it was rooted in healthcare—or, more accurately—the lack of it.
My father was a strong, hard-working man who was diagnosed with cancer in his early 40s. Because we were poor and black, he did not receive medical attention appropriate for his condition. In 1968, I watched my father die at age 44. That same year, the Rev. Martin Luther King Jr. was assassinated. Dr. King had become a superhero to me, and his death impacted me almost as deeply as the loss of my father.
I was filled with rage and despair, shutting down completely and almost losing my way. But my mother wasn't having it. She channeled my fury in a positive direction. Become a doctor yourself, she said. Go to college. Go to medical school. Make a difference. I took her words to heart. I was accepted to Harvard University, won a Rhodes scholarship and earned a Ph.D. in immunology at Oxford University. Ultimately I earned my medical degree in 1987 from Johns Hopkins University School of Medicine. I could have done many things in medicine. But I knew what my mother meant all those years when I was such a sad and angry child. Don't just make a difference for yourself. Make a difference for us. Help your people.
That's what I did. Troubled that African-Americans were 13% of the population but made up 45% of new AIDS infections, I focused my research career on HIV and AIDS. Years later, in 2015, I accepted the position of president at Meharry Medical College in Nashville, one of the nation's oldest historically black medical schools. I wanted to have the greatest impact possible on preparing doctors to care for the underserved—and that is precisely Meharry's mission.
I am not an anomaly. I am a case in point. Many of us from disadvantaged, marginalized and minority communities will use our educations to better the places we came from. Data bear this out in the medical field. A study published in February 2018 in the Journal of Health Care for the Poor and Underserved looked at the racial and ethnic composition and distribution of primary-care physicians. It found the preponderance of physicians serving in health professional shortage areas, or HPSAs, across the country—primarily areas of urban and rural poverty—come from those very communities. Of almost 150,000 physicians in the study cohort, 72.5% were white, 11.2% Asian, 6.8% black, 5.9% Hispanic, and 0.7% Native American. Yet among family physicians and general practitioners working in HPSAs, 44.3% were Native American, 34.5% black, 30.2% Hispanic, 28.9% white, and 17% Asian.
The study concluded: "Eliminating disparities in K-12 education, enhancing pipeline programs and college-level interventions, transforming medical school admissions through holistic review processes, and improving under-represented minority placement into graduate medical education are some promising ways to increase physician diversity."
I concur. The medical field must do its part to give students incentives and support those, particularly minorities, who enter medical school determined to work in impoverished areas. We need them. Minority and underserved communities are not only the most unhealthy in the nation, suffering inordinately from heart disease, diabetes and cancer, they also are woefully short of physicians. Lack of decent care can send patients and their families into downward spirals—physically, emotionally and economically—from which many will never recover.
We can help solve this disparity of care. We can help create turning points that lead in a positive direction, both for talented students eager to serve and for the places they come from.
At Meharry, we have recently enhanced our stellar degree program with initiatives that include: an inaugural summit, held this fall, for black men considering health careers; our MeharryNOW program to cultivate an interest in math and science among young minority students; and our three-plus-three-year program, a partnership with Middle Tennessee State University that creates an accelerated path for talented students to graduate as physicians, and encourages them to practice in underserved areas of the state.
Meharry also is ensuring that the curriculum exposes students to cutting-edge data science, as well as healthcare policy and administration. In this way, they will be prepared to participate in and run successful, sustainable healthcare practices in a changed and changing healthcare ecosystem.
Meharry intends to do even more and urges other medical schools to follow suit. We must create a more robust pipeline of qualified medical school applicants who want to specialize in primary care for our most vulnerable citizens. If we do not, too many Americans will continue to die needlessly the way my father did, without access to quality care because of the color of their skin or the dire economic circumstances of their birth. If we do, we will be fueling the passion of so many young people determined to make our nation healthier by giving back to the communities that helped make them who they are.
Dr. James E.K. Hildreth is president of Meharry Medical College in Nashville. Founded in 1876, Meharry is one of the oldest historically black medical colleges in the nation.
