Page |1                             OUR STORY IN BRIEF:           THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEA...
Page |2what had already been extremely poor living conditions. The result was major outbreaks ofpneumonia, cholera, diphth...
Page |3Increasing diversity of physicians might decrease disparities in health by three separatepathways. The first pathwa...
Page |4University of California banned the use of race as a factor in admissions. With the passageof Proposition 209, publ...
Page |511. Moy, E.; Bartman, B.A.; & Weir, M.R. (1995). Access to hypertensive care. Effects of   income, insurance, and s...
Page |6       561.566.   23. See www.AAMC.org.Further Study:IVMS Race Trust and Tuskegee-Medical Ethics Broken Trust and H...
Page |7Medical ethicist Harriet A. Washington Random House "The fear of medicine is based on realevents. And real events g...
Page |8ABOUT The Institute for Minority Physicians of the FutureMission Statement                              THE INSTITU...
Page |9                     Marc Imhotep Cray, M.D.                    drcray@imhotepvirtualmedsch.com                    ...
P a g e | 10Dr. Marc Imhotep Cray is originally from Newark, NewJersey.    He is a physician and medical teacher,independe...
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OUR STORY IN BRIEF: THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEALTH AND MEDICINE Marc Imhotep Cray, M.D.

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OUR STORY IN BRIEF:
THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEALTH AND MEDICINE
Marc Imhotep Cray, M.D. June, 2010, Last Updated March, 2011

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OUR STORY IN BRIEF: THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEALTH AND MEDICINE Marc Imhotep Cray, M.D.

  1. 1. Page |1 OUR STORY IN BRIEF: THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEALTH AND MEDICINE Marc Imhotep Cray, M.D. Institute for Minority Physicians of the Future (IMPF)Health disparities across racial and ethnic groups in the United States have been welldocumented for over a century .These disparities have remained remarkably persistent inspite of the changes in many facets of the society over that period. Despite dramaticimprovements in overall health status for the U.S. population in the 20th century, members ofmany African- American populations experience worse health along many dimensionscompared with the majority white population (1). Because many minority neighborhoodshave a shortage of physicians (2) and less access to medical care, increasing the supply ofminority physicians has been proposed as an intervention that may help to amelioratedifferences in health status.Medical training for African-Americans first became a topic of policy debate in the UnitedStates in the context of the post-Civil War south as a way to address the health needs of theAfrican-American community. Disparities between the health status of Whites and African-Americans have been observed throughout American history. In the antebellum South, slaveowners documented health problems that threatened productivity, and pointed out healthdisparities between African-Americans and Whites to reinforce beliefs that “biogeneticinferiority of blacks” justified slavery (3). Conditions in the South after the Civil War were notdissimilar to other post war periods, with many blacks left homeless – refugees in search of aplace to live and a way to make a living (4). Lack of food, water and sanitation exacerbated OUR STORY IN BRIEF: THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEALTH AND MEDICINE Marc Imhotep Cray, M.D. June, 2010, Last Updated March, 2011
  2. 2. Page |2what had already been extremely poor living conditions. The result was major outbreaks ofpneumonia, cholera, diphtheria, small pox, yellow fever and tuberculosis. Yet, very few whitephysicians were willing to see black patients, and very few African-Americans could affordtheir fees. The education of African-American physicians and other health professionals wasseen as a necessary step to improve the health of Blacks and to protect the public health ofthe communities where African-Americans lived, primarily in the South. African-Americanmedical schools were founded to address this need. Against the backdrop of sociostructuraland institutional racism and legal segregation, Flexnor (5) echoed both social justice andpublic health arguments for training