In late April, Einstein hosted its inaugural Diversity Week, which highlights diversity in medicine and science. The initiative was sponsored by the office of diversity and inclusion and featured daily lectures over the course of the week. The 9th Annual Duvivier Lecture, which was co-sponsored by the department of obstetrics & gynecology and women’s health, kicked off Diversity Week and was followed by four additional speakers. Of the week’s five presenters, three were Einstein alumni.
“While we have a range of lectures, workshops, and activities that speak to diversity, equity, and inclusion [DEI] throughout the year, Diversity Week is an opportunity to bring to campus, in-person or virtually, leading physicians, scientists, and thought leaders who can share their insights and perspectives with our community members,” said Lynne Holden, M.D., senior associate dean for diversity and inclusion and professor of emergency medicine at Einstein and an emergency medicine physician at Montefiore. “April is National Minority Health Month, during which we have the annual Roger Duvivier, M.D., ACOG, Lecture, so it was a natural time to launch this new week of programming.”
Honoring a Legend and Addressing Bias
Dr. Duvivier, a native of Haiti who graduated from Einstein in 1974 and is now an associate professor emeritus of obstetrics & gynecology and women’s health at the College of Medicine, often quotes Dr. Martin Luther King: “Of all the forms of inequality, injustice in health is the most shocking and the most inhuman.” A committed supporter of global health initiatives in Guatemala and an inspiring leader, Dr. Duvivier dedicated his life to advancing justice in healthcare, both in the Bronx and abroad. As for the United States, he has said, “The white supremacist current will continue for a while, but parallel to that will be a movement of antiracism. Whether [these movements] remain separate like two railroad tracks or merge down the road is unknown, but more and more people are adding antiracism to diversity, equity, and inclusion.”
Camille Clare, M.D. ’ 97, professor and chair of obstetrics and gynecology at Downstate Health Sciences University (DHSU), spoke to these and other issues when she delivered the ninth annual Roger Duvivier lecture.
“So how many of you have implicit bias?” Dr. Clare asked the audience. “Everyone should be raising their hand, because we all have unconscious activations and prejudicial notions that influence our decision-making when we’re taking care of patients,” she said in “Advancing Diversity, Equity, and Inclusion in Obstetrics and Gynecology: The Role of Positionality in Academic Medicine.”
She explained that “positionality” is the social and political context that creates identity and can influence our views on race, class, and more. Such biases have caused disparities in Black health, for example in postpartum death rates, said Dr. Clare, who is also professor of health policy and management at DHSU School of Public Health and has developed antiracist curricula for students and residents. “A lot of self-assessment needs to happen,” she said.
Mold, Asbestos, and Hitting the Streets
“Why are these patients getting fungus balls in their lungs?” asked Dr. Raja Flores, M.D. ’ 92, during his presentation, titled “The Impact of a Key Social Determinant on My Career as a Thoracic Surgeon.” The cause was poor housing. When Dr. Flores, system chairman, department of thoracic surgery and professor of cardiothoracic surgery at the Icahn School of Medicine at Mount Sinai, visited the New York City apartments of his patients who had fungal infections in their lungs and other chest-area illnesses, he saw flooding, mold, asbestos, pest infestation, and peeling lead paint. Then he realized: “Oh my God, this is public housing.”
The saddest thing is that these conditions are preventable, said Dr. Flores, but “politics permeates medicine, and a lot of it is business driven.” In 2021, Dr. Flores ran for mayor; he lost the election but raised awareness about the importance of improving public housing. The COVID-19 pandemic derailed a planned march on City Hall for safe homes, but “I’m doing this march again,” he informed his audience. Explaining his commitment to improving the social factors that drive health, he suggested that physicians are, “meant to do more than just benefit from the profession of medicine.”
Science and Self-Knowledge
After Courtney Ferrell Aklin, Ph.D., earned a doctorate in clinical psychology, she was unsure of her next step. Fast forward two decades and she is now acting associate deputy director of the National Institutes of Health (NIH) and senior advisor in the Immediate Office of the Director. What was her roadmap?
“Sometimes you’ve got to be a scientist,” she said in her presentation “Applying the Scientific Method to a Winding Biomedical Career Path.” She designed “career experiments” that required a meaningful connection to the work, a policy foundation, and big-picture impact. She tested her hypothesis in several jobs and found ways to help mentor others and diversify the workforce. “At times, there was an assumption that I was coming in to just focus on DEI, perhaps because of how I looked,” she said. “I turned that challenge into an opportunity.”
At the NIH, she participates among the leadership in oversight of initiatives such as UNITE, which addresses structural racism in biomedicine. Her experiments were a success.
Patterns and Data
“Many have less access to healthcare than they should because of structural racism,” said Yvette Calderon, M.D. ’ 90, in her talk titled “Advancing Equity in Clinical Care.” She cited a disturbing study in which 55% of Hispanic patients with a broken bone received no pain medication, compared to 26% of white patients. “We need to recognize patterns, whether it’s overt racism or implicit bias,” she said. Dr. Calderon is chair and professor of emergency medicine at Mount Sinai Beth Israel, and dean/vice-president for equity in clinical care at Mount Sinai.
In his presentation “Using Big Data to Advance Medical Science,” Hassan Tetteh, M.D., M.B.A., explained how data analysis foretells risk. “If an African American has comorbidities such as chronic kidney disease, we have predictive variables,” he said. It informs prevention: ZIP code analysis predicted COVID outbreaks to prioritize vaccinations. Dr. Tetteh, a U.S. Navy captain, associate professor of surgery at the Uniformed Services University of the Health, and a heart and lung surgeon, called for handling Big Data with care and compassion.
With the success of the first Diversity Week, Dr. Holden is looking forward to 2024’s event. “There is never a shortage of dynamic speakers who can bring their own unique perspectives and insights to our community,” she said. “Diversity Week is a great opportunity to address important topics in the fields of science and medicine and spark conversations around DEI and health equity. The office of diversity and inclusion was honored to host national thought leaders during the inaugural event.”
Posted on: Wednesday, July 12, 2023