Physician Outlook

The Sekhmet Writing Project 8/12 The Clutch One


Since COVID-19 has disproportionately affected minority races, the importance of her work goes far beyond academics and science research.

Nearly a year ago I had this thought, “If we as women want healthcare to be better, then we need to start being better for one another.” When I committed myself to this twelve month longitudinal writing project I had no idea that the hardest part of the process would be choosing the women I would feature. You see when I began purposefully looking around the country at the work my female colleagues were doing, I found it overwhelming the number of individuals who deserved to be recognized. All across the country, I learned about female physicians who are leading positive, productive change in academia, research, healthcare administration, and above all the way patient care is delivered. While there are so many physician women I could have featured in this month’s edition, I decided to deviate slightly by bending my own rules and showcasing a female with her doctorate in both microbiology and immunology. For the work that she has done and continues to do is redirecting humanity towards a whole new (and safer) trajectory.

Kizzmekia Corbett, P.h.D

Dr. Corbett is thirty-four years old. She works for one of the most prestigious research facilities in the world: The National Institutes of Health. Her boss, none other than Dr. Tony Fauci.

By all accounts, Dr. Corbett grew up as a precocious and tenacious Black girl in rural North Carolina. Her love for academia, especially the sciences, was obvious to many who knew her. While she continued to thrive in primary and secondary school, she absolutely flourished through her undergraduate and post-graduate studies. While her academic accolades can easily speak for themselves, there are more reasons than these as to why I write about her today.

Currently in America, there are two glaring data points that everyone should be aware of. The first is the representation of Black individuals in STEM careers. According to the US National Science Foundation, Black men represent 3% and Black women represent 2%1. More on this in a moment. The second is the disproportionate health outcomes existing between the Black race compared to all other races. According to the US Department of Health and Human Services, African Americans have the highest mortality rate for all cancers combined compared with any other racial and ethnic group2. Their infant mortality rate is 11 per 1,000 deaths compared to the 4.7 per 1,000 births of Non-Hispanic Whites2. They are also 2.5x times likely to have diabetes and across the board are less likely to have access to preventive health services including routine mammograms, colonoscopies and vaccinations2 (more on this in a moment).

Let’s break down the first data point.

To understand the extraordinary achievement of Dr. Corbett, we must first dive headfirst into America’s past. When Brown vs the Board of Education mandated all schools in America be integrated, like all entities controlled by white American culture, this process would prove to be far from simple.  In the early 1950s, most of America’s largest cities were occupied by the white race. But two things would occur around this time that would forever change the landscape of equitable education in America. The first is the passing of the GI Bill in 1944. While the GI Bill helped pull America out of the recession that followed the Second World War by addressing key social needs like unemployment, housing, and education of America’s veterans, it also helped build the white middle class. As many Black individuals fled the outwardly racist and oppressive culture of the South, they still were met with equal amounts of racism and oppression from a similar type of culture that was able to hide these transgressions better than southern tenants. One in particular is known as the White Flight.

As Black families began moving into other regions of America, shortly after, white families began leaving these city regions. This was mainly accomplished due to their privileged access to the GI Bill that pertained only to the purchase of a brand new home. This meant that property outside of city-dwelling became an affordable and cheap way to increase housing opportunities.  Though the bill was not written to exclude women or minority races, studies show that directly following WWII, and both the Korean and Vietnam wars, Black veterans were disproportionately denied access to the GI Bill compared to white veterans (data based on per 1,000 individuals)3.  This becomes yet another contributing force that negatively impacted the Black communities. In fact there is a direct correlation between this and the inequitable distribution of educational resources seen in these communities. This along with other factors including rapidly diminishing property values in the red-lined housing districts, exclusion of access for Black individuals to new mortgage loans,  decreased accessibility to funding for higher education, are all reasons as to how America’s education system has remained segregated, though decades ago it was ruled unconstitutional. The effects have been devastating, especially pertaining to generational gaps in both education and wealth among the white and Black races, gaps still very much in effect today.

