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‘Health Justice at Upstate: Breaking Down Barriers’ gets students talking

On Rev. Dr. Martin Luther King Jr. Day, a group of eight medical students presented “Health Justice at Upstate: Breaking Down Barriers,” a program of talks and discussions focusing on health care as a human right.

More than 100 people attended the five-hour event in the Academic Building. A followup interactive session may be scheduled soon. Reflecting on the Health Justice event, each planning committee member tackled a specific topic or issue. Their thoughts follow.

Hiba Zafar

What did you hope community members — Upstate faculty, students and others who attended — would take away from this conference?

Originally, our goal was to have this conference be a means for fellow students, faculty and community members to gain an understanding of how to incite change on a policy level—at Upstate and in the larger Syracuse community, to help break down structural barriers patients face in accessing and receiving adequate healthcare. While many of us are aware of these barriers, we are unsure of where to go from there. How does recognizing issues of socioeconomic status, ethnicity, race and trauma as factors of a medical complaint, translate into modifying curriculum, training and policy on an institutional and societal level? And how can we—as students and colleagues take a part in creating tangible improvements?

Through planning and attending the conference, I realized that each of us is at a different point on this path to improve medical education and service. For some, this conference helped to spark discussion of those disparities, and recognize that Upstate is not immune to them. Others were somewhere else on the path, aware of existing prejudices and biases because of our various perspectives and were more eager to see how they individually could make change happen alongside their primary role of student or employee.

And for others, it was a point of yes, I am actively involved in healthcare advocacy and social justice but want to show my fellow community members how this task is manageable alongside an obligation of being a student or employee. So, I suppose our modified take-away is that each person travelled a little further, and found themselves walking away from the conference a little closer to their destination as a social justice advocate. Because at the end of the day, part of being a healthcare professional and caring for a patient means being that patient’s advocate.

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Madelyn Garcia

Why was it important for you to participate in this conference, and what implications do you think it’ll have in your professional life?

I’ve learned that even in a field full of conscious, educated individuals there is a gap of knowledge and passion for advocacy. Though we are taught the facts of negative outcomes and behaviors, we are disengaged in further talking solutions or addressing the root causes plaguing the very communities we live in. Plainly said, not enough of us are talking about it. So, how do we begin breaking these barriers? What does it look it? Simply, we create spaces where people can come together to discuss these troubled areas. We move to educate, share knowledge and take action. Health Justice at Upstate is an initiative to assist in creating that space where we can further fine tune the wheel to bring small changes—even if it’s simply creating or increasing awareness. It begins with one person, one conversation, one event. The goal is get a diversity of people on the same page, regardless of varying perspectives.

Being part of the conference initiative, especially with such powerhouse women, was an opportunity to further acquire tools and skills to be a change agent amongst my peers. I want to be a voice at the table for those who do not have one–whether that’s advocating for an individual patient in a clinical setting or on a grander scale in policy making.

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Kywanna Alfred

Why is being aware of biases and race in medicine important to you?

Unfortunately, still in today’s world, we hear of countless stories where deeply rooted racial biases play a role in how members of a particular community receive healthcare. Quick judgments are often made that can inadvertently lead to poor outcomes for patients and even those around them.

There are many ways in which we can alter these prejudiced views. I believe the most important way, and quite often the most difficult, is becoming aware of our own implicit biases and how they can potentially affect those we come in contact with. As physicians, we must be aware of our own biases to ensure it doesn’t skew the way we treat and care for our patients. Martin Luther King, Jr. once stated that “Of all the forms of inequality, injustice in health care is the most shocking and inhumane.” Life is a basic right and as such, healthcare should be too. Being denied proper care because of differences that make us unique is most certainly inhumane and a complete disregard for our fellow citizens.

Our goal in having this conference was to make topics like these less taboo; to have open and honest conversations about race and its impact on health. I believe we reached that goal and sparked a flame at Upstate. I hope to see it grow and see Upstate become a pioneer in changing how we interact with those we vow to help.

Upstate medical students Tanesha Beckford, left, and Sydney Russell Leed, right, with Helena Hansen, MD PhD, keynote speaker at “Health Justice at Upstate: Breaking Down Barriers.”

Sydney Russell Leed

Several speakers stressed that change must be radical. What does that mean to you, from the perspective of a future physician?

As medical students, we are taught that the epidemiology of a disease is crucial to diagnosing patients, but our education neglects the epidemiology of poor social conditions. I believe that we must consider individual patients in a holistic context that includes environment, socioeconomic status, and intergenerational trauma. For example, Erica Garner, daughter of police brutality victim Eric Garner, recently passed away after a heart attack. She was only 27. Our medical education teaches us the histopathology of a myocardial infarction, but not the cardiovascular effects of living in a society plagued by racism. To treat the patient, we must address the context of the disease on a structural level.

To me, radical change in healthcare means addressing root causes of disease with structural change. Ms. Garner and her father both had asthma, which contributed to their deaths. One approach to this fact would be to acknowledge that residents of low-income neighborhoods are more likely to suffer from both asthma and police brutality. Another, the “structurally competent” approach, would be to ask ourselves how to combat the income inequality and segregation that led to the very existence of low-income neighborhoods. I am passionate about community-based participatory research, and I believe that socially conscious physicians can work with lawmakers to use this type of research to prescribe evidence-based solutions to the social inequalities that drive disease.