black physicians in his famous report, with the underlyingassumption that the best way to meet the great health needs of black communities in theUnited States was by providing more black physicians. His recommendation was toconcentrate resources on two black medicals schools (out of seven) that he believed had thebest chance of meeting the standards being set for modern medical training programs,Howard and Meharry. The preface to his recommendation reflects the tension between thesocietal goals for improving access to care by training more black physicians, whilesimultaneously maintaining an unstated goal and trend of restricting entry of blacks into theprofession (6). As recently as 1965, only 2% of all medical students were black, and three-fourths of these students attended Howard or Meharry. The human rights and civil rightsmovements, the assassination of Malcolm X, Martin Luther King Jr., , and a rash ofurban riots and uprisings woke many White Americans up. And academic medicinewas one the first to respond to the wake-up call. Dr Jordan Cohn, AAMC President, in his“Bridging the Gap” address, explains the consequences of these sociopolitical events mosteloquently. “This brought about a significant rise in admissions of minorities to medicalschools. This wasn’t because of scores on the Scholastic Aptitude Test, grade-pointaverages and Medical College Admission Test scores of minorities suddenly skyrocketing.Rather, academic medicine began to take affirmative action to increase racial, ethnic andgender diversity in medical school classes. Enrollment of underrepresented minorities in U.S.medical schools rose rapidly to about 8% of all matriculants by early 1970. Then progressstalled in the mid 1970s, with admissions remaining flat for the next 15 years. To makematters worse, the fraction of individuals from the same groups in the U.S. population thatwere underrepresented in medicine continued to grow during this periodminoritypopulations increasing from 16% in 1975 to 19% in 1990.”(Source: www.AAMC.org DrJordan Cohn’s AAMC President / Bridging the Gap) OUR STORY IN BRIEF: THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEALTH AND MEDICINE Marc Imhotep Cray, M.D. June, 2010, Last Updated March, 2011
  3. 3. Page |3Increasing diversity of physicians might decrease disparities in health by three separatepathways. The first pathway is through the practice choices of minority physicians, whichmay lead to increased access to care in underserved communities. Since the 1970s and1980s, when minority students were first admitted to medical schools in large numbers, anumber of studies have examined the practice patterns of minority physicians compared withwhite physicians. Despite their differences, empirical analyses regarding the practicelocation and patient population of minority physicians have been remarkable consistent.Minority physicians tend to be more likely to practice in underserved areas and to havepatient population with a higher percentage of minorities then their white colleague (7-9).Evidence also suggest that minority physicians tend to have a higher percentage of patientpopulations with lower incomes and worse health status and who are more likely to becovered by Medicaid (10-13). The second pathway is through improvement in the quality ofhealth care due to better physician – patient communication and greater cultural competency.The foundation of this hypothesis is that for many minority patients, having a minorityphysician my lead to better health care because minority physicians may communicate betterand provide more culturally appropriate care to minority patients. If minority physiciansprovide high-quality care to minority patients along the interpersonal dimensions of care,including doctor-patient communications and cultural competence, this could result in higherpatient trust and satisfaction. This may in turn facilitate better health outcomes (14-21). Thethird pathway by which increasing diversity in the health professions might serve to decreasehealth disparities is through improvements in the quality of medical education that mayaccrue to medial students as a result of increasing diversity in medical training. This wouldexpose physicians-in-training to a wide range of different perspectives and culturalbackgrounds among their colleagues in medical school, residency and in practice. Suchexposure may provide physicians with experiences and interactions that