Black Americans don’t see many clinicians who look like them in the doctors’ offices, clinics and hospitals where they get care. That’s because only 5% of U.S. doctors are Black, a number not likely to increase significantly in the near future, since only 7% of current medical students are Black. So how can health care systems promote health equity?
A shortage of Black physicians erodes trust among Black patients in the health care system as a whole, and it discourages many Black Americans from seeking necessary care altogether.
The pandemic has focused a bright light on the real and severe consequences. Black Americans continue to die from COVID-19 at three times the rate of white Americans.
The shortage of Black doctors is a serious problem that requires bold, immediate and tangible action.
CommonSpirit Health, the parent company of Dignity Health, is one of the few health systems that truly understands this. And the system has put its money where its mouth is, quite literally. It has partnered with the Morehouse School of Medicine (MSM), a historically Black medical school, in a $100 million initiative to train more than 300 minority doctors over the next decade.
“We’re immediately leveraging our partnership to address health inequities magnified by the COVID-19 pandemic, as Black Americans are disproportionately impacted by COVID-19,” commented MSM President and Dean Valerie Montgomery Rice. “Together, we will foster a culturally competent system of care that includes testing, care delivery and vaccine allocation, directed at the most vulnerable populations to reduce the impact of COVID-19 in racial and ethnic communities.”
Program participants will be recruited from underserved communities and spend the last two years of their four-year training in one of five designated CommonSpirit hospitals across the country; at least one of these sites will be in California at a Dignity Health facility. All of the training sites will be located in the communities that are home to minority patients, so that they can start receiving care from physicians who mirror their own image as soon as possible.
The impacts of this initiative are far-reaching. Most immediately, the program will double MSM’s student class size, from 100 to 200, and triple the number of graduate medical education slots for residency training over the next 10 years.
Programs like these have a history of success. The University of California’s Programs in Medical Education (UC PRIME), for example, is a medical school program with a special curriculum designed to help students meet the needs of underserved populations. There are six PRIME campuses, and 64% of PRIME students come from groups that are underrepresented in medicine.
Like UC Prime before it, the MSM program will serve as a model for other historically Black medical schools — and their potential health system partners.
A call to action from the highest level
A program like this is, of course, only possible when leadership drives it. And few health care leaders are more committed to addressing health inequities than CommonSpirit CEO Lloyd Dean. Dean said, “America is supposed to be a nation of equality, but there is nothing equal about America’s health system. For people of color, there often are vast disparities — in access, treatment and outcomes. As healers, we know it doesn’t have to be this way. As humans, we know it just isn’t right. And as problem solvers, we know it can be changed.”
Dignity Health prioritizes active work to address health equity issues, both to improve outcomes for its patients of color and to improve the professional path for clinicians of color. “It is important for future generations that we see representation of people of color in all walks of life at every level,” Dean remarked, “because it sends the message that you can be what you want to be if you prepare yourself and you work hard.
“We have to continue to move forward, we have to call out injustices. We have to reach back with a helping hand and pull somebody else forward.” And that’s exactly what Dignity Health is doing.
As the COVID-19 pandemic raged last fall and winter, case rates among California’s Latino and Black residents outpaced rates among the general public, underscoring health equity disparities that impact communities of color more severely throughout the state.
Now, as COVID-19 vaccination efforts accelerate, Dignity Health has come together with AEG, the City of Carson and other partners to host a five-day vaccination clinic specifically for vulnerable communities.
More than 20,000 high-risk residents received the vaccine over the course of the event.
Lining up in the massive Dignity Health Sports Park lot at 6:15 a.m., health care workers safely covered with face shields and masks walked up to smiling — some would say beaming — L.A. residents, who simply drove up in their cars, rolled down the window and received their shot.
“When prayers go up, blessings come down,” said Carson Mayor Lula Davis-Holmes. Many of the residents who were vaccinated echoed her sentiment, finally feeling safe enough to hope for the future again.
