Knutson

=Struggles of African Americans Entering the Medical Field =

The struggles of African Americans interested in a professional career in the medical field have gradually gotten easier as time has increased. In the early 1930's African American endeavors to obtain a medical education were restricted by the segregation in schools. They were limited to Historically Black Colleges and Universities (HBCUs) for a higher educations that are a result of America's social contract to educate blacks under the "separate but equal" act [10]. However, these black colleges lacked the financial resources to continue to graduate their Black students into the middle class. As it became more difficult for Blacks to get admitted to these few black colleges, due to the increase in African Americans applying to college, they began lobbying to be admitted into Principally White Institutions (PWIs). In 1933, Thomas Hocutt became the first black student to file a lawsuit in an attempt to gain admission to an all-white professional school. Even though Hocutt was denied admission, the case helped shape the direction of successive desegregation cases. Soon an increasing number of states began admitting black students to previously all-white graduate and professional schools under court orders. To prevent desegregation of higher education schools, many adopted acts, similar to the Murphy Act created by the University of North Carolina, which would cover the expense difference for Negroes if they attented a Negro college in another state [10]. One of the most popular Negro colleges was Merharry Medical College in Nashville, Tennessee. The Sanger Committee urged state officials to consider professional education on a regional basis, so that public funds would meet the need for training more black health professionals while spreading the expense among several states. The white population was content with this because they believed they were pleasing the Negro by giving them the education they desired while preventing desegregation of predominantly white schools. However, this required many Negroes to travel long distances to attended these professional schools [10]. What people didn't understand was that the declining health of the African American population was correlated with the minimal numbers of African American physicians.

Early Struggles with Discrimination
In the early 1930's African Americans were still experiencing the effects of racism. African American physicians that were fortunate enough to receive a medical education continued to suffer from racial segregation. The American Medical Association issued a directory of American physicians that contained the word "colored" after the names of all Negro physicians on the list. Shortly after, the N.A.A.C.P. (The National Association for the Advancement of Colored People) protested against this unnecessary racial designation by demanding the immediate removal of the word. The N.A.A.C.P. also encouraged Negro physicians to protest against the unfair discrimination because no other racial groups were required of this labeling [13]. Despite the N.A.A.C.P.'s efforts, the attitudes of the white population can be seen in the editor's note at the end of the article. The editor stated that, "We can not join or support the protest. It seems clear to us that there is no grounds or reason for it. The protest on its face is a veritable CONTRADICTION, since the Association itself uses the protested term every time it writes or speaks its name" [13]. The editor states that they cannot take sides, but they clearly show their bias and lack of support for the African Americans when they state that there is no reason for the protest.

However, because a majority of whites didn't feel much sympathy for the African American population didn't mean that every white person felt that way. For example, Mr. Julius Rosenwald left a fortune of millions to an expert board of people that were instructed to find the best ways to distribute the money. Edwin R. Embree, president of the Rosenwald Fund stated that the Fund hoped to change Southern states and counties attitudes towards Negro schools and health. Every year the Rosenwald Fund pays out one million dollars to Negro Schools and other aspects of Negro welfare and race relations. The Fund helped to create 5,357 Negro public schools in 883 counties of 15 Southern states. In terms of medical professions, the Fund has created fellowships for Negroes, giving them opportunities for advanced study in professional fields. It has also donated a million dollars to build a dozen hospitals to serve as a place for colored patients to go for treatment and a place to train colored medical and nursing professions. The deeds of the Fund have created an interest in Negro health among southern health officers [3]. This increased interest has enabled people to realize that a majority of African American health issues are caused by insufficient African American doctors entering into the medical field. The only way to address this issue is to realize that many African American are unable to receive a proper medical education due to segregation and discrimination in the application process to higher education institutions.

