“Celebrating Martin Luther King, Jr.-A Role Model For Equity, Diversity & Inclusion”
Mia Kang, MD, MHS, FASA
Clinical Associate Professor, Division Chief, Neuroanesthesia, UNC Department of Anesthesiology, NC, USA
Chair, EDI committee, SNACC
As I write this the United States is celebrating the birthday of Reverend Dr. Martin Luther King, Jr. which is a national holiday observed on the third Monday of January annually. (His actual birthday is January 15, 1929.) Dr. King is celebrated not just in the U.S. but internationally as a prominent civil rights activist who fought tirelessly against racial discrimination and injustice. Most readers know of the important role he played during the American Civil Rights Movement. He delivered his famous “I Have a Dream” speech (https://www.youtube.com/watch?v=vP4iY1TtS3s) on the steps of the Lincoln Memorial during the March on Washington for Jobs and Freedom on August 28, 1963, with over 250,000 people in the crowd. He was an advocate of nonviolent approaches, such as grassroots organizing, protests, and civil disobedience, in the fight against racial discrimination and injustice. He is the only American who was never President to be honored with a national holiday.1
Despite the significant progress that has been made in the United States in terms of reducing racial discrimination there continue to be significant racial disparities in health care outcomes. In the neurosurgical population, Black patients with supratentorial tumors had worse outcomes in terms of mortality, length of stay, and higher complication rates. Black and Hispanic patients undergoing pituitary surgery were found to have worse outcomes and be more likely to utilize low-volume surgical centers than their white counterparts. In the pediatric population nonwhite patients have been found in several studies to have higher death rates as well as longer hospital stays after cerebrospinal fluid shunt procedures. Glauser and colleagues undertook an analysis to of this data which demonstrated that the effects of race were mitigated when adjusted for socioeconomic status (SES).2
The unfortunate reality in the United States, however, is that Black and Hispanic Americans continue to be overrepresented in the lower SES groups because of the history of systemic racial and economic discrimination that they have faced historically. Towards the later part of his life Dr. King focused more and more on the economic injustices that black Americans faced, including lack of economic opportunities and lower wages as compared to white Americans. In the southern United States, there were often Jim Crow laws that mandated strict segregation of the races including of schools and workplaces.* Dr. King rightly knew that to achieve true equality these economic injustices had to be remedied.
One important way to reduce racial disparities in health outcomes is to have a health care force whose demographics reflect the communities they serve. According to the American Association of Medical Colleges a great deal of progress has been made in terms of diversity of the medical profession from 1980 to 2019. In fact, there were actually more women than men entering the medical profession by 2019. The report goes on to note: “However, gains in diversity were not shared by all groups. In particular, the growth of Black or African American applicants, matriculants, and graduates lagged behind other groups.”3
SNACC demonstrated its commitment to the aims of reducing racial disparities in the field of neuroanesthesia well as patient outcomes when it formed the Diversity and Equity Committee in 2018. The Committee’s goals were to help promote better understanding of the diverse groups represented in SNACC, develop a mentorship program with special focus on underrepresented groups, and focus on diversity-driven initiatives such as global health with trainee focus.4
Dr. King was an ordained minister in the Baptist Church and often used references from the Christian Bible in his speeches. He delivered his last speech at the Mason Temple in Memphis, Tennessee the night before he was killed, noting that:
“We’ve got some difficult days ahead. But it really doesn’t matter with me now, because I’ve been to the mountaintop … And He’s allowed me to go up to the mountain. And I’ve looked over, and I’ve seen the Promised Land. I may not get there with you. But I want you to know tonight that we, as a people, will get to the promised land.” (https://www.youtube.com/watch?v=Oehry1JC9Rk)
Although we have made a great deal of progress in the U.S. in matters of reducing the impact of race on healthcare outcomes, even in 2023 we still have far to go to attain Dr. King’s vision of a more just society free from racial inequalities.
*Jim Crow laws refer to the state and local laws enforcing racial discrimination and segregation in the Southern United States after the end of the Civil War. They were in effect from Reconstruction until 1965.
- https://en.wikipedia.org/wiki/Martin_Luther_King_Jr (accessed 1/14/2023)
- Glauser G, Detchou, DK, Dimentberg R, et al. Social Determinants of Health and Neurosurgical Outcomes: Current State and Future Directions. Neurosurgery 88(5):p E383-E390, May 2021. | DOI: 10.1093/neuros/nyab030
- https://www.aamc.org/data-reports/workforce/report/diversity-medicine-facts-and-figures-2019 (accessed 1/16/2023)
- Theard MA, Aglio LS. Diversity and Inclusion, Here and Now–SNACC Reaches out to all its Members. ASA MonitorAugust 2018, Vol. 82, 52–54. https://pubs.asahq.org/monitor/article/82/8/52/6086/Diversity-and-Inclusion-Here-and-Now-SNACC-Reaches