will broaden theirinterpersonal skills and help in their interactions with patients (22).At the same time minoritypopulations are increasing, data from the American Association of Medical Colleges show amarked decline in the number of African-Americans and Hispanics admitted to medicalschools (23). These declines coincided with two significant events. First, in 1995, the UnitedStates Court of Appeals for the Fifth Circuit in Hopwood v. Texas, struck down asunconstitutional an affirmative action program that had been placed in the University of Texaslaw school. In doing so, the court effectively precluded higher education institutions as wellas other entities in the Fifth Circuit, which cover Texas, Louisiana and Mississippi, fromtaking race or ethnicity into account in the admissions process. Secondly, the Regents of the OUR STORY IN BRIEF: THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEALTH AND MEDICINE Marc Imhotep Cray, M.D. June, 2010, Last Updated March, 2011
  4. 4. Page |4University of California banned the use of race as a factor in admissions. With the passageof Proposition 209, public higher education institutions in California are no longer free toconsider race, ethnicity or gender in admissions decisions, in recruiting programs, or even inplanning and implementing minority-targeted outreach activities, such as tutoring programsand educational enrichment courses. California, Texas, Mississippi and Louisiana, these fourstates alone contain 35% of the minority population that remain underrepresented amongmedical students, and 75% of those from the Mexican-American community.REFERENCES 1. Kington, R.S., & Nickens, H.W. (2001) Racial and ethnic differences in health: Recent trends, current patterns, and future directions. In America becoming: Racial trends and their consequences, NJ Smelser, WJ Wilson, and F Mitchell. (Eds). Washington, DC, National Academy Press. 2. Komaromy, M.; Grumbach, K., et al. (1996). The role of black and Hispanic physicians in providing health care for underserved populations. New England Journal of Medicine; 334, pp. 1305-1310. 3. Savitt, L. (1985). Black health on the plantation: masters, slaves and physicians. In Sickness and health in America, J. Leavitt & R. Numbers (Eds.) University of Wisconsin Press. 4. Summerville, J. Educating Black Doctors: a History of Meharry Medical College. University, Alabama: University of Alabama Press, 1983. 5. Flexnor, A. (1910). Medical Education in the United States and Canada. Carnegie Foundation for the Advancement of Teaching. Merrymount Press: Boston, MA. 6. Starr, P. The Social Transformation of American Medicine. New York: Basic Books, 1982. 7. Rocheleau, B. (1978). Black physicians an ambulatory care. Public Health Reports; 93(3):278282. 8. Lloyd, S.M., & Johnson, D.G. (1982). Practice patterns of black physicians: Results of a survey of Howard University College of Medicine Alumni. Journal of the National Medical Association; 74(2), pp. 129-141. 9. Keith, S.N.; Bell, R.M., et al. (1985). Effects of affirmative action in medical schools: A study of the class of 1975. New England Journal of Medicine; 313, pp. 1519-1525. 10. Davidson, R.C., & Lewis E.L. (1997). Affirmative action and other special consideration admissions at the University of California, Davis, School of Medicine. JAMA; 278(14), pp. 1153-1158. OUR STORY IN BRIEF: THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEALTH AND MEDICINE Marc Imhotep Cray, M.D. June, 2010, Last Updated March, 2011
  5. 5. Page |511. Moy, E.; Bartman, B.A.; & Weir, M.R. (1995). Access to hypertensive care. Effects of income, insurance, and source of care. Archives of Internal Medicine; 155(14), pp. 1497-1502.12. Cantor, J.C.; Miles, E.L., et al. (1996). Physician service to the underserved: Implications for affirmative action in medical education. Inquiry, summer; 33, pp. 167- 180.13. Gray, B. Stoddard, J.J. (1997). Patient-physician pairing: Does racial and ethnic congruity influence the selection of a regular physician? Journal of Community Health; 22(4), pp. 247-259.14. Department of Health and Human Services OOMH. (2000). Office of Minority Health national standards on culturally and linguistically appropriate services (CLAS) in health care. Federal Register; 65(247).15. Lavizzo-Mourey, R., & Mackenzie, E.R. (1996). Cultural competence: Essential measurements of quality for managed care organizations. Annals of Internal Medicine; 124, pp. 