cheryl-holder_web.jpgSome of American history really hurts. Still.  

For years, numerous studies have documented the African-American legacy of separate and unequal care. Black people are more likely than whites to die of cancer and heart disease, more likely to get diabetes and asthma, and less likely to get preventive care and screening.

Economics has been unveiled as a factor — those with low income tend to have poor dietary and exercising habits. Having no health insurance keeps them from seeking care until a disease is at its most advanced stages.

Low-income people of all races are less likely to have insurance and seek the routine physicals and screening tests that can catch disease in early stages. Black patients, however, are the ethnic group that waits the longest to seek medical care, making their illnesses even harder and more expensive to treat, experts say.

Since 1895, the National Medical Association, which addresses the interests of doctors and patients of African descent, has focused on a less conspicuous aspect of health disparities: the  legacy of racial divide in the organized medical community.

The NMA will hold its 2010 Convention and Scientific Assembly in Orlando from July 31 through Aug. 4. Doctors there will address these continuing disparities, and how to overcome them.

•The historical medical divide•

As much as women prefer to see a female gynecologist, black patients seem to seek out black doctors. And in the past, they were hard to find.

In 1840, black physicians were excluded from membership in the American Medical Association, which seeks to help doctors care for patients nationwide.

Yet the AMA once listed black doctors as “colored” in its American Medical Dictionary.

Because in most states doctors could not work in hospitals unless they were members of local medical societies, black doctors endured more than a century of limited work and access to patients.

Many black patients, already strained from facing segregated wings and second-rate care, were reluctant to see a white physician, and just gave up on seeking care altogether.

“Historically, there’s distrust of the black community in the medical community,” said Linda Blount, The American Cancer Society’s national vice president of health disparities. “Old perceptions that led patients not to believe that a non-black doctor is working on their behalf.”

In 1968, the AMA came around to a more tolerant position, and threatened to expel organizations that had racially exclusionary policies. Yet a culture of avoidance had already been established.

A shortage of black doctors seems to perpetuate the distrust. In 2008, African-American physicians accounted for only 6.2 percent of the total number of physicians employed in the country, according to the “Labor Force Characteristics by Race and Ethnicity Report” by the Bureau of Labor Statistics. Data from the Association of American Medical Colleges show that less than 2 percent of medical students are black.

•Bridging the gap•

In 2008, the AMA issued a formal apology for its shameful discriminatory policies.

“The AMA failed, across the span of a century, to live up to the high standards that define the noble profession of medicine,” said AMA Immediate Past President Ron Davis, M.D., in a commentary published in the July 16, 2008 Journal of the American Medical Association.

The NMA accepted the apology, and called on the AMA to work to recruit more black students into the profession, as well as to make cultural competency training mandatory.

In 2002, the AMA launched the “Doctors Back to School” program to raise awareness about the need for minority doctors, and to get minority doctors interested in medicine. Physicians and medical students share their personal stories, and talked to students about careers in medicine.

With 112 affiliated societies through the nation, the NMA provides education and mentorship, and organizes health fares and other events such as the “Walk a Mile with a Child,” which took place in May for the second consecutive time in Overtown.

The organization also engages its more than 30,000 members in a network that facilitates referrals, increasing the viability of black physicians.

•Unique challenges•

Cheryl Holder, director of the James Wilson Bridges Medical Association, and director of the local chapter of the NMA, said the challenges black physicians face are still staggering.

Because of the low-income areas where many black doctors serve, and the kinds of patients they treat, their health outcomes tend to be poorer than those of other physicians. Patients take more time to recover, hospitalization takes longer, and it is much more costly.

Therefore, the rating that black physicians get from HMOs is compromised, and they don’t get paid as much. Also racism, Holder said, is still a predicament among physicians.

“Even when I identify myself as a doctor, some people look down on me,” she said. “The racial barrier is tiring.”

“We will keep taking care of our people,” she said.

For more information about the National Medical Association, log onto

Photo: Cheryl Holder