Race, the Unexpected Hot-Button Issue of the Day

At a conference like today's "Improving Health Literacy in Los Angeles," which focused on the sensitive issue of improving health literacy in some of Los Angeles' underserved communities, racial stereotypes should be a far-away concern.

But when the time came for tables of conference attendees to report back to the whole after doing a group interactive activity, it became clear that even the most well-meaning and forward-thinking health professionals have far to go.

Each table of conference attendees was asked to react to and analyze a film, Robert's Story, the second in the four-part "Worlds Apart" documentary series used as a learning tool to frame the discussion throughout the day. In it, an African-American man named Robert went through dialysis as he waited to receive a donor kidney, after his own failed due to hypertension and diabetes. Despite his best attempts to stay healthy, he was worried about how he would maintain his health as he waited for what his doctor said could be up to three years.

Over the course of the film, Robert, a highly educated and articulate professional, touched on some hot button items.

African-American men, he began, are less likely to receive donor kidneys.

"There's a big attitude like an African-American man who has hypertension and diabetes is just going to ruin it anyway, so why give him a kidney," he said.

He talked about his doctor not taking his calls, and feeling like he was a nuisance when he was able to reach the doctor. "They get annoyed when you call too much," he said. But "I'm not calling just to bug you, I'm calling because if I don't have [a kidney], I'll have problems, so respond to me accordingly, don't respond to me like I'm another file you have to pull out every time I call you."

And Robert mentioned the African-American community's mistrust of health care providers, dating back to the Tuskegee experiments.

Following the film, each table's appointed spokesperson shared their perspective on how Robert's situation spoke to health literacy. When one such group stood to present their conclusions, their findings elicited audible gasps from the audience.

"He is a challenge to the system because he is educated," the spokesperson said. "What is his background? Why didn't he take care of himself?" she asked, despite the film having shown Robert in otherwise excellent health, and exercising regularly. "Who is he hanging around with?" she went on. "Where did he get his information?"

Finally, she stated that she, and the other two members of her group, would be interested in "looking into his mental health issues, because it's clear that he has some."

While the comments went unchallenged, the moderator, Karen Coleman, PhD, was visibly shaken.

(Coleman then went on to share that, for her, the film spoke to the need for providing more information so patients such as Robert can understand some of the underlying reasons behind the long waits endured by African Americans who need organ donations).

Still, the remarks made by the controversial spokeswoman for her table lingered in the air, in stark contrast to the assumption that the panelists were speaking to "the choir," as another audience member, Shanpin Fanchiang, suggested earlier. And they were a jarring reminder to never write off the deeper reasons behind racial disparities in health care.