In the area I grew up, the academic success of its children was built on a foundation supported by white privilege.  This model of education in the community ensured the success of future generations by providing more than adequate academic tools necessary for students to succeed.  However simultaneously, with intent or not, this model also created a disparity towards the minority populations that it failed to recognize, thus favoring white interests above others, weakening nearby minority communities, and further widening the racial divide.  Having the funds to support more teachers and staff with fewer students per class, having an overabundance of educational materials needed to teach, having free on-campus collegiate level courses with transferable units to any university after completion of high school, and having boosters available to fill financial gaps when allocated funds from the state/county fell short, are all examples of the embedded advantages my community used simply as safety nets to ensure a student’s success.  In other words, measures implemented to first ensure the success of our white community, without pause or reflection to give our excess to the communities of minorities who already had less. As a teenager growing up in this world, I had no idea these safety nets even existed, let alone existed uniquely for us.

This is why my success as a physician is far from extraordinary when compared side by side with Dr. Corbett’s achievement in her STEM career. For every one roadblock I encountered to obtain my graduate degree, she encountered ten. She should not be seen as the exception but as an example of how hard it is for Black individuals to achieve success in fields such as STEM. Perhaps if we did that, we could all easily trace the line of her success back to the thousands of ways Black individuals have endured oppression at the hands of the white race.

Now for the second data point. Again let’s dive into America’s history.

One of the many privileges white America benefits from is the centuries worth of collected medical research used today to improve overall health outcomes (for the white race more so than any other). What most white Americans fail to recognize is the very data they benefit from came at the cost of Black suffrage.

Though scarcely talked about, America’s healthcare system is saturated with racism. From the care previously, and in many cases still currently delivered by healthcare providers. To the inequitable access to healthcare services. To the lack of recognition in which social determinants of health negatively impact minority populations compared to the white. To unethical research practices which favored the participation of minority races, it becomes more work to NOT acknowledge the rampant racism in healthcare to those who are unwilling to see it. While this topic alone could take anyone years to fully understand ( I would recommend reading Medical Aparthed by Harriet A. Washington as a great introduction to this topic) I will limit this discussion specifically to unethical research practices. Perhaps the most notorious is the infamous “Tuskegee Study of Untreated Syphilis in the Black Male” funded by the United States Public Health System. This study aimed to understand the natural progression of syphilis on the human body over time. The study included 600 Black male participants and extended from 1932 to 1972. Even though in 1947 Penicillin had become the known drug of choice to treat syphilis, participants were still denied access to it as well as discouraged from seeking medical treatment outside their assigned researching physician4. While the study was meant to last only six months, it continued for a total of forty years (of which twenty-three occurred after a well established treatment option was known). This study is just one example of thousands in which the consequence of unethical practices led to the rightful distrust by the Black community ofAmerica’s healthcare system. The Tuskegee Study became a symbol of [the Black race’s] mistreatment by the medical establishment, a metaphor for deceit, conspiracy, malpractice, and neglect, if not outright genocide (Corbie-Smith et al. (1999)).

This is why Dr. Corbett again represents so much more than what is seen on the surface. Since COVID-19 has disproportionately affected minority races in both infection rate and disease related deaths, the importance of her work goes far beyond academics and science research. She represents a familiar face in a space that has historically been monopolized by white men. She represents an opportunity for a new relationship to forge between the healthcare system and minority races. She represents the face of our future, a face minority children can identify with. And most importantly, she will become the greatest of tipping points towards the high COVID-19 vaccination rates of minority individuals.

Her work is undeniably monumental.

More so, undeniably, she is monumental.

She is clutch.

And we should all be eternally grateful for her tenacity as I cannot even begin to imagine the obstacles she faced that the white race intentionally or unintentionally placed in her path towards success. 

Sources:

1. https://www.nsf.gov/statistics/2017/nsf17310/digest/occupation/overall.cfm

2. U.S. Department of Health and Human Services Office of Minority Health, “Cancer and African Americans,” available at https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=4&lvlid=16 (last accessed April 2020)

3. https://journeys.dartmouth.edu/censushistory/2016/10/31/black-and-white-veterans-and-the-gi-bill/

4. https://www.cdc.gov/tuskegee/timeline.htm

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