[[image:eng102fall11/bath_aids.jpg width="239" height="158" align="left" caption="A man with AIDS"]]Medical Disparities Among Black & White Populations
One of the best ways to measure the effects of racisms is to investigate the health discrepancies within the Black community. The overall death rate is higher and the Black communities tend to have shorter life spans than the White community. Regardless of new medications, Blacks were still 5.8 times more likely to die from HIV/AIDS and 2.8 times more likely to die from diabetes. Diabetes isn't a disease that should be killing anyone because there are medications and different diets that can manage the symptoms of the disease. In 1994, the four leading causes of death among Blacks included heart disease, stroke, cancer, and diabetes [2]. These are all treatable with proper medical attention, but the problem is that the Black community is still unable to attain the medical attention that they direly need. The U.S. Commission on Civil Rights listed the factors contributing to poor health outcomes as poverty, discrimination, cultural barriers, and the lack of access to health care [2]. In 1943, many spokesmen for colored Americans began protesting the policy of storing Negro and White plasma in separate blood banks, for the treatment of Negro and White wounded needing transfusions. This separation is a major sign of discrimination from our past. Phrases like "I am of pure Anglo-Saxon blood" confirmed to the human race the superstition that race and other inherited characteristics can be transmitted through the blood stream [6]. Many people from that time period did not understand that the race of the donor had nothing to do with the blood type and that the constituents of a Negroes blood were equal to that of any White man's blood. The reason behind the increasing medical discrepancies among the Black and White populations is the lack of higher education schools that will accept aspiring Black physicians. The U.S. Black patient seeking outpatient care is more likely to visit a Black physician, rather than a White physician [2]. This tendency has created a decrease in African American health because they are sometimes unable to find a practicing Black physician, let alone a completely knowledgeable one.

The Color Barrier
The Federal Government spends millions of dollars every year to improve the public health, but we very seldom do anything to strengthen the weakest link, the health of the Black community. The white population had created a severe shortage of Negro doctors, which is a top contributor to the high rate of Negro mortality and the spread of disease through both colored and white populations. In 1948, only 4,000 Negroes were practicing medicine compared to 176,000 white physicians. This leaves one colored doctor to every 3,337 colored patients [4]. Out of the seventy-seven medical schools, only two freely admit Negro applicants, and the two that do are Negro institutions. The hospitals that are essential to the training of all physicians have continually turned down colored medical graduates [4]. Due to the lower social economic status (SES) of many Black students attending higher education schools, they must somehow find the funds to cover the expenses. Often times this leads to minority graduates that have higher loan debt than White graduates resulting in the need to start working sooner to pay back their loans, instead of continuing in long residencies. Minority graduates instead pursue family practice because it is one of the shorter residencies. This causes Black physicians beginning practice with less experience and less ability to treat their Black patients. Black patients tend to receive lower quality of care for the treatment of cardiovascular disease and HIV infections, because these types of diseases require the attention of a specialist. However, there are very few African American specialist physicians in the medical field because of the factors above. Both cardiovascular disease and HIV are on the list of leading causes of death for Black Americans. Today (1998), only 16% of the nation's five million hospital workers are Black. However, the Black population constitutes a majority of the patient population.

Success Stories
Despite the many hardships placed upon Black physicians, many continue to strive to achieve their lifelong goals. Robert Jordan, M.D., Chief Resident in Pediatrics at Presbyterian St. Luke's Hospital, had high hopes to become a doctor in his younger years. At his integrated high school in Chicago he didn't feel that he was treated badly but was more or less ignored. He felt that counselor's just assumed that he wasn't college material because of the color of his skin becuase he was never given any information about college. Even after he achieved an excellent score on the M.C.A.T (medical college admissions test) exams, he was still discouraged by his counselor to become a doctor, but instead should go into social work. After high school, he didn't have the funds to attend college right away so he settled down with his wife and started a family. After working for ten years at a local post office, he decided that he would go back to school and finally achieve his dreams. Now, in 1981, he has achieved his goals as the Chief Resident in Pediatrics at Presbyterian St. Luke's Hospital. The little encouragement he received while going to school has caused him to reserve time to participate in programs aimed at motivating minority students to consider the health-related professions [11].

Gerard Michaels became one of the newest health care managers for one of the largest hospital networks in Austin, Texas, in 1998 [7]. There is only a handful of African Americans that are able to succeed in health care management. Not only is health care management a new field opening up for African Americans, but the Nursing careers are actually searching for African American applicants. The suburban hospitals that once administered to Anglowhite populations in the past are now hiring many African American nurses because of the growing diversity of America's population. In 1995, minorities mad up about 20% of all the nurses with bachelor's degrees and about 12% of the nurses with master's degrees were African Americans [7]. All of these are extraordinary achievements for the African American population because of the hardships place upon them. Regardless of the achievements, there still is room for improvements to increase the aspiring Black physicians and decrease the lack of proper health care for the entire Black population.

In Conclusion
Today, African Americans can more easily attain a medical education due to the increased access to higher education medical schools. The application process for many of these schools has also become more simple and less discriminatory against minorities. The increased numbers of Black physicians and health care workers will help boost the health of many in the African American population. Hopefully, in our future we will be able to see the effects of these changes become even more prevalant. The decrease in health issues and disease among all populations is something that everyone can wish for. However, regardless of the advancements aiding African Americans in their quest to become medical professionals, we still have a long journey ahead of us to create a truly equal country, in all aspects including the medical field.