“It’s so important that we do all we can to help our communities most at risk,” said Julie Sprengel, president of Dignity Health’s Southern California Division. “Our mission has always been to improve the health of the people we serve and address inequities in health care.”
For more than a year, through all the ups and downs of the COVID-19 pandemic, California’s more than 400,000 farmworkers never stopped showing up for work. They’ve continued picking and packing and processing day after day to make sure Californians have enough food to eat.
This despite the fact that like other essential workers, they are at much higher risk for contracting the virus. They labor in rural settings with limited healthcare facilities and providers. Many receive no health benefits from their employers to take advantage of what limited care does exist near them. Because of the high cost of living and their comparatively low earnings, many farmworkers live together in multigenerational homes, creating a ripe breeding ground for the virus to spread.
Farmworkers are unquestionably one of the state’s most vulnerable populations.
Bringing the vaccine to the community
Dignity Health has been a pioneer in leading community-based efforts to vaccinate California’s farmworkers. The system recognizes that the best way to get these essential workers their shots and reduce their risk of contracting the virus is to go to the fields.
Herman Varela, community health educator at Dignity Health’s Woodland Memorial Hospital, is a former farmworker who now dedicates his career to protecting the health of this population. “They are essential,” said Varela. “Whereas before, a lot of times, we don’t even pay attention to them. But now, they are essential. They are out there and are exposed to this.”
Varela and others at Woodland Memorial partnered with Yolo County and Durst Organic Growers to offer multiple rounds of free on-site COVID-19 tests to local farmworkers. The hospital and county partnered again, starting in February, to deliver first-round doses of the COVID-19 vaccine to area farmworkers.
And Woodland Memorial is not the only hospital in the system actively working to protect this high-risk group. Dignity Health’s Dominican Hospital, which serves Santa Cruz County and the Monterey Bay region, partnered with the Santa Cruz County Farm Bureau’s COVID-19 task force and the California Strawberry Commission to host a two-day vaccination clinic for farmworkers in that area. This event also occurred in February.
For decades, Dignity Health has advocated for the health and equity of every Californian, including those that come to us from other countries. This pandemic has highlighted gross inequities among our communities, particularly around access to quality health care. It’s our duty and privilege to fill these gaps and deliver much-needed care.
“We get patients on the worst day of their lives, and it is our mission to make sure that by the time they are discharged, they’re as whole as they can possibly be.” That’s how Chris Turner, RN, Department Manager of the Bothin Burn Center at Dignity Health’s Saint Francis Hospital in San Francisco describes the personalized approach the Center takes with its patients.
As the largest American Burn Association Verified Burn Center in Northern California, the Bothin Burn Center serves more than 500 burn victims each year, accepting patients not just from California, but throughout the West Coast.
The team provides critical care for these patients, who suffer some of the most traumatic injuries a person can live through. The center’s team includes an array of specialists — not just plastic surgeons and registered nurses, but also physical and occupational therapists, respiratory therapists, dietitians, psychiatrists, case managers, pharmacists and even art and play therapists. Every single team member is highly trained to meet the complex needs of burn patients, from critical care through rehabilitation. And Robert and Lisa’s stories show just how much of an impact this multidisciplinary team truly has.
Robert’s story: Getting a dancer back on his feet again
Robert Strawder loves to dance, and after recovering from his burn injury, he practically danced out of the Bothin Burn Center to the joy of his family and friends. He was burned in a house fire in December 2011 and taken to the Bothin Burn Center to recover.
It happened quickly. Robert had returned from his job counseling at-risk youth and gone to sleep, only to wake up at 4 a.m. His room was on fire, and so was he. Six weeks later, he woke up at the Bothin Burn Center with second- and third-degree burns over 70% of his body.
When describing the care delivered by the center staff, Robert said, “Everyone was phenomenal to me and my family.” He had a flood of people who came to support him, and the center staff made it easy for Robert’s friends and family to be there for him. According to Robert, the staff made each patient feel genuinely special. “At the time I was so angry and unhappy and nasty to everyone, which is just not me. But the staff had unconditional acceptance and told me not to worry about it,” he said.