919-921.16. Coleman, M.T., Lott, J.A., & Sharma, S. (2000). Use of continuous quality improvement to identify barriers in the management of hypertension. American Journal of Medical Quality; 15(2) pp. 72-77.17. Chinman, M.J.; Rosencheck, R.A.; & Lam, J.A. (2000). Client-case manager racial matching in program for homeless persons with serious mental illness. Psychiatric Services; 51(10):1265-1272.18. Rosenbeck, R., Fontana, A., & Cottrol, C. (1995). Effect of clinician-veteran racial pairing in the treatment of posttraumatic stress disorder. American Journal of Psychiatry; 152(4), pp. 5550-5563.19. Thom, D.H., Ribisl, K.M., Stewart, A.L., et al. Further validation and reliability testing of the trust in physician scale. Medical Care; 37(5), pp. 510-517.20. Saha, S., Komaromy, M. et al. (1999). Patient-physician racial concordance and the perceived quality and use of health care. Archives of Internal Medicine; 159, pp. 997- 1004.21. Morales, L.S., Cunningham, W.E., & Brown, J.A. et al. (1999). Are Latinos less satisfied with communication by health care providers? Journal of General Internal Medicine; 14, pp. 409-417.22. Rathore, S.S.; Lenert, L.A. et al. (2000). The effects of patient sex and race on medical students’ ratings of quality life. American Journal of Medicine, 108(7), pp. OUR STORY IN BRIEF: THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEALTH AND MEDICINE Marc Imhotep Cray, M.D. June, 2010, Last Updated March, 2011
  6. 6. Page |6 561.566. 23. See www.AAMC.org.Further Study:IVMS Race Trust and Tuskegee-Medical Ethics Broken Trust and Health Disparities/PptBlack and White: Health Disparities in America / Marc Imhotep Cray, M.D./Doc American Health Dilemma: Race, Medicine, and Health Care in the United States. OUR STORY IN BRIEF: THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEALTH AND MEDICINE Marc Imhotep Cray, M.D. June, 2010, Last Updated March, 2011
  7. 7. Page |7Medical ethicist Harriet A. Washington Random House "The fear of medicine is based on realevents. And real events go way beyond -- way before and way after -- Tuskegee," saysHarriet Washington. "There are things that are happening now that will keep [AfricanAmericans] from going to the hospital." http://www.youtube.com/watch?v=mcOTMSZTLSs OUR STORY IN BRIEF: THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEALTH AND MEDICINE Marc Imhotep Cray, M.D. June, 2010, Last Updated March, 2011
  8. 8. Page |8ABOUT The Institute for Minority Physicians of the FutureMission Statement THE INSTITUTE FOR MINORITY PHYSICIANS OF THE FUTURE is a collective voice of African American, Native American, Hispanic American and progressive European American physicians and medical scientists. IMPF believes that the root cause of minority under- representation in United States medical schools is academic disadvantage borne by lack of access to high-quality high school and college preparation. Consequently, IMPF mission is to become a leading organizational force for parity in medical education by helping minoritystudents develop the skills that will enable them to compete on a more equal footing in the medicalschool admission process, and once in medical school, provide them with learning aids from the bestmedical education communities around the world . The Institute for Minority Physicians of the Futureelucidates, distills and fuses educational psychology, information technology and undergraduatemedical education data; and then develops programs, projects and products that serve to increaserecruitment, admission and retention (RAR) of underrepresented minorities (URM) in major UnitedStates medical schools. The ultimate goal being for these students to defend, define and developmedical careers that will be committed to the elimination of health disparities in racial/ethnic minoritiesand the poor.Vision StatementTHE INSTITUTE FOR MINORITY PHYSICIANS OF THE FUTURE is a national professionaleducational organization representing the interest of minority high school and college students with theaptitude and desire to become physicians and medical scientists. Established in 1999, the collectivebody is committed to the vision of improving the health and well-being of future U.S. generations byincreasing the minority physician/medical scientist workforce in such a way that the professions ofmedicine and biomedical research are reflective of the racial/ethnic profiles of the people physiciansand medical scientists will serve. IMPF’s vision is directly linked to the AAMC data minority physiciansare four times more likely than are others to practice in undeserved communities. Such communitiesare more frequently than not overwhelmingly populated by racial/ethnic minorities.Core StrategyTHE INSTITUTE FOR MINORITY PHYSICIANS OF THE FUTURE’S core strategy is to identify,inform, recruit, assist, advise and educate promising African-American, Native-American, andHispanic-American, high school and college students in order to increase the number of minoritymedical students and PhD candidates in United States medical schools.