As conversations on racial injustice and systemic racism continue globally, medical professionals identifying as POC are highlighting healthcare disparities. Various factors including but not limited to race, ethnicity, age, and socioeconomic status contribute to a person’s ability to achieve good health. POC individuals often face further obstacles in seeking healthcare services due to stereotypes and other biases toward their race or identity.
According to a report released by the National Academy of Medicine (NAM), “providers are less likely to deliver effective treatments to people of color when compared to their white counterparts—even after controlling for characteristics like class, health behaviors, comorbidities, and access to health insurance and health care services.” The data found that within POC communities, Black patients, specifically, are less likely than any other POC group to receive the same quality of health care as white patients with the same issues.
In addition to bias, a lack of inclusive materials and resources available for healthcare providers furthers the disparities POC individuals face when accessing health care. Reference or resource books often depict light-skinned individuals in examples of how to note disease symptoms. This causes many symptoms to be dismissed or overlooked when present in Black individuals because they do not match the symptoms seen on white counterparts. The practice deemed as “white skin bias” is relevant to textbooks and medical resources distributed globally. After noticing the clear lack of diversity in learning materials available to medical students, Malone Mukwende, a second-year medical student at St George’s, University of London, created Mind the Gap.
Mukwende created the handbook, Mind the Gap, to teach doctors and healthcare providers how physical symptoms appear differently on varying skin tones. “On arrival at medical school I noticed the lack of teaching in darker skin. We were often being taught to look for symptoms such as red rashes which I was aware would not appear as described in my own skin,” Mukwende told BME Medics. “When flagging this to tutors it was clear that they didn’t know of any other way to describe these conditions on patients of darker skin tones and I knew that I had to make a change to that.” One example the handbook refers to is Kawasaki disease, a disease commonly characterized by a rash—but the condition appears differently on Black and brown skin as it does on white, often making it more difficult to notice on darker skin tones.
According to the Atlanta Black Star, with the support of his school, Mukwende partnered with university staff including diversity lecturer Margot Turner and clinical lecturer Peter Tamony to complete the handbook. Together as a team, the three began hosting various training sessions for medical tutors using the handbook in July.
“The booklet addresses many issues that have been further exacerbated during the Covid-19 pandemic, such as families being asked if potential Covid patients are ‘pale’ or if their lips ‘turned blue,’” Mukwende said in a statement. “These are not useful descriptors for a black patient and, as a result, their care is compromised from the first point of contact,” Mukwende added. “It is essential we begin to educate others so they are aware of such differences and the power of the clinical language we currently use.”
In conversation with BME Medics, Mukwende said he hopes the handbook will make healthcare providers more aware of bias in addition to the implications such bias could have on patients. “It is important medical professionals are aware of variation in presenting symptoms when treating the diverse range of patients that they serve. I hope the work will help to increase the confidence of darker skinned patients to seek medical advice,” Mukwende added.
News of Mukwende’s handbook has made its way across various social media platforms. As of this report, Mind the Gap is not yet available for distribution and awaits publication.