Jul. 18 2019

Alumna Leads on Equity

In his 1906 report “The Health and Physique of the Negro American,” sociologist W.E.B. DuBois detailed racial disparities in disease and death rates in the post-Reconstruction era. Whether they lived north or south of the Mason-Dixon line, blacks were far more likely to die of tuberculosis, pneumonia, and what we now know as infant mortality. The problem was neither racial inferiority nor geography, DuBois concluded, but rather an artifact of social circumstances. “With the improved sanitary condition, improved education, and better economic opportunities,” he wrote, “the mortality of the race may and probably will steadily decrease until it becomes normal.”

A century later, however, race-based health disparities in the United States remain profound. Black babies today are twice as likely to die as white infants. Their mothers are more than three times as likely to die of preventable causes during pregnancy, childbirth, and the first year of parenthood as their white counterparts. People of color—including Latinx and Native Americans—also receive lower quality of care for pain management, diabetes, hypertension, and cancer, and fewer preventive services to avert those diagnoses.

“These differences aren’t fair, they’re unjust, and they’re avoidable,” says preventive medicine physician K. Aletha Maybank, MPH’06, who points out that disparities are a direct result of our nation’s legacy of colonialism and slavery. “We have to be able to name structural causes for why inequities exist, how people with power have made policies, and how biases and racist ideologies are embedded in policies, as well as how this impacts how we deliver health care both at the individual level and at the institutional level.”

In April 2019, Maybank was named the inaugural chief health equity officer of the American Medical Association, the nation’s largest professional organization of physicians and medical students. Previously a deputy commissioner of New York City’s Department of Health and Mental Hygiene (DOHMH), Maybank was founding director of the DOHMH Center for Health Equity. She launched the Race to Justice Initiative, renewed the agency’s commitment to neighborhood-based work, and oversaw development of the first place-based community health worker efforts in New York City public housing.

As a vice president of the AMA, Maybank will launch a Center for Health Equity to elevate and sustain the organization’s commitment to combatting disparities and develop processes to embed the pursuit of health equity at the core of the AMA’s operations. And because healthcare inequities run the gamut from interpersonal bias in provider-patient interactions to the echoes of institutional racism embedded in policies on housing, transportation, and civil rights, she plans to take a full-spectrum approach to the enterprise.

Maybank was already a board-certified preventive medicine physician when she enrolled at Columbia Mailman, and she credits Associate Dean for Community and Minority Affairs Robert Fullilove and others with opening her eyes to the often-insidious ways race amplifies how social determinants of health play out. In addition to their role in her scholarly and intellectual development, Maybank credits her faculty mentors with an abiding professional influence. “They were phenomenal professors, understanding of me at that time as a young, black physician figuring out what I was going to do,” she says. “They opened doors for me and that’s absolutely important for all students, but especially students of color.”

In the years since she left Columbia Mailman, Maybank has made a point to hold the door for young and old, alike. In 2012, she co-founded “We Are Doc McStuffins,” a movement created by African American female physicians inspired by the Disney Junior character Doc McStuffins. “As physicians, we take an oath to do no harm and keep patients safe,” she says. “If biases are causing harm, we have to confront them for the sake of excellence in patient care.”