by Brooke Bunch

(Editor’s note: Today we feature the lecture of Darrell Grace, D.O., a Minority Health Month speaker. Next week we present the April 11 lecture of Nicholas Espinoza, D.O. (’90).)

The focus on Minority Health Month continued April 7, with a lecture on the importance of cultural competency as seen through the lens of the history of health-care disparities among African-Americans.

OU-COM students and faculty gathered to hear Darrell Grace, D.O., a graduate of Michigan State University College of Osteopathic Medicine. She is in private practice with Forum Health and the medical director of Windsor Nursing Home. She established Grace Place Medical Service, a clinic for the underserved, uninsured and underinsured, in association with the Greater Youngstown Coalition of Christians.

Grace presented “A New Paradigm: Trust and Parity Through Cultural Competency,” which focused on the health status and conditions of African Americans in the early history of the settlement of this country by Europeans to the present.

Using landmarks of the past, Grace, a Centers for Osteopathic Research and Education clinical professor and medical equity teacher, made the case for the importance of minority physicians in America’s health care.

Grace said the disparities in African-American health care can easily been seen throughout history, dating all the way back to the period of slavery, 1619–1865, when slaves received little or no medical care.

“From this we developed a separate black health-care system,” she said. “Even after slavery ended, blacks rightly feared hospitals or were denied treatment in hospitals. There was severe discrimination in the early hospital system.”

Medical care for African Americans suffered under the Jim Crow doctrine of “separate but equal,” because according to Grace, medical care was far from equal.

“It was a substandard medical care,” she said.

Grace pointed out the ups and downs in the health care of black Americans since the end of the Reconstruction. The Flexner Report brought about the closure of five black medical schools in 1910, further deepening the health-care disparity. But in 1965, civil rights legislation began a significant improvement in health care for blacks, said Grace.

She noted a major millstone of American medicine, the Tuskegee Syphilis study, which spanned the years 1932–1972 and has been called the “longest non-therapeutic study of human beings in history.” She said fallout from the study helped to perpetuate a climate of suspicion and distrust in the health-care system among black Americans.

She addressed the under representation of African Americans in America’s physician population. According to a June 1999 U.S. Census, 12.8 percent of the population was black, compared with just 2.5 percent blacks in the physician population as of the year 2000, said Grace.

“Since 1980, there’s been a continued deterioration in black health care,” she said. “Blacks have the worst death rates in 14 out of 16 leading causes of death in the United States.”

As a result, the implementation of cultural competency is critical in contemporary health care.

“Physicians must be knowledgeable of the patient populations they serve,” said Grace. “They need to understand disease incidence and prevalence among minorities.”

She offered some tips for future D.O.s when dealing with minority populations, such as: never assume — always ask. Grace said, never address black patients by their first names, do not use slang, listen without judgment, do not mimic pronunciation and avoid “color blindness.”

Grace concluded by professing the need for affirmative action in medical schools, which can help significantly increase minority enrollment. An advocate of affirmative action, she said the policy can help alleviate the health-care disparities experienced by minorities and create an environment of cultural understanding by increasing the number of minority physicians.

“I worked hard to get where I am,” she said. “I’m a product of affirmative action, and I’m proud of it.

“Minority patients are four times more likely to be seen by minority physicians,” she said. “So we need many more minority physicians than we currently have.”

"And we need cultural competency taught in all our medical schools.”

The lecture series will continue Friday, April 22, with Chau Pham, D.O. (’95), presenting “Ethnogeriatrics: The Southeast Asian Culture.” Former OU-COM Dean Barbara Ross-Lee, D.O., will conclude the series Thursday, April 28, with her presentation, “Wrap-Up: Policy and Health Disparities.” Ross-Lee is currently dean of New York Institute of Technology College of Osteopathic Medicine.

All presentations are from noon to 1 p.m. and are sponsored by the Center of Excellence for Multicultural Medicine and the Office of Student Affairs. For more information, please contact De-Anthony King, academic enrichment administrator, at (740) 593-2465.