Dr. Marcella Alsan P’29 Discusses Health Disparities and the Roots of Medical Mistrust

A timely and powerful all-school Assembly featuring Dr. Marcella Alsan P’29, member of the 2021 MacArthur Genius Fellows and professor of public policy at the Kennedy School at Harvard University, shed light on health disparities historically rooted in racial discrimination and mistrust of the medical community. 

Winsor’s Director of Community and Inclusion Julian Braxton opened the Assembly with a personal story about his father, who “never went to the doctor and never talked about why.” When his dad passed away 10 years ago from a cancer that could have been prevented with early detection, Mr. Braxton realized the roots of his dad's fears: mistrust of the medical community. 

Putting in historical context, Mr. Braxton and Dr. Aslan both referenced an early research study, the Tuskegee Study of Untreated Syphilis in the Negro Male, which still clouds the institutional memory of many Black people still living in Alabama years later. The Tuskegee Study violated several basic bioethical principles including nonmaleficence (participants were harmed, because treatment was withheld after it became the treatment of choice), and justice (only African Americans were recruited). This study led to changes in research policies and practices to better protect participants.

The lesson: history matters. 

Fast forward to the present day, recent epidemics such as COVID-19 and HIV/AIDS, continue to highlight differential disparities and higher death rates among marginalized groups. Infectious diseases show the inequalities in quantitative data, with younger people dying at higher rates. 

“We’re looking at a disparity on top of a disparity,” said Dr. Alsan. Historically, from an empirical basis, the gap in mortality rates widens between the dominant and immigrant populations. “Far from being a leveler, a new pathogen, a new pandemic, tends to show the cracks in our society.” 

Dr. Aslan referenced the cycle of poverty and disease: getting medications to where they are most needed. It’s a simple formula, if drugs are available people live, if not, people die. 

Additionally, mentorship is important. For Mr. Braxton’s father, it was impossible to find a Black doctor near him. Diversity means opportunity and finding diversity among doctors that reflects the patient body is important in trust building. 

Dr. Aslan shared her experiences as both a physician and economist, and passed along some wisdom to Winsor students along their path in life. 

“It’s important to answer these three questions: What are your strengths? What do you like? Is it helping the world? If you can answer those questions, then you can keep going, rejection or not.”