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Adaobi Ikpeze

How do you balance being a medical student while being actively engaged in social activism?

As students, it can be challenging to balance our concern for social justice and advocacy with every day commitments such as school work, maintaining interpersonal relationships and self-care.  For anyone who is passionate about ameliorating injustices that plague our health care system, or is simply aware of structural inequalities that greatly impact the lives of others, we may feel an urgency to “fix” these issues immediately. Although pressure can be a strong motivating force to complete a task, subjecting our physical bodies and minds to constant stress does more harm than good to our overall well-being.

As a black medical student, the constant pressure to mobilize and respond to increasingly overwhelming displays of hatred, bigotry and injustice, particularly in the Trump era, is exhausting and I am learning to prioritize my joy and take care of my mental and physical well-being in the mindset of it all.  Activities such as exercise, prayer, meditation and relying heavily on my support system for emotional uplifting has allowed me to have enough energy to continue the fight. I’ve also had to incorporate delegating tasks and collaborating with allies, faculty and administrators into my daily practice. Personally, finding my balance has been a lifelong task, but as students it’s important that we never lose sight of our top priority, which is to graduate with our degrees. Ultimately, we are students first. As a young black woman pursuing my medical degree, my existence is also a form of resistance.

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Tanesha Beckford

The second half of the event was called “Breaking Down Barriers.” Can you suggest where and how individuals and institutions in health care can start?

In order to Break Down Barriers we must start right here at Upstate!  We must begin to challenge ourselves on an individual level. This is what starting our very first Health Justice conference was all about. There is no easy solution to tackling health injustices, however by honing in on our individual action and being a part of an institution where students can be the voice of change is a great place to start.

Providing a place both in and outside the classroom here at Upstate to educate and bring awareness can help to be a vehicle for a change in culture. There is no place for silence when it comes to battling the health injustices that have been crippling our communities for centuries. National organizations such as the Student National Medical Association (SNMA) have been devoted to tackling disparities in medicine for decades, but this is not enough.  It takes revolutionary effort, along with the help of our allies to implement change. We must be the change we want to see, and challenge our colleagues to do the same. As future health professionals we must follow Dr. King’s reminder to rise above the confines of our individualistic concerns, in order to focus on the broader concerns of humanity.

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Milly Pau

What is one way individuals can address their own implicit biases to break down barriers and make connections?

Empathize.

Allowing ourselves to be vulnerable to others.

How?

By sharing our implicit biases and experiences first.

If they shared theirs

Be open to theirs and your own.

Our differences.

We break down barriers by being vulnerable and open.

Accept that these biases exist in me, you, and everyone.

Accept that we are all not perfect.

But our feelings and thoughts are not fixed

These implicit biases can be changed.

Changed for the better.

We make connections by embracing acceptance and change.

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Humayra Mayat

Keynote speaker Helena Hansen, MD PhD, cited a survey in which 80% of doctors said social factors interfere with the care of their patients, but they had no clue what to do about it. What is your reaction to that?

I wasn’t very surprised when Dr. Hansen stated this because it’s something that has come up a lot in my experiences shadowing and working in health care settings. This helplessness that physicians often feel in their day-to- day interactions seems to correlate well with the high rates of physician burnout.

I’m interested in emergency medicine and I’ve spent a significant amount of time working and shadowing at different emergency rooms in New York. In these settings I’ve come across very similar systemic issues time and time again. We saw uninsured patients using the emergency room for primary care, homeless patients trying to get away from the cold, very overweight patients coming not compliant with their diabetic medications. In these cases, when we were aware of all the social and economic undercurrents of the situation, simply addressing the medical condition at hand was sometimes demoralizing. Yet, we pushed through because it was the task at hand — even if in the back of my mind it felt like were were putting a Band-aid on a cut that was already festering.

In this way, I believe that physicians that work at the forefront with very vulnerable populations need to be at the forefront of health advocacy and actively working with policy makers. Physicians do not have the luxury of staying on the sidelines of these issues because of the recognition that a great deal of our work is influenced by systemic problems that occur outside of the emergency room. It’s a recognition of this reality and the work that needs to be done that I think pushes me forward.

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Several campus organizations, faculty, staff and departments helped put on “Health Justice at Upstate.” Tanesha Beckford is president of one of the groups, the Student National Medical Association, which hosts a Feb. 17 gala and fundraising drive for the YWCA’s Zonta House, an after-school program to support STEM education. For ticket info, e-mail upstatesnma@snma.org.

These eight medical students planned “Health Justice at Upstate: Breaking Down Barriers” on campus on Dr. Martin Luther King Jr. Day. Students, from left, are: Tanesha Beckford, Madelyn Garcia, Hiba Zafar, Sydney Russell Leed, Kywanna Alfred, Humayra Mayat, Milly Pau and Adaobi Ikpeze.

—This article also appeared in With Distinction.

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