Due to the extent of his injuries, he was having difficulty getting back on his feet. The therapists worked with him so he could stand and walk, but he just couldn’t make it out the door of his room. One night a nurse who was caring for him said, “You look like you like to dance. You are not only going to walk out of this room, you are going to dance again.” This encouragement gave Robert the push he needed. The next day, with the help of his physical therapist, he walked out of his room using a walker the staff had decorated just for him.
Robert is a courageous burn survivor, but he is not alone. When he attends the monthly Burn Support Group he is inspired by the courage of other survivors and by the courage of those currently healing.
Lisa’s story: Helping an executive regain use of her hands and get back to business
For a split second on a sunny Friday morning in downtown San Francisco, Lisa Nash was the unluckiest woman in the world. As she walked across the empty intersection of Kearny and Post streets, an underground electrical transformer exploded. It blew a manhole cover 30 feet into the air, buckled concrete and caught the marketing executive in a blast of superheated smoke and flame.
As Lisa picked herself up from the street, she opened her eyes and remembered thinking, “Thank God, I can still see.” A female bicycle messenger gingerly guided her to the curbside. A San Francisco Fire Department ambulance crew, driving nearby, heard the explosion and sped to the scene.
“I think I need to go to the hospital,” Lisa said, standing with her hair singed off, her face blackened and her right arm shattered.
Having received third-degree burns on her hands, face, back and ankles, she was taken to the Bothin Burn Center at Dignity Health Saint Francis Memorial Hospital. And just as suddenly, her luck changed again.
Lisa was delicately and quickly whisked up one-way Pine Street eight blocks to Saint Francis Memorial Hospital, the only hospital in the Bay Area with a specialized burn unit. She was wheeled through the Emergency Department door at 9:06 a.m., five minutes after the blast. Doctors slipped her into a drug-induced coma and battled to save her. A little over two weeks later, she woke up to begin her marathon recovery. .
A team of Saint Francis surgeons performed five major surgeries on Lisa. She was burned over 40% of her body. Her burned skin was first replaced with high-tech materials made of collagen, which served as a foundation for the skin harvested from healthy parts of her body and grafted about two weeks after the injury. Then the long and painful process of restoring mobility began. The team of specialists at the Burn Center helped Lisa learn how to walk again and regain full mobility in her hands.
The specialized care that Robert and Lisa received is available to any Californian who needs it, including Medi-Cal patients who might otherwise not have access.
For people experiencing homelessness, even mundane aspects of life are a big challenge. Getting around, staying warm, accessing running water for cooking and cleaning—essential things that most people do without much thought—require a great deal of effort and energy.
This harsh daily reality makes it nearly impossible for unhoused people to stay healthy. It also makes them among those least likely to have access to health care.
To be effective in reaching and supporting people without housing, health care providers must rethink their traditional care delivery approach. They must look beyond their hospital and clinic walls and focus their resources on addressing a foundational need that affects health — housing.
That’s exactly what Dignity Health has set out to do in the Central Valley.
Together with San Joaquin Whole Person Care, Dignity Health has launched a partnership with STAND (Stocktonians Taking Action to Neutralize Drugs), providing a Homeless Health Initiative Grant to create permanent housing for the homeless population in Stockton.
The $1.8 million grant from Dignity Health will fund the creation of four housing units on STAND’s existing property, as well as the purchase and rehabilitation of three additional units. Together, the units will house at least 16 people and provide them with permanent housing that they would not have otherwise.
“Dignity Health’s Homeless Health Initiative Grant program is an extension of our organization’s long-standing commitment to serving those most vulnerable among us, including the unhoused,” said Don Wiley, president and CEO of St. Joseph’s Medical Center.
