Doctor shines spotlight on inequalities in US medical system on Black patients

In recent years, conversations of racism and prejudice in health care have become more mainstream, from Black patients not being taken seriously when it comes to pain, to Black women having the highest maternal mortality rate in the United States, according to data.

Dr. Uché Blackstock has studied these issues, and advocated for change in the health care system. Her book, "Legacy: A Black Physician Reckoning with Racism in Medicine," dives into her career in medicine and the disparities in health care.

She recently spoke with ABC News Live's Linsey Davis about her research and advocacy.

ABC NEWS LIVE: I just want to get into the idea. I didn't realize only 2% of medical doctors are Black women, and the significance of your mom. She's a doctor, pass it along, [and] you and your twin sister are the first mother-daughter legacy to graduate from Harvard Medical School. How did she influence you to decide [that] you too wanted to become a doctor? And not just you, but also your twin sister.

DR. UCHÉ BLACKSTOCK: Well, thank you so much for having me here today. Well, my mother was our -- she was our role model. And essentially, I grew up thinking that most physicians were Black women. I had my mother who returned to the community that she grew up in, in central Brooklyn, to take care of her neighbors and family. And then I also had, other Black women physicians. My pediatrician was a Black woman. So I actually grew up thinking that most physicians were Black women. And then I entered college and I was pre-med, and I saw the statistics and said, "Wow, we actually are the unicorns." This is actually a rarity.

ABC NEWS LIVE: And we've heard a lot, at least anecdotally, about the systemic inequalities in the health care system. But what made you want to take a deeper dive into it and then write a book about it?

BLACKSTOCK: Having a mother who was a physician, understanding that our numbers were so low, and then looking at the history as to why there were practices and policies that were put into place in the early 1900s that closed historically Black medical schools and actually have led to between 25,000 and 35,000 Black physicians essentially being erased. They would have been educated by those medical schools. So it really was my own journey from medical student to practicing physician to seeing what my patients were going through that made me want to delve deeper into the history to figure out why, as you mentioned, Black mothers are three to four times more likely to die of pregnancy-related complications, to recognize that there is nothing inherently wrong with Black Americans, but it's a system the legacy of slavery, Jim Crow, [and] systemic racism that has led to these health inequities that we see today.

ABC NEWS LIVE: And you point out that it's not just unconscious bias, but in some cases, it's actually taught that, for example, Black bodies are different from white bodies.

BLACKSTOCK: So we were taught both implicitly and explicitly in medical school that there are differences in kidney function, for example, between Black patients and non-Black patients because of myths that Black people had higher muscle mass and that correlated with kidney function. And essentially what that has led to is Black patients not receiving the specialized kidney care that they needed, not being placed on the kidney transplant lists. So those beliefs or those myths about Black people being biologically different than other people have actually led to us being harmed, and worsening health outcomes.

ABC NEWS LIVE: What kind of personal experiences have you observed with regard to these kinds of inequities within your own experience?

BLACKSTOCK: I think about my own experience as a medical student, I had appendicitis and I went to the E.R. three times as a medical student. I was misdiagnosed. There was a delayed diagnosis. I ended up rupturing my appendix. And during that whole process, I really was questioned as to how much pain are you really in? Like, what is your past medical history? Some of my complaints and concerns were minimized.

ABC NEWS LIVE: What can people do once you're equipped with the knowledge and you are aware of the statistics and the disparities, how can you change the outcomes?

BLACKSTOCK: So need medical schools to educate our students, to be able to care for a racially diverse patient population. We shouldn't just leave it up to Black physicians to do that. Everyone should be able to care for patients in the most equitable way. So looking at our curriculum and seeing how medical students are taught, but also holding hospitals and health care institutions accountable. So making sure that they're keeping track of metrics, keeping track of patient feedback and intervening when needed. And then expecting our policymakers to look at policies that we invest in Black communities.