Hundreds of Emory medical workers kneel, highlighting issues of race and health

On Friday at 1 p.m. Jeremy Amayo, clad in his scrubs and white hospital coat, walked to a grassy quadrangle near Emory University Hospital and took a knee.

For eight minutes and 46 seconds, the length of time George Floyd lay under a Minneapolis policeman’s knee as he died, Amayo and several hundred doctors, nurses, physician assistants and other health care workers kneeled “in remembrance of George Floyd and countless others,” in the words of a flier that flashed around social media this week. The demonstration planned by an Emory medical student on Twitter struck a nerve and grew to include workers at seven hospitals across metro Atlanta. Emory didn’t organize it, but offered support as the size became clear.

» PHOTOS: The White Coats for Black Lives demonstration at Emory

The organizers called it "White Coats for Black Lives" and say they did so for a reason. Racism isn't just a human rights problem, they say; it's destructive to health and they see that on the front lines.

The deaths of George Floyd and Ahmaud Arbery came right on the heels of the COVID-19 pandemic, a disease that growing evidence links to a disproportionate impact in black and Latino communities. That is only one of the ways in which being black, Latino or Native American is associated with poorer health outcomes in the United States. Those communities also suffer higher rates of chronic health conditions, such as diabetes and heart disease, and higher rates of maternal deaths.



Research suggeststhe racial inequities in health care go beyond the impact of poorer economic status and environment on health, to the medical impact that comes just from experiencing racism. And it calls for public notice, the health care workers say.

“I mean, look no further than coronavirus,” said Dr. Johnny Jones, a gastroenterologist who took part in the demonstration at Emory Decatur Hospital. “There definitely is some intersectionality in terms of life expectancy amongst black people relative to the majority.”

“We all have the same organs,” said Dr. Maneesha Agarwal, a pediatric emergency doctor who took a knee from home while caring for her young daughter. “But how you’re treated poorly due to race can result in a lot of differences in the hormones in the body, and how your organs grow and develop. A mother’s experiences and hormonal changes can even impact her unborn child in utero. That can impact a person’s own health through life.”



The stress factor

Nduka Vernon, a fourth-year medical student at Emory, will never forget the time a high school classmate in Mississippi called him the n-word, and laughed. This spring he watched the video of Ahmaud Arbery’s killing — like Vernon, Arbery was 25 — and once again felt the impact on a personal level.

“I saw the video,” he said. “I sort of put it off. Just tried to bury my emotions about it. It really came out, my anger and frustration came out, when I was with my mom on Mother’s Day.

» COMPLETE COVERAGE: Protests in Atlanta

» MORE: The latest on the coronavirus pandemic in Georgia

“While medical school is stressful for everyone, I think the added stress of being a minority in these professional settings, especially African American and dealing with the stereotypes that come with skin color in this country, add stress. And on top of that have to see images of black people being targeted because of the color of their skin.”

According to the research of a team at the University of Michigan, that stress has a physiological impact that grows over time. Scientists can measure the impact through the production of stress hormones and the development of high blood pressure and other precursors for heart attacks, as well as inappropriate immune responses.



In a research sample of patients of different demographic groups, it turned out those impacts hit black women worst, Dr. Arline Geronimus at the University of Michigan, found. She and her co-authors found that these differences aren’t accounted for by wealth: Non-poor black women were more affected by toxic stress than poor white women. They called it “weathering,” like constant wind wears down a rock.

“The weathering effects of living in a race-conscious society may be greatest among those Blacks most likely to engage in high-effort coping,” Geronimus wrote. Her findings have recently been cited as a possible reason for the high death rate among black women as compared to other women. Even educated, well-off black women die from pregnancy at rates much higher than white women. Causes of their deaths are often the types of vascular and cardiac conditions related to the stress hormones whose impact Geronimus investigated.

Crisis lends hope

The good news, say Vernon and others, is that this moment of crisis lends hope.

The event that first-year Emory medical student Katie Sharma started organizing on Twitter after seeing a similar one in Philadelphia caught fire on social media. When it outgrew the space they were planning, Emory’s administration stepped in and helped find locations at seven hospitals.

“It’s inspiring to see people — non-black people, quite honestly — embracing social justice,” said Dr. Jones, surveying the diverse crowd standing up from the long kneel in front of the Decatur hospital. “I think that’s a good start. And that’s a vital thing that we need to take place before we have true healing.”

Another step forward may be the order by the federal government this week requiring laboratories to report the race, ethnicity, age and gender of people tested for COVID-19. The marked racial disparities in deaths from COVID-19 in the few places where it could be counted made headlines, but also shone a spotlight on how little attention had been paid to collecting good data.

Dr. Agarwal and Dr. Sheryl Heron, a researcher on injury and associate dean at Emory, hope the moment will lead to increasing interest in solutions to the health problems that disproportionately impact communities of color.

Among the solutions is educating health care workers on implicit bias: Data shows health workers can dismiss black patients' concerns about pain or symptoms. Another is addressing a patient's ability to afford trips to medical care and the drugs a doctor tells a patient to take.

Heron was working in the emergency room Friday afternoon and couldn’t take part in the demonstration, she said, but she was glad to see it. “What I hope is this is not going to be a one and done,” she said.