Dr. Ashley Demark grew up in St. Louis, Missouri, a city where about 25 percent of the population is African American and yet are 20 times more likely to live in poverty than white Americans. Racial disparities are nothing new to her as she’s seen them all her life. “Black urban communities just don’t have the same access as the affluent white ones,” she said. And that leads to problems.
We’re currently seeing the impact of the coronavirus pandemic crippling Black communities at disproportionate rates compared to others — especially in areas where inequities are the most extreme. Those who are highly educated about the issue will tell you it’s not because Black people aren’t social distancing or washing their hands. It’s because of social detriments that Black Americans were born into because of their skin complexion.
Food deserts, air pollution, toxic water, unemployment and underemployment, limited access points for healthcare – these are challenges Black communities face across the U.S. They lead to chronic conditions like asthma, diabetes and heart disease, perpetuate a lackluster attitude about healthcare, and increase distrust in government and healthcare institutions. And this is what keeps Black people dying from COVID-19 at alarming rates.
Dr. Denmark believes having more doctors of color can help improve healthcare conditions since most doctors of color return to their communities to work. She’s a prime example — she returned to St. Louis, Missouri, in a full circle moment to become the first African American female family medicine physician at Missouri Baptist Medical Center since its opening in 1884.
We had a chance to speak with her about the pandemic’s toll on Black America, practicing healthy habits and her mission to increase Black and Brown doctor representation.
MillBuzz: What are some ways that Black people are being disproportionately affected by COVID-19?
Denmark: The racial disparities that were present are now more prominent. Take it from myself, being from and working in St. Louis, I see how these Black urban communities just don’t have the same access as the affluent white ones, and that leads to problems. So, what you see right now is like a perfect storm. When you give people limited tools to survive, and something like COVID hits, it really just falls apart and causes these communities to be more vulnerable than they already were.
When you think about chronic conditions, such as asthma, diabetes and heart disease, that exist in these communities, these things stem from social determinants, meaning those factors they had no control over or were born into. Maybe their neighborhood is a food desert, or there is lack of clean water like Flint, Michigan, lack of employment or educational opportunities, or limited access points for healthcare. A lot of time if you pull out a map for hospitals and clinics, you’ll see that Black communities have a limited number compared to white affluent communities that have unlimited healthcare access points. So, all of these things kind of come together and lead to what we’re seeing with higher mortality rates among the Black communities. This shines a light on a disparity that already existed. Minorities were left kind of defenseless in their communities, and are at a greater risk for dying.
MillBuzz: What has been the response from public leaders and where are they missing the mark to address this issue?
Denmark: Well, I understand the economic struggle, of course with people being laid off, businesses closing and facing permanent closure, but I feel like they’re missing the mark on listening to science, looking at the data of how this virus has taken a course. There’s been a lag time on how they’re responding. I’m in a physician’s monitoring group, that’s focusing on COVID, and we were talking about things before leaders were or media was. We’re reading things and new information from countries around the world, so when we’re seeing what’s happening against what’s being reported by leaders, we were seeing the actual lag time, and it’s problematic.
Let’s take proper measures to reopen the economy safely. You can’t have an economy with dead people, and that’s just the bottom line and my point. We have to lead by example and be considerate to those on the front line, and we’re not doing that right now.
I think this kind of goes to the fact that we’re missing minority leadership at the table who understand disparities because they may grow up in it. It’s a matter of making sure the proper resources are available when they need them. We’ve got to protect our vulnerable communities. I had affluent white patients that were buying $200 COVID tests because they could. But my African American patients could not do that and had to drive out of their way to get a COVID test screening. We have to understand that there are some communities that are lacking more than others and make sure that everyone is getting the resources that they need. Maybe they can’t stay home from work, they have to go to work to pay bills, then when they go out and pick up the virus in a possible multi-family home, it’s spreading wildly to everyone, with limited resources.
MillBuzz: What can Black people do to help lessen the impact, if anything?
Denmark: The main thing is handwashing, a must, 20 seconds. Use hand sanitizer if you’re out and can’t get to a sink. Practice social distancing which means only come into contact with those in your household. If you have to go out, stay six feet apart at a minimum. But I do think for Black people specifically, now is a great time to get your health in order. The underlying conditions, you know diabetes is not just a “high sugar” disease. It can affect your kidney, heart, vision, and even your nerves. We have to get out of this honeymoon state that we’re in with chronic conditions and being okay with co-existing with them. Especially when we know that COVID will be around for the next 12-18 months until we find a vaccine that really works, and these underlying conditions can make you more vulnerable, even fatal, to the disease.
If you don’t have a primary care doctor, look into one. I know that this is another disparity because in my own home, my parents didn’t have one growing up, or really know what a primary care doctor was until I became one. Physicians are doing Zoom visits right now that can help you start to get things under control, so definitely call your local doctor’s office and look into that.
Practice healthy habits. Make sure you’re increasing your vegetable intake, increasing water intake, reducing amount of carbs and sugar, simple walking right now can even help in keeping your body active and healthy. It’s really easy to stay on auto pilot right now and say well this is how I learned to eat, versus redefining your diet. Now is the time to be intentional about diet and healthy habits.
MillBuzz: Tell us about Project Diversify Medicine?
Denmark: Project Diversify Medicine is my way of mentoring future Black and Brown doctors. On my journey itself, I didn’t have a lot of support. I had my mom and dad, but they didn’t know how to become a doctor. So, it was just a random Google search or mentor here and there. I think I stumbled a lot of the way, and I still made it, but I want to simplify the process for people that look like me. Right now, there are only 5% African Americans, 5% Latino and 1% Native American physicians, and I want to change those numbers because I know from the research, a lot of them would go back into the communities where there are healthcare deserts. And I want to find a way to give back and mentor to them. I leverage social media and pop culture to engage the younger people.
MillBuzz: What are some of the key areas that Project Diversify Medicine is working to address?
Denmark: To support our sole mission of increasing Black and Brown doctor representation, we focus on items that are key to getting started in the medical field. We teach maintaining a good GPA, studying for the medical college admissions test to get into medical school, finding recommendations, getting personal items structured, and more. We have digital products, coaching, online mentoring and daily posts to keep youth inspired and educated along the way.
MillBuzz: What is Project Diversify Medicine specifically doing to address the COVID-19 impact on Black people?
Denmark: Our goal is to bring awareness and provide updated information about COVID-19. We started #TeamNoCOVID on social media, to highlight what people are doing or new information about the situation. For instance, we might make a post about steps you can do to prevent or highlight other doctors in the community who are making interactive videos or memes. Most recently we did the #MaskOn challenge. We highlight doctors making masks, doing community work, and just overall being on the front line and behind the scenes. They’re not just working the hospitals or the clinics, they’re coming home and having to worry about putting their families in harm’s way. I’ve got a platform of 30,000 that are willing to listen to news about COVID, the disparities, and situation for healthcare workers, so we’re putting the info out there!