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Patients sometimes died in the hearse as the driver searched for a hospital willing to accept a Black person. Since White hospitals frequently refused to send ambulances for Black patients, Black medical workers repurposed hearses for medical transport. Alvin Poussaint, a leader in the health care civil rights movement, with an “ambulance” during the 1965 march from Selma to Montgomery, Ala. Black patients received segregated care Black medical students were excluded from training programs Black physicians lacked resources for their practices.ĭr. The new rules brought advances to doctors across the country, giving the field a new level of scientific rigor and protections for patients.īut there was also a lesser-known side of the Flexner Report.īlack Americans already had an inferior experience with the health system. and Canada closed, and the numbers of practices and physicians plummeted. As state boards enforced the standards, more than half the medical schools in the U.S. Medical schools should partner with hospitals, invest more in faculty and facilities, and adopt Northern city training models.

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Published in 1910, the Flexner Report blasted the unregulated state of medical education, urging professional standards to produce a force of “fewer and better doctors.”įlexner recommended raising students’ pre-medical entry requirements and academic terms. Abraham Flexner, an educator, was chosen to perform a nationwide survey of the state of medical schools. Physicians led by the American Medical Association (A.M.A.) were pushing for reform. Dangerous quacks and con artists flourished. Churning students through short academic terms with inadequate clinical facilities, medical schools were flooding the field with unqualified doctors - and pocketing the tuition fees. Some clues to why health care is failing African Americans can be found in a document written over 100 years ago: the Flexner Report. During the pandemic, this racial longevity gap seemed to grow again after narrowing in recent years. Research shows Black Americans receive less and lower-quality care for conditions like cancer, heart problems, pneumonia, pain management, prenatal and maternal health, and overall preventive health. Racism drives some of the key social determinants of health, like lower levels of income and generational wealth less access to healthy food, water and public spaces environmental damage overpolicing and disproportionate incarceration and the stresses of prolonged discrimination.īut the health care system also plays a part in this disparity. The overall mortality disparity has existed for centuries. Black babies were more than twice as likely as White babies to die before their first birthday.

The age group most affected by the inequality was infants.

In 2019, the most recent year with available mortality data, there were over 62,000 such earlier deaths - or one out of every five African American deaths. In 2019, almost 3,600 more Black babies died before their first birthday.īlack Americans die at higher rates than White Americans at nearly every age.

The biggest inequality affected Black infants, who had more than twice the White infant mortality rate.