Black people live every day with hurdles that former health chief tried to diminish

February 17, 2023 12:09 am

Virginia Health Commissioner Colin Greene faced questioning from Faye Prichard (right) and other members of the state’s Board of Health over his comments dismissing the role of racism in public health disparities. (Kate Masters/Virginia Mercury)

News this week that the richest Black mothers and their babies are twice as likely to die in the year after childbirth than their white counterparts is just one indicator of why Colin Greene, the onetime chief of the Virginia Health Department, was rejected by the state Senate.  

Similar medical facts contribute to why Democratic legislators, African-Americans around Virginia and department employees were so appalled by Greene’s pronouncements last year about racism. The state health commissioner downplayed more than a century of second-class treatment, stereotypes and structural barriers that Black people and other minorities have faced regarding health care in this country. 

The account Sunday in The New York Times, citing a study by the nonpartisan National Bureau of Economic Research about births in California, also found maternal mortality rates were just as high among the richest Black women as they were among poor white women.  

“It’s not race, it’s racism,” an economist focused on public health and obstetrics told The Times. “The data are quite clear that this isn’t about biology. This is about the environments where we live, where we work, where we play, where we sleep.” 

Exactly. You can’t improve health care for Black people without noting the circumstances and structures that have long harmed them. That’s why the comments by Greene, the state’s one-time top public health official, were so reprehensible.  

The Washington Post reported last year that Greene said he had yet to see “compelling evidence” that racism played a role in well documented maternal and infant health disparities for Black mothers and their babies. He also took issue with the term racism, telling The Post that “if you say ‘racism,’ you’re blaming White people.”  

His obtuseness was insulting. There has been no shortage of reports and data proving that Black people have suffered from unequal treatment and poor outcomes involving medical care.  

The Democratic-controlled state Senate, along party lines, sent Greene packing last week. Gov. Glenn Youngkin had named him to the post in 2022, but he didn’t face confirmation proceedings until the current General Assembly session.  

Virginia’s Maternal Mortality Review Team, which identifies pregnancy-related deaths and develops ways to produce preventable deaths, continued doing its work as usual under Greene, a program official told me. It recently prepared a report due every three years that’s required by state code.  

Greene’s dismissiveness on racism was more than just an issue of semantics. Black people and other people of color have faced neglect and worse in navigating health care in America. They live with those effects every day.  

Fear of alienating whites should never outweigh actually assisting people long marginalized in this country.  

“The fundamental purpose of the Health Department is to focus on some of our most vulnerable communities and those in the health system,” Sen. Scott Surovell, D-Fairfax, told me. Greene “didn’t seem to have any appreciation for that.” 

Fear of alienating whites should never outweigh actually assisting people long marginalized in this country.

– Roger Chesley

Forget that Native American, Black and Latino people suffered from higher rates of  hospitalizations and deaths related to COVID-19 compared with whites. Longstanding disparities and inequities pre-COVID aren’t hard to find. Greene must have known that. 

In 1946, for example, as Jim Crow reigned, the Hospital Survey and Construction Act provided money to build public hospitals and long-term care facilities. But it also allowed states to construct racially separate and unequal facilities, the journal Health Affairs reported.  

There’s also the myth that Black people and Black skin are somehow resistant to pain, and that they don’t need pain meds in the same quantities that whites do. Some of this claptrap can be traced to the work of J. Marion Sims, often touted as “the father of modern gynecology.” He conducted experiments on enslaved Black women without anesthesia.  

The 19th century doctor was developing a treatment for vesicovaginal fistula, which resulted from vaginal tears during complicated deliveries. But the enslaved women couldn’t consent, first of all.  

Sims’ decision not to administer anesthesia was akin to sadism, too. My colleague Samantha Willis included Sims in a 2018 magazine article about Confederate era monuments that were coming down, including one of Sims in Central Park in New York.  

Vestiges of Sims’ rationale exist today. White medical students and residents held misguided beliefs about biological differences between Black and white people, 2016 studies found, and this led to racial bias in pain treatment.  

Or consider the federal money that’s been allotted to cystic fibrosis (CF), a disease that primarily affects whites, versus the dollars devoted to sickle cell disease (SCD), which affects Black and Latino people and people from some Mediterranean nations. (Full disclosure: My late sister Saundra, who died last year at age 65, suffered horribly from sickle cell over her lifetime.) 

Both sickle cell and cystic fibrosis are inherited disorders. There are roughly 100,000 Americans with sickle cell disease and 35,000 with CF. Yet, over an 11-year period, federal funding was greater per person with CF, at $2,807, compared to sickle cell sufferers, at $812.   

“Despite SCD being 3 times as prevalent as CF, both diseases received a similar amount of federal government research funding between 2008 and 2018,”  the Journal of the American Medical Association Network Open reported. “The funding disparity was markedly increased when factoring in disease-specific private foundation funding.” 

For these reasons and more, Youngkin should appoint someone more sensitive about racial bias in health care than Greene.  

The evidence is overwhelming that problems exist. The new health commissioner shouldn’t proclaim otherwise. 

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Roger Chesley
Roger Chesley

Longtime columnist and editorial writer Roger Chesley worked at the (Newport News) Daily Press and The (Norfolk) Virginian-Pilot from 1997 through 2018. He previously worked at newspapers in Cherry Hill, N.J., and Detroit. Reach him at [email protected]