r. Oluwaferanmi O. Okanlami told members of the Frank H. Netter MD School of Medicine community that people of color have been disproportionately impacted by COVID-19 due to social determinants. He served as the keynote speaker for the State of the School address on Monday, August 10, presenting, “Disabusing disability: Demonstrating that disability doesn't mean inability.”
"Today, I'm going to use the COVID-19 pandemic to discuss just how things of the past are still affecting the care of people that fall into two specific neighborhoods due to the inextricable link between health care and society," said Okanlami. "No matter how long my white coat or how visible my stethoscope, there are still people that cannot see beyond the color of my skin."
Okanlami described how communities of color have been disproportionately impacted by COVID-19 due to social determinants. According to the World Health Organization, these circumstances are shaped by the distribution of money, power and resources at global, national and local levels.
"Right now, people around the country are becoming increasingly more aware of the driving force behind these factors: racism," said Okanlami. "Racism had already negatively impacted their health outcomes and through epigenetics. We also know that the history of trauma experienced by generations of Black and brown people that came before us has a measurable impact on our health outcomes today. And now the pandemic, with its results and shut down in quarantine, measures have begun to hit the same communities from all sides."
Okanlami said that there is a long history of mistrust of the health care system in many minority communities due to misconceptions and mistreatment of these communities.
“Repairing the relationship that communities of color have with the health care system is possible, but will take a consistent commitment to doing so and an honest assessment of why the relationship is so damaged in the first place,” said Okanlami. “I had been learning from my medical students during this time about some of the race-based practices that I was taught in medical school, but never questioned. It was through their efforts that I read more about the work being done around the country to eliminate the use of race as a factor in the VBAC score, spirometry and estimating GFR.”
From there, Okanlami transitioned to discussing another community that has been vulnerable and marginalized for quite some time — the disabled.
“People with disabilities and chronic health conditions fear that their lives were already seen as less valuable and now worried that, due to limited resources, care will be rationed if they are hospitalized, skipping over them in favor of individuals with lives worth saving,” said Okanlami. “Often the solution to a problem is much easier than one may imagine, especially when we listen to the voices of those that are impacted by it. But who is actually being impacted by the things that are going on right now? It once again comes back to who you consider to be your neighbor.”
Okanlami said that despite being an orthopedic surgery resident who took care of people with disabilities, he did not know or understand the experience of the disabled community himself — until he became part of the neighborhood after a diving accident paralyzed him from the chest down. It was this incident that sparked his passion for addressing inequities that exist due to the intersections between disability and race.
“People often wonder how much of a difference any one person can make,” said Okanlami. “But both of these pandemics — COVID-19 and racism — have shown me that institutions are just structures that had been built upon the beliefs of a few individuals with the power to move the needle.”
Racism is a public health and medical crisis and medical students across the country are sending a very clear message to their institutions that the time to act is now, Okanlami said.
“Our students are demanding that we dismantle an already broken healthcare system — incorporating comprehensive anti-racism and health justice curricula for students, faculty and staff — putting an end to race-based practices and medicine and establishing a culture of intolerance for prejudice of any kind,” said Okanlami. “You can't all become disabled, Black Nigerian physicians — but it shouldn't take having the same lived experience to acknowledge the implications of racism and ableism on those that you may not have considered your neighbors yesterday. However, my hope is that after this talk today, you will begin to consider them your neighbors tomorrow.”
Okanlami concluded by using an analogy of a Venn diagram to encourage participants to look around and see that they are all more connected than they are disconnected.
"You may have no idea what the intersections of your Venn diagram are until you actually talk to other people and figure out which circles intersect with theirs," said Okanlami. "And then you will find that by advocating for some of these social justice things, you are truly helping someone that is your neighbor, your family member, your friend and someone that benefits from all of this work. It shouldn't be thought of that this work only benefits the minority, because if that's how we still feel, then we have a long way to go to recognize that this work is important for all of us."
Bruce Koeppen, dean of the Frank H. Netter MD School of Medicine, commended the work of the medical school community for adapting to virtual learning — and stressed the importance of following the health and safety guidelines not just on campus, but everywhere, all the time.
"We know this virus can be deadly, and the last thing anyone would want to see is it impacting one of us or a family member in this way," said Koeppen. "If you feel ill, get tested and self-isolate. Protect yourself and protect those around you, especially those most vulnerable. We all have to be smart in order to stay safe."
Koeppen also noted that this academic year, his last as dean, the school will be preparing for its first re-accreditation survey visit and is in the process of creating a Family Medicine residency in collaboration with the Northern Maine Medical Center and St. Vincent’s Medical Center in Connecticut.
After reflecting on the history of the Frank H. Netter MD School of Medicine, Koeppen addressed the final challenge of the school: diversity and inclusion. During the event, the experiences of several medical students were shared, highlighting some of the areas of opportunity facing the medical school community.
“Over the past weeks, I have listened to, and I have heard, the voices of our students. They demand action, and not just words,” said Koeppen. “I have also had conversations with members of my leadership team, as well as faculty. I have taken the thoughts and ideas I have heard and developed a blueprint to address bias and advance racial justice at Netter. I call it a blueprint because, it is a starting point for what we need to build, which is a culture that values and respects everyone at Netter, but most importantly those who have been negatively impacted by bias, racism or treated unjustly.”
The blueprint includes action steps such as: reviewing and revising the curriculum; establishing an Office of Diversity, Equity and Inclusion; implementing enhanced training; developing a system for reporting incidences of bias and effectively addressing said incidences; enhancing recruitment and retention of those who are under-represented in medicine; and expanding and enhancing mentoring opportunities for under-represented students.
“This blueprint is not etched in stone. I expect it to be refined, and additional steps may also be added. It is, as all blueprints are, a starting point. And we need to start now,” said Koeppen. “As I have said each year in my State of the School address: diversity, equity and inclusion is everyone’s responsibility. That is why I expect everyone to support and work with this blueprint.”