Q&A: Addressing the unmet need for equitable health care access
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The Association of Black Gastroenterologists and Hepatologists is committed to eliminating health disparities, increasing Black professional representation and advocating for positive change in digestive health equity.
“Black communities in the U.S. have been plagued by unmitigated health disparities in several areas, including cardiovascular, gastrointestinal and neoplastic diseases. Colorectal cancer is an example of a preventable disease with various screening methods and effective treatment modalities; yet disparities in incidence, morbidity and mortality among Black individuals have persisted in the U.S. since the late 1980s,” Pascale M. White, MD, Icahn School of Medicine at Mount Sinai, and colleagues wrote in Nature Reviews Gastroenterology and Hepatology. “Given these circumstances, it is clear that more is needed to bring awareness of and resolutions to disparities in digestive health diseases.”
According to 2019 data, despite representing 13% of the general population, Black physicians are few in the field of gastroenterology and hepatology (> 4%) and accounted for less than 7% of the medical student population and 5% of the practicing physician population. Translated, these numbers carry significant implications on racial concordance between physician and vulnerable populations, and more specifically, on CRC screening uptake in clinical practice. Thus, the first step to mitigating Black health disparities begins with bolstering Black representation in medicine.
Healio Gastroenterology spoke with Sophie Balzora, MD, FACG, the Association of Black Gastroenterologists and Hepatologists (ABGH) board of directors, NYU Grossman School of Medicine, about ABGH’s goals for addressing equitable health care access and the legacy it intends to leave behind for future Black gastroenterologists.
Healio Gastroenterology: What was the impetus for founding ABGH and what is its mission?
Sophie Balzora: The year 2020 was wrought with a deluge of experiences that reaffirmed how widely systemic racism casts its net, whether from COVID-19, colorectal cancer or police violence. What started as a means of cathartic release for a group of gastroenterologists and hepatologists to discuss these tragic events, occurring both inside and outside of the hospital walls, transitioned into a drive to galvanize and formally advance the mission of ABGH.
The heart of ABGH lives in the Black community. Ultimately, what we have achieved thus far and that we look to accomplish moving forward with this growing group of future and current Black gastroenterologists, hepatologists and digestive disease scientist ABGH members is for Black people to truly live their best life. I know this phrase may seem trite, but truly, the essence of health equity is exactly this, because health touches every aspect of our lives in small and big ways. ABGH as an organization works to channel its members’ and allies’ energy and momentum toward the goal of health equity through workforce diversity, equity and inclusion, through community engagement and by improving health outcomes for Black people’s digestive health.
Healio: With its establishment early this year, what successes and setbacks have you encountered so far?
Balzora: The successes have been clear — we’ve organized two community-facing events and three professional networking sessions that have been well-received and well-attended, despite the challenges with which COVID-19 has presented to all of us. While in our infancy, we’ve moved quickly and we’re an enthusiastic and effective group that continues to expand. The support we’ve received from professional societies, thought leaders in the field of GI, patient advocates and cancer survivors as well as advocacy groups has been astounding; we’re incredibly grateful for this.
In terms of setbacks, we tend to rise to challenges. Instead of viewing obstacles as setbacks, ABGH founders and board of directors have turned challenges into lessons and opportunities to grow. Doing all of this throughout the pandemic, when people are so stretched, when burnout is so rampant and when people need time to breathe and process all that has happened over the last 18 months or so is tough. But at the same time, these so-called setbacks were part of what allowed this group of 11 of us ABGH co-founders to finally come together to facilitate the sense of community that Black GIs, hepatologists and scientists crave. People are ready and excited to continue to build the community that will allow us to thrive and expand our network and impact. The pandemic has set us up for a particular circumstance that has fostered creativity in terms of the best ways for our programming to be effective and lasting despite some challenges.
Healio: What is your current plan for addressed the unmet need for equitable access in health care?
Balzora: We have both short and long-term goals in the pipeline to accomplish this goal. As detailed in our vision, the path to health equity for Black communities is not a sprint. Attacking issues from all sides, both within the profession of medicine and within the community, and by engaging key stakeholders, will offer the best success. We truly need to harness all our members’ energy, as well as activating our allies, to work toward this collective goal that ABGH sees as a priority — improving the digestive health of Black communities.
Healio: What implications might this organization have for Black patients/healthcare workers in the future?
Balzora: During our inaugural community-facing event in March 2021, “Colorectal Cancer in the COVID-19 Era,” one of our panelists, an early age onset CRC survivor and patient advocate, Dianne Nathanial, said with relief, “Well it’s about time!” I anticipate many Black/African American patients will share this sentiment as we grow and they learn more about ABGH and what we hope to do as an organization.
As for health care workers, there’s a similar vibe — people are finally feeling seen, and their experiences understood, with the hope to change things for the better.
Healio: What does this organization mean to you?
Balzora: ABGH is our lifeline, and we hope it will be our legacy as Black gastroenterologists, hepatologists and scientists who lived ABGH’s founding during a cultural climate that our country has never experienced before.
The ABGH board of directors and co-founders as well as the founding members, all echo a similar sentiment: Finally! We see our mission as a priority that ought not just be ours, but everyone who has a hand in health and health care and I take that very seriously. It is what drives me, both professionally and personally. We are working to build a healthier future.
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White P, et al. Nat Rev Gastroenterol Hepatol. 2021;doi:10.1038/s41575-021-00464-y.
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