Systemic racism creates a compounded effect where people of color and minority populations are disadvantaged in many aspects, from food security and imprisonment to education and housing. Healthcare has not escaped the effects of systemic racism, where people of color experience poorer health outcomes and higher death rates across the United States.
Mass General Brigham has undertaken a widespread campaign called United Against Racism (UAR) that is dedicated to dismantling the barriers and systems that contribute to medical care disparities.
Several UAR outreach programs have been implemented at Brigham and Women’s Hospital. Quoc-Dien Trinh, MD, MBA, director of ambulatory clinical operations in the Division of Urology, is heavily involved in these efforts. Dr. Trinh was recently featured in a STAT News article highlighting his efforts in a Mass General Brigham outreach program that provides individualized support for patients of color. In this Q&A, Dr. Trinh discusses the outreach program and how his team’s research continues to reduce healthcare disparities.
Q: How does systemic racism in the U.S. affect health outcomes for patients of color?
Trinh: Unfortunately, societies foster racial inequity through mutually reinforcing systems of housing, education—virtually everything, including healthcare. This translates into systematically worse outcomes in individuals of color for many medical conditions. In fact, the mortality of Black men with prostate cancer is 2.1-fold higher than their white counterparts.
Q: How has Mass General Brigham’s “United Against Racism” initiative been implemented in the Brigham’s Division of Urology?
Trinh: One of the pilot projects funded under the United Against Racism initiative was our Prostate Cancer Outreach Clinic (PCOC), which I co-founded with my Massachusetts General Hospital counterpart, Adam Feldman, MD, MPH. PCOC is a Mass General Brigham system venture to provide better access to prostate cancer care for men of color. Indeed, despite having near-universal insurance coverage in Massachusetts, men of color are 22% less likely to receive treatment for prostate cancer when treatment is warranted.
Q: Why is this outreach program so important?
Trinh: First, it’s the ethical thing to do. I was born and raised in Canada, where everyone—including my parents, who were Vietnamese refugees—has access to the same healthcare and education system. After more than a decade in the U.S., I’m still shocked by the inequities that we see in all aspects of life. Second, “minorities” will soon constitute more than half the U.S. population by 2045. As a healthcare organization, we need to be in a position that addresses the needs of the entire population we serve. With PCOC, we take a more personalized approach with patients of color where we walk through the screening and treatment process for prostate cancer, answering their questions and listening to their concerns. I block off time in my schedule specifically for those patients who come through the program.
Q: Do your research efforts relate to further reducing health disparities?
Trinh: Yes! For the past decade, our research at the Center for Surgery and Public Health has focused on inequity in cancer care delivery. The PCOC was informed by research that we did in collaboration with the Massachusetts Department of Public Health, most recently funded by the American Cancer Society.