"Why We Can't Wait" January 2023 Discussion

[PSPA Health Disparities Committee]

This month, we are reading "Why We Can't Wait" by Martin Luther King Jr. This book was published in 1964 and is about the nonviolent movement against racial segregation in the United States, and specifically the 1963 Birmingham campaign.

To guide our discussion, I wanted to ask you to compare the problems that MLK outlines in 1963 to our current world (now almost 60 years later) - what similarities and differences do you notice, particularly in your own community/position in healthcare? What are some ways we as healthcare providers can lessen these disparities?

[Nichole]

I really enjoyed reading “Why We Can’t Wait” by Martin Luther King, Jr. While reading the book, I could not stop thinking of all of the similarities that MLK discussed in 1963 to our world today. The Birmingham protests of 1963 paved the way for the Civil Rights Act of 1964 – however, as MLK cites in “Why We Can’t Wait”, the scars of racism still remained in Birmingham after the peaceful protests and still appear to be present across the United States in 2023.

It is an unfortunate truth that members of racial and ethnic minorities often have worse health outcomes for certain health conditions. Although the CDC cites that African Americans are living longer, they also note that younger African Americans are living with/dying of conditions that are typically found in older ages of their white counterparts (hypertension, diabetes, stroke, etc).

In my own job in hematology/oncology bone marrow transplant, patients of ethnic minorities are less likely to match with donors for allogeneic stem cell transplants (29% vs 79% odds for black vs white patients, respectively). For patients with certain hematologic malignancies (leukemia, myelodysplastic syndromes, etc) and/or benign hematologic conditions requiring allogeneic bone marrow transplants (sickle cell anemia, aplastic anemia), this can unfortunately be the difference between life and death. In addition, a study from 2009 showed that African American patients who underwent unrelated donor stem cell transplants, the survival was worse than their white counterparts, even after adjustment for transplant and socioeconomic factors. This makes you ask the question of why this may be.

For this specific situation, ways to help lessen these health disparities are to increase access to care for these patients and to increase representation of minorities in the national bone marrow registry (Be The Match) through volunteering and education at community events. I plan on contacting Be The Match to organize donation events throughout my local area (Pittsburgh) in an attempt to increase representation, as well as increase awareness of this issue.



https://www.cdc.gov/vitalsigns/aaheal...

https://bethematch.org/transplant-bas...

https://www.sciencedirect.com/science...

[Jane]

Thank you for your post. I felt the book was well written. I found it to be a somber reminder that there is so much we as providers can help with in our own specialties. I appreciate you and your public affirmation for the underrepresented and your continued actions.