Racism in Occupations Thesis

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African-Americans in the Field of Medicine: Social, Financial, Institutional, And Psychological Barriers

They call themselves 'the three doctors.' They are three African-American young men from the inner cities of Newark, the children of single mothers, all of whom became doctors. Their achievement is chronicled in their bestselling book The Pact: Three young men make a promise and fulfill a dream. These three fatherless young men were intellectually brilliant -- all tested high enough on a placement exam to attend University High, a magnet high school in Newark. However, without guidance at home, they cut classes and did not take academics seriously until they accidentally wandered into the school library and saw a presentation on Seton Hall University's scholarship for minorities in its Pre-Medical/Pre-Dental Plus Program. This made the dream of becoming a doctor real for these young men. They vowed to graduate from high school, attend Seton Hall to participate in the program, and become physicians who would serve their community. They achieved all of these dreams. They overcame the psychological barriers that suggested black men could not succeed, institutional barriers that inhibited minority access to healthcare and role models in healthcare, and financial barriers such as the expense of a medical education.

As impressive as their achievement may be, the fact that three African-Americans became doctors is enough to warrant publishing a book gives the reader cause to pause -- why are blacks historically underrepresented at the higher echelons of medicine? Why is the fact that three young black men became doctors newsworthy? The statistics are sobering: in the 1960s and 1970s, African-Americans comprised only 3.1% of all U.S. physicians (Rao & Flores 2006, p.986). By 2001, only 3.6% of all practicing physicians were African-Americans, which represented only a slight increase in previous years (Dennis, 2001, p.15). In 2007, the number was estimated at only 4%, while African-Americans comprised 13% of the U.S. population as a whole (Rao & Flores 2006, p.986)

Why was it so hard, even for black young men at a Newark magnet school, to imagine themselves doctors until the possibility of a scholarship was literally dangled in their faces? The greatest obstacles for the three doctors were finances, knowledge about the opportunities for scholarships and success in medicine, and psychological self-perception of what they could achieve. Social barriers were a factor too: Poverty played a role, and familial instability. But the idea that they could make their dream a reality if they worked hard enough to receive a scholarship fostered their ambition and enabled them to overcome personal challenges. They Newark doctors have always credited the presentation given in their school about that minority scholarship for individuals specializing in medicine as the source of their mutual decision. This suggest that greater cultural competency is needed in informing African-Americans about the possibility of scholarships -- and the need to dream.

The lack of black doctors in America today is not merely a tragedy for talented students whose aspirations are thwarted because of a lack of role models. Individuals may be more apt to be candid about health matters who an individual who looks like them, in terms of race as well as gender. (That is why the 'three black doctors' vowed to return to their communities with the medical knowledge they had gleaned). African-American doctors may be more sensitive to the needs of African-American patients, such as the greater prevalence of certain disorders in the community, or lifestyle practices that may give rise to health issues. Peer-reviewed studies have revealed that racial biases and stereotypes influence medical decision making. A lack of cultural competency in encouraging African-Americans to become physicians results in poorer healthcare overall (Dennis, 2001, p.16).

Institutional and financial barriers have been growing for African0Americans: limits on affirmative action programs have played a critical role in reducing the number of medical school applicants -- the three black Newark doctors specifically credited such a program for their vocational success. African-American college matriculation is on the decline nationwide, even while overall college matriculation is increasing nationwide (Dennis, 2001, p.16). In 1996, African-American enrollment in college dropped to 8.1% and African-American enrollment in medical school declined 8% between the years of 1994 to 1998. Applications for admission to medical school in states that passed anti-affirmative action legislation declined most significantly: there was a 19% reduction in minority applicants in California and a 22% in Texas, Louisiana and Mississippi between the years of 1994 and 1998.

The number of minorities overall who matriculated from U.S. medical schools peaked in 1994, and stagnated, again after the increase in anti-affirmative action legislation (Rao & Flores 2006, p.986). What is particularly interesting about these figures is that applications as well as matriculants have declined -- in other words, the absence of affirmative action programs (like the ones that inspired the 'three black doctors') may deter African-American students from applying.

Sadly, racism has been endemic to the medical profession and the brief flowerings of interest in increasing the number of African-American doctors have not eradicated negative perceptions. Historically, African-American physicians were denied hospital staff privileges in America because of race. Prior to the civil rights movement of the 1960s, African-Americans were denied access to equal facilities by whites, and wards, floors and even hospitals were segregated (Dennis, 2001, p.16). Board certification exams were often subjectively administered, and thus many African-Americans were unjustly denied certification before the civil rights movement.

There is widespread evidence that within the African-American community, a negative impression exists of the medical profession. An example of this is the paucity of African-Americans willing to participate in biomedical research trials. African-Americans were often used as unwilling subjects in research, most famously in a 1930s study where African-American males were denied penicillin for the treatment of syphilis, and treated with a placebo instead. Yet more participation in such trials is necessary: "metabolism and response to adverse reactions, which are influenced by environment, culture, and genetic factors, vary in different racial, ethnic and gender groups. [For example] serum levels of cotinine, a nicotine metabolite, are substantially higher in African-Americans than in white or Mexican-American smokers who smoked the same number of cigarettes per day" (Dennis, 2001, p.17). Having more African-Americans involved in conducting the research could make participation in research studies less intimidating and suspicious, and work to improve the heath of the African-American community through the discovery of new, high-quality information.

Perhaps inspired by the 'three black doctors' seminal experience at a high school, Vijaya Rao and Glenn Flores published a 2007 qualitative study involving two high school focus groups of African-Americans in areas demographically similar to that of the Newark doctors, inner city high schools in Milwaukee. Financial pressures were "an overwhelming barrier for students, and they felt that they would not be able to afford such high tuition for medical school. Although most students were aware of options to take out loans and apply for scholarships in order to finance medical school, they perceived loans and scholarships to be of little help overall" (Rao & Flores 2006, p.988).


This response supports the research of Dennis (2001) indicating that a lack of available affirmative action and financial support for minorities reduces applications to college and medical school, not just matriculation rates at these institutions, for African-Americans. The absence of available support discourages students from applying -- it is not merely that a decline in affirmative action programs results in supposedly lesser-qualified minorities being turned away. Other significant deterrents were the fact that very few students knew any African-American physicians personally, a lack of peer and family support, a lack of familiarity with the field (reflecting lower rates of seeing physicians amongst African-Americans) and "there was consensus that physicians were typically white and male: "I picture a tall, white man in a white coat" said one student (Rao & Flores… [END OF PREVIEW]

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"Racism in Occupations."  Essaytown.com.  November 8, 2009.  Accessed February 20, 2019.