“Come on and chill wit us on the Atlantic Ocean during our annual retreat and at the same TIMELEARN what it means to become a Healer and Medical Scholar in the 21st century”. OUR STORY IN BRIEF: THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEALTH AND MEDICINE Marc Imhotep Cray, M.D. June, 2010, Last Updated March, 2011
  9. 9. Page |9 Marc Imhotep Cray, M.D. drcray@imhotepvirtualmedsch.com Visit Our Online Classroom Environment The e-Teaching Community on WiZiQ http://www.wiziq.com/drimhotepFounding Director: Office of Medical EducationInstitute for Minority Physicians of the Future (IMPF)OUR PRODUCT IS IMHOTEP VIRTUAL MEDICAL SCHOOLABOUT IMHOTEP VIRTUAL MEDICAL SCHOOL:IVMS is the ultimate medical student Web 2.0 companion. This SDL-Face to Face hybridcourseware is a digitally tagged and content enhanced replication of the United StatesMedical Licensing Examinations Cognitive Learning Objectives (Steps 1, 2 or 3). Includingauthoritative reusable learning object (RLO) integration and scholarly Web InteractivePowerPoint-driven multimedia shows/PDFs. Comprehensive hypermedia BMS learningoutcomes and detailed, content enriched learning objectives. OUR STORY IN BRIEF: THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEALTH AND MEDICINE Marc Imhotep Cray, M.D. June, 2010, Last Updated March, 2011
  10. 10. P a g e | 10Dr. Marc Imhotep Cray is originally from Newark, NewJersey. He is a physician and medical teacher,independent undergraduate medical education consultantand USMLE tutor. From 1999-2004 Dr. Cray served asdirector of the Office of Medical Education at AmericanInternational School of Medicine in Georgetown, Guyana,and associate professor of basic medical sciences andcampus curriculum coordinator at International Universityof Health Sciences-School of Medicine in Saint Kitts,West Indies. Dr. Cray earned a Bachelor of Science inpharmacy at Massachusetts College of Pharmacy in1980. Next he received his medical doctor degree fromNew Jersey Medical School in Newark, NJ in 1984. Later, he completed training as apost graduate intern at Columbia Presbyterian College of Physicians and Surgeons atHarlem Hospital Medical Center in 1985, worked in private general practice at HarlemCommunity Medical Clinic. Dr. Cray served on the NYC Committee of Interns andResidents in New York from 1986-1989 where he planned, developed, implemented andcoordinated the medical license review course, was an educational coordinator &lecturer in pharm & medical therapeutics. From 1990-1991 he worked at MorehouseSchool of Medicine in the department of community health and prevention as a researchassociate/ programs coordinator for community health and awareness programs. From6/1991‑4/1992 Dr. Cray studied at Morehouse School of Medicine as a PGY‑2 residentin Psychiatry. From 1993-1996 he worked as a medical emergency house physician atGeorgia Regional Hospital of Atlanta and Royce Occupational Health Group, returned toMorehouse School of Medicine as a senior research associate under a NASAcommission grant from 1997-1998, and was director of clinical diagnosis at The PrimaryCare Center in Decatur, Ga 1999-2002. Dr Cray is an expert in case-based learning withexperience as a facilitator of USMLE Step 1 level proficiency in the “4 P’s”-Physiology,Patho-physiology. He is an experienced web developer, e-Professor / Online Lecturerand author of several e-articles, e-books, and e-magazines. He has designed USMLEtagged virtual medical school course ware. He is currently working on a project inmedical pharmacology and therapeutics with specialty in autonomic and cardiovascularand introduction to clinical Medicine. OUR STORY IN BRIEF: THE HISTORICAL RELATIONSHIP BETWEEN AMERICA, BLACKS, HEALTH AND MEDICINE Marc Imhotep Cray, M.D. June, 2010, Last Updated March, 2011

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