Nadia Abuelezam, Sc.D., Sasha DuBois, MSN, RN, and Joshua Barocas, MD presented on the "double pandemic" of COVID-19 and racism in the healthcare industry in a webinar on Tuesday, Oct. 27 at Boston College. The webinar was hosted by the Gabelli Presidential Scholars Class of 2023.
Abuelezam works as an assistant professor in the Connell School of Nursing as an epidemiologist. She focuses on mathematical modeling and public health, while her current research looks at understanding health risks in hard to reach populations.
DuBois is a nurse administrator at Brigham and Women’s Hospital. She is also the President of the New England Regional Black Nurses Association. She focuses on mentoring nurses and implementing racial bias training.
Barocas is an assistant professor of medicine at Boston University School of Medicine as well as a doctor at the Boston Medical Center. He leads an interdisciplinary research program that attempts to improve health outcomes for patients with infectious diseases.
The first question from moderator Gregori Estime, CSOM '23 asked the panelists to speak to how they became focused on health disparities in medicine.
“I started off my work in HIV modeling and found myself…crowded out…I felt like I wasn’t really able to make my own mark,” Abuelezam began. She had always been interested in serving her community and wanted to focus on studying Arab-American health. Working at Boston College, she was able to transition her work to focus on immigrant populations.
DuBois spoke next, describing her path as a “calling,” since she has lived in Roxbury and first saw the disparities between different groups of people there. “I always asked the question: why me? Or why not her? Or why not him? How did I get to this place? Sometimes it’s more than just hard work, but for some people as hard as they could try they couldn’t get the best access to healthcare,” she explained.
Barocas continued the theme of using an experience to explain how he became focused on healthcare disparities. “Right around the age of twenty, I had an awaking that I was racist—and not a Confederate flag waving racist, but a racist. It was then that I figured out it wasn’t enough to figure it out or admit it—so that’s why I went into what I do,” he said.
“How has the pandemic impacted your everyday work and have you witnessed the exacerbation of existing racial disparities in healthcare in Boston during COVID-19?” Estime asked.
Barocas has focused his work on setting up safe quarantine housing for people experiencing homelessness or who are unstably housed. He has also been working to expand quarantine housing for those who cannot safely isolate in their own homes. “When you add in people who can’t safely isolate, all of a sudden it’s like a mushroom cloud of a population. Those disparities become incredibly stark,” he emphasized.
The pandemic and trying to find safe isolation places for the people that need them has completely changed Barocas’s worldview. COVID-19 exposed the breadth of the inequity facing communities of color.
“I think the testing is really what’s going to help close the disparities because we have to know what the disparities are,” Dubois added.
Abuelezam focused on how COVID-19 has changed the way people participate in the community. She acknowledged the power of virtual communities but stressed that there is something important about in-person relationships.
This is especially relevant for immigrant communities. “I think, especially for those ethnic immigrant communities, one reason we might be seeing increasing in rates is because of this deterioration of the social cohesion they once felt,” she said.
An audience member asked, “When large hospitals like the Brigham come to communities of color and do testing and other forms of care, is there ever any pushback or distrust from community members?”
“The very honest answer is that we have screwed up for the last 400 years in healthcare in the United States. We have abandoned patients and experimented on patients and have done nothing to gain their trust,” Barocas said.
“It would be disingenuous of me and it would be me speaking from a point of privilege to say that ‘because I participate in XYZ’ I’m making strides,’” he continued.
The COVID-19 vaccine will likely pose another challenge, with communities of color being wary of allowing medical professionals to come into their community with a new shot. Healthcare professionals will have to figure out how to earn the trust of these communities.
“We can’t assume, I can’t assume, that I have done anything to gain anyone’s trust,” Barocas finished.
“Healthcare needs more racially, linguistically, and culturally concordant providers,” DuBois stated bluntly. “We work in a big city. Most of the providers don’t look like the patients that they care for. And if they don’t, how can they learn that?” she questioned.
“The trust is not here. Tuskegee is a real thing. Henrietta Lacks is a real thing. I still have family members that remember those stories and have family members that have been impacted by that,” DeBois explained.
“It takes a long, long, long time. But you have to just put yourself out there and you have to provide the access,” she concluded.
For those interested in learning more about the disparities present in the United States healthcare system, Abuelezam recommended listening to the 1619 Project’s Podcast: How the Bad Blood Started.