Twenty years ago, and then Ten years ago and then Five years ago, I wrote this piece. The last evergreen piece was published in the American-Statesman. Not surprising, nothing has really changed. Therefore, here is this updated evergreen piece. My confidence level, that something will be done has diminished over the Twenty plus year, but just maybe, this time. Studies have shown that racial and ethnic minorities frequently receive lower-quality health care, are less likely to get routine care and have higher rates of morbidity and mortality than non-minorities. Even as medical discoveries improve health care overall, these disparities are cited over and over again as something that has to change.

Where our health is concerned, who you are and your life experiences determine the solution you find to address problems. If those tasked with making discoveries are not concordant with those who are suffering the problems, you end up with the situation described by an editorial published by the American Medical Association. It said that despite all of the effort on addressing health care disparities, the gap remains and in some cases is getting worse.

As comedian Jackie “Moms” Mabley once said, “If you always do what you have already done, you’ll always get what you always got.”

I moved my young family to Houston in 1980, taking a joint position as an assistant professor in the Department of Gynecology and assistant biochemist in the Department of Biochemistry at the University of Texas System M.D. Anderson Research and Tumor Institute, as it was called then. I rose through the ranks there, becoming the first African-American full professor and director of the Experimental Gynecology/Endocrinology Research Laboratory.

One of the driving reasons I had taken the UT position was to change the way we addressed the issue of the overall high mortality rate from breast cancer in African-American women, especially among young women. In a 1998 interview, Frank Michal, a member of the Houston Chronicle editorial board, asked me what had been achieved in addressing this issue. Other than policy changes over nearly two decades, I told him I was concerned that little true change had taken place. “Benign neglect, institutional discrimination and internal politics have left us with a system that has been unresponsive to both research and health-care needs,” I said in his Sept. 21, 1998, editorial, “Racism can be cancer on the health system.”

Michel wrote:

“Problems are ignored. Boat-rockers like Jones are ostracized or patronized or shunted off into corners by good-old-boy networks. Racial and ethnic biological factors are overlooked in research projects. Cultural differences are not factored into scientific data gathering. Minority doctors and researchers are paid less, promoted less, put down as troublemakers or just tolerated. Like cancer itself, the disease can take many forms and many disguises that often make it hard to detect, hard to prove and very hard to eradicate.”

Little did Michel realize what responses his article would bring. He received calls from readers saying that he needed a brain transplant and that he should blow his liberal brains out. People were angry that he reported how deliberate and unintentional discrimination within the nation’s medical establishment, especially the Texas Medical Center, led to a different, and sometimes deadly double standard. I told him I was not surprised.

Since that time, we have made progress regarding gender, specifically in white women, but what about others? “Health disparities” has long been part of medical research lexicon, but The New York Times and others, since the piece was originally written five years ago, reported the mortality rate from breast cancer in African-American women has not really changed.

How can this be? One factor often overlooked is that lack of concordance. The gap remains because, at the leadership and faculty level, the researchers don’t understand the problems.

So how much has really changed, other than more money, more papers being published and more meetings on the subject to point out that we have a problem?

I can point to the lack of real change at the leadership and faculty level. In fact, it may be worse in some instances. Again, who you are shapes how we look at problems, and there lies the crucks of the problem.

We can’t continue to publish papers and get more grants without reducing the gaps that are acknowledged over and over again. It is a threat to the very being of this nation. If you don’t agree and think that we are making sufficient change, at the very least it is worth putting that position to the rigors of scientific and social inquiry. More importantly, it should not be dismissed as brainlessness or the rants of a boat rocker or malcontent, because so much is at stake for my children and you

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