Caring for those experiencing homelessness: Isabel’s story
Isabel Vega is a Stockton resident, and both a Dignity Health patient and a client of STAND. She was just 8 years old when she ran away from home because she was being abused. A few years later, she reconnected with her birth father in hopes of finding another caregiver, only to suffer further abuse. Working with Dignity Health and STAND has had a tremendous impact on her life, she said. Today, Isabel has a job, is pursuing her education and is giving back to her community by helping others who are experiencing homelessness.
Dignity Health cares for Californians experiencing homelessness like Isabel by providing access to programs like STAND, in addition to serving these patients in hospitals and clinics across the state. In keeping with our mission to bring the healing power of humanity to everyone we serve, Dignity Health is committed to addressing homelessness and supporting health equity for the most vulnerable Californians.
Jewels Long Beach is a comedian, host, drag queen and philanthropist. She has called Long Beach her home for over 21 years and has received numerous honors and awards for being a community activist, including her work on behalf of the CARE Center, which directly benefits the LGBTQ community, at Dignity Health’s St. Mary Medical Center.
The CARE Center is an outpatient center that is dedicated to providing high quality, compassionate care and access to the community. Jewels leads one of the city’s most long-standing annual LGBTQ community fundraising traditions—the Easter Walk parade—which directly benefits the CARE Center.
When the COVID-19 pandemic hit, Jewels was determined to find a way to carry on the Easter Walk tradition. This year’s event was held virtually—and was a smashing success, raising more than $5,000 via Facebook Live, all benefiting the CARE Center. In this interview, held on the eve of the parade, Jewels explains why the Easter Walk and the CARE Center are so special to her and to the LGBTQ community in Long Beach.
What makes Long Beach such a special place?
I moved here in 1998, so I’ve been in Long Beach my entire adult life. One of the first things I found is that Long Beach is a large city with a small-town feel. It is truly an intimate community of people who care, and the beauty and magic of Long Beach is caring through not just our vibrant organizations in the LGTBQ community, but also through many other types of outreach to folks of every creed, color, sexuality, and religious affiliation.
How has the Easter Walk grown over the years, and who are funds being raised for?
This event started from humble beginnings by founder Rick White (aka Sheeya Mann), with a few intimate friends, and turned into the massive fundraiser that we know today. Each year it grows in scope and participation. We’ve added people each and every year—all sorts of fabulous drag queens, kings, people of any gender or none. It’s a wild circus of folks who care about their community and parade down the street in all sorts of finery and ridiculous costumes to raise funds for this awesome program.
A huge proportion of folks in the LGBTQ community, those affected or infected with HIV and AIDS, are served by the CARE Center, which is the largest provider of services for that population in Long Beach and the surrounding communities. We are taking care of our own. Some of our participants are also clients of CARE and some of us have friends who are clients of CARE. It is truly grassroots, direct service, dollar by hard-fought dollar raised to support those who support us.
What does the CARE Center mean to you and the LGBTQ community?
One of the reasons that the CARE Center at St. Mary Medical Center is so very special is because it came from a very dark time. It was started by a very courageous nun who wanted to reach out to those suffering in the very early days of the AIDS pandemic, when literally no one would help these patients. No one would speak to them. No one would hug them. And no one would give them any care at all.
And from those original nuns who fought to make this possible comes a beautiful organization, which is now the largest of its kind with direct service to our clients. It is a very specific, unique organization to our city with unique foundations. Who knew that crazy drag queens would be repping an organization started by nuns? We’re both in fabulous frocks, which is just a polite coincidence. And so many years later, their hard work and their compassion still extends through the community. It truly shows that God’s love, or your higher power’s love, or our universal love and thoughtfulness for our fellow citizens extends regardless of where you came from. We can all be fabulous, we can all reach out, and we can all truly care.
The CARE Center serves 2,000 clients annually and provides 100 new PreEP/PEP services each year. The CARE Center also provides services, including health education, benefits counseling, access to a food pantry, HIV medical care, mental health services, nutritional counseling, and more.