The Urgent Fight for Health Equity | Yolandra Hancock | TEDxFoggyBottom

Summary

The video script narrates the tragic story of Mrs. Sarah Johnson, an 86-year-old African American woman whose life was deemed not worth saving by a doctor during the COVID-19 pandemic due to her age and race. It highlights systemic racism in healthcare, where black patients face higher mortality rates. The speaker, a physician and public health expert, shares her personal experiences and calls for action to dismantle institutional racism and health inequities, advocating for policy changes and corporate responsibility to improve health outcomes for black communities.

Takeaways

• 😔 Mrs. Sarah Johnson, an 86-year-old African American woman from Louisiana, was deemed unworthy of life-saving measures by a doctor during the COVID-19 pandemic.
• 🏥 The doctor in question prematurely recommended a Do Not Resuscitate (DNR) status for Mrs. Johnson, citing her age and alleged health conditions that were later contested.
• 📉 Mrs. Johnson's actual health conditions, as documented by other healthcare professionals, were not as severe as initially described, suggesting a potential bias in medical judgment.
• 🏢 The healthcare system involved is under investigation for similar alleged cases of racial bias in patient care during the pandemic.
• 🚑 Despite her age, Mrs. Johnson showed signs of improvement and was misdiagnosed with severe health issues that could have been managed with proper care.
• 🏡 She was sent home with hospice care, which implies a focus on palliative care rather than curative treatment, potentially due to the aforementioned bias.
• 🔍 The incident highlights a broader issue of racial disparities in healthcare, where Black patients may receive different or substandard care compared to their White counterparts.
• 🌟 The speaker shares a personal experience with their grandmother, illustrating the systemic nature of racial bias in healthcare and the importance of advocacy for patients of color.
• 📊 COVID-19 has disproportionately affected Black, Native American, and Latinx communities, with death rates significantly higher than those of White individuals.
• 🌐 The pandemic has exposed and intensified discussions about systemic racism and its impact on health outcomes, including the social determinants of health that affect communities of color.
• 💪 The speaker emphasizes the need for collective action to combat institutional racism and health inequities, advocating for policy changes and corporate responsibility.

Q & A

Who is Mrs. Sarah Johnson and what was her situation?

Mrs. Sarah Johnson was an 86-year-old African American woman from Louisiana who had dedicated her life to caring for others as a mother, grandmother, and nurse. She contracted COVID-19 and was admitted to a hospital overwhelmed with patients. Despite her age, she was independent and mentally sharp. However, she was deemed unworthy of being saved by a doctor due to her race and age.

What was the doctor's initial assessment of Mrs. Johnson's condition?

The doctor documented in Mrs. Johnson's chart that she was of advanced age, severely malnourished, had renal failure, and advanced dementia, which led to pushing for her to have a Do Not Resuscitate (DNR) status.

What were the actual conditions of Mrs. Johnson according to her medical records?

According to her medical records and other healthcare professionals, Mrs. Johnson was only mildly malnourished but significantly dehydrated. Her mental status was altered, which was not unusual for COVID-19 patients presenting similar symptoms.

What was the hospital's response to Mrs. Johnson's condition?

Instead of calling the family to inquire about her functional capacity, nutritional status, or mental status, the hospital informed the family that there was nothing they could do to save her. The family reluctantly agreed to hospice care, and Mrs. Johnson was discharged home.

What were the findings of the later investigation into Mrs. Johnson's case?

A later investigation revealed that Mrs. Johnson had improved prior to her discharge, no longer had renal failure, and her elevated blood sodium level could have been managed with IV fluids and close monitoring, potentially saving her life.

How did the speaker's personal experience relate to Mrs. Johnson's case?

The speaker had a similar experience with their grandmother, who was also prematurely discussed for a DNR status and end-of-life plan without a proper diagnosis. This personal experience highlights the systemic bias in healthcare.

What are the racial disparities in COVID-19 death rates mentioned in the script?

The script mentions that the age-adjusted COVID-19 death rates for blacks are over three and a half times that for whites, and for Native American and Latinx communities, it's at least two and a half times higher.

What is the role of social determinants of health in the script's discussion?

The script discusses how social determinants of health, such as where we live, work, and play, define 80% of our health outcomes and can either provide access to resources or facilitate the devaluation of black life due to systemic racism.

How does the script connect historical events like slavery to current health disparities?

The script connects historical events like slavery to current health disparities by discussing the transgenerational impact on the hypothalamic pituitary adrenal axes and how societal and legislative racism influence the social determinants of health.

What actions does the speaker advocate for to address health inequities?

The speaker advocates for communities to join forces, calling on elected officials to create norms, practices, and policies to dismantle institutionalized racism, and to hold big food and big soda accountable for their practices.

What is the speaker's approach to addressing health issues as a physician and public health expert?

As a physician and public health expert, the speaker uses their position to help patients with their health issues and address the social determinants driving those issues. They also work on raising the next generation of public health professionals, crafting legislation, and advocating for policy changes.