Naba Khan, Contributing Writer
The United States likes to call itself an egalitarian society — but that is a far cry from the truth, especially when it comes to health care.
As a third-year medical student, I can personally attest to this.
When my clinical rotations began, it was a flurry of non-stop action from day one. In those first few weeks, I gleaned a great deal of wisdom through observation alone, but one of the most important lessons I learned was this: the people who tend to be the most hesitant about treatments are people of color and Black patients.
This should not come as a surprise. Throughout history, grave injustices have been carried out against the Black community by means of medical racism.
The 1932-1937 Tuskegee Syphilis experiments deliberately left Black sharecroppers untreated and unaware of their syphilis diagnoses— even when penicillin was an available cure.
There was the testing of gynecological surgeries on enslaved women in the 19th century.
And do not forget Henrietta Lacks and her family, who have yet to receive justice and compensation for the illegal and non-consensual use of her cervical cells in scientific research.
VCU itself is no stranger to the historical exploitations of Black bodies: in 1994, hundreds of bones were uncovered and found in a well during the construction of a new VCU medical building. They had been grave robbed by the medical students and faculty in the mid-1800s from Black cemeteries to practice dissections.
Virginia’s first-ever heart transplant was done at MCV and taken from Bruce Tucker, a Black construction worker who was declared brain dead. His family was never notified, and when his brother tried to sue the facility, an all-white jury ruled in favor of the surgeons.
These injuries are not confined to the recent past; they echo into the present, in which Black mothers remain disproportionately more likely to die during childbirth than their white counterparts. Where Black children are much less likely to receive opioids for pain compared to white children, even when presenting with the same level of pain.
Medicine is a profession defined by human involvement. It is also a profession liable to human error. Physicians can harbor subconscious biases and, frighteningly, those can lead to differential treatment.
In Richmond, racial health disparities aren’t theoretical. Black residents experience higher rates of hypertension, diabetes complications, chronic obstructive pulmonary disease and stroke compared to white residents. Neighborhoods historically shaped by redlining are often associated with reduced access to preventive care and a higher utilization of the emergency department.
Structural racism — housing segregation, disinvestment, gentrification — determines which communities have access to primary care clinics and therefore which communities are healthier. When predominantly Black districts lose hospitals or face longer emergency wait times, that’s decades of policy manifesting into clinical reality.
One way to begin approaching this massive, tangled mess of a problem is active representation.
The concepts of diversity and inclusion have too often been reduced to pandering buzzwords for the benefit of individual organizations, ignoring the actual benefits that these virtues accrue. In the U.S., only about 5.7% of doctors are Black, even though around 15% of the population identifies as African American.
It’s no secret that medical education has a deep-rooted history of exclusion and racism, but it can be argued that current standards for admission are also classist. The requirements for exam prep and clinical experience are significantly harder for lower-income applicants to achieve, and typically, the cost of medical school alone is enough to weed out potential students from lower socioeconomic backgrounds.
In a country where wealth and race are inseparable, these standards are functionally racial gatekeeping under a different name. With the limitations brought about by Trump’s One Big Beautiful Bill to student loan policies, one can only imagine the impact on applications going forward.
Black History Month invites reflection, but reflection without transformation is insufficient. The medical field must confront not only its historical transgressions, but its present-day inequities as well.
Trust, once fractured, requires more than an apology.
It requires accountability.
It requires change.
It may feel futile — like we are hopelessly chipping away at a behemoth of an issue — but futility is a luxury we cannot afford right now. The systems that perpetuate inequity were not accidents of nature; they were engineered, brick by brick, policy by policy, assembled deliberately and reinforced over time.
And anything that has been built can be rebuilt.