By Lucie Turkel
From mental health crises to extreme poverty, the effects of the ongoing Covid-19 pandemic continue to bring to light fissures in both our national and global societies. One such fissure is the racial and ethnic disparities that are present in medical care and health outcomes in the United States, as is shown by the way Covid-19 affects Black, indigenous, Latinx, and other people of color the most.
But these racial discrepancies in healthcare are not new; rather, one can track an entire history of differing medical treatment and outcomes in the United States in order to understand how we got to where we are and what we can do to change it, as the Phi Beta Kappa Baltimore Association’s virtual event, “Healthcare and Hypersegregation: Racial Inequities in Medicine,” highlighted.
The speaker for the event was Graham Mooney, a professor of the history of medicine and epidemiology at the Johns Hopkins School of Medicine. Originally a geographer, Mooney was always fascinated by questions of place and space. “[I’m interested in] trying to work out why people’s health outcomes are different from place to place,” Mooney said. “And then when you think about that, you begin to realize that those spatial differentials are connected to other aspects of society and culture that are also spatially structured, such as race and class.”
These connections between space, race, class, and health in urban America are the basis of not only the book Mooney is currently working on but also a class he teaches at the Bloomberg School of Public Health on the history of public health in Baltimore. The lecture he gave to the ΦBK Baltimore Association focused on this topic.
Mooney began his lecture by discussing the latter term in the event title “Healthcare and Hypersegregation,” explaining how housing ordinances, restrictive covenants, and redlining were three major ways in which the majority of urban cities in the United States were residentially segregated. A similar sort of segregation occurred in primary care, with the merging and disbanding of many medical schools across the country triggered by the 1910 Flexner Report, which ended up shutting down five of the seven medical schools that educated African Americans.
By the 1920s many communities of color, specifically the Black community in Baltimore, were becoming aware of racial and socioeconomic disparities in health outcomes. The 1948 Baltimore Medical Plan originally seemed to be a way to offer respite to this issue, as it allowed family physicians to refer patients on welfare to medical centers. However, Mooney explained how the program ended up exposing the inequalities of the private medical market, the lack of quality care for Black patients, and the heavy caseload Black physicians faced due to the refusal of some white doctors to treat Black patients.
While Mooney discussed the city of Baltimore specifically, there is no doubt that the effects of segregation in healthcare are felt by Black people all throughout the United States. Nationwide through January 13, Black/African American people were most likely to have died from Covid-19. It is because of the continuously pressing and devastating issue of racial disparity in the delivery of healthcare that ΦBK Baltimore felt this event was important both to Baltimore and to wider virtual communities.
“Everyone should be entitled to equal access to healthcare. However, that is not true, and it has become even more evident as we face the coronavirus,” ΦBK Baltimore President Pamela Malester said. “We in Phi Beta Kappa understand the importance of learning more about this systemic problem and how we can help to eliminate such heinous inequality.”
Mooney believes that the only way forward is to learn from our past. “If we understand some of the structural causes of health disparities, they can help us understand how we can address them, and we can begin to create a more equal and just society,” he said. “These are things that should interest us all as citizens of the world and as people who are able to observe inequality and social injustice all around us.”
Lucie Turkel is a senior at the University of Connecticut pursuing an individualized major in comparative literary and cultural studies. She was inducted into Phi Beta Kappa in May 2020. UConn is home to the Epsilon of Connecticut chapter of Phi Beta Kappa.