New Documentary: Historical Roots of Racial Disparities in American Health Care

“Racial inequity shows up in every dimension of health care,” says Neel Shah, an assistant professor in obstetrics and gynecology at Harvard Medical School and chief medical officer of Maven Clinic, a pioneering virtual clinic for women and families. “The thing about maternal health that has made it the galvanizing focus of my whole career is that the wellbeing of mothers is a bellwether for the wellbeing of society as a whole.”

The physician lent his expertise to Color of Care, a new documentary from the Smithsonian Channel about racial disparities in health—and how to address them. The program, executive produced by Oprah Winfrey and set to premiere on May 1, will delve into these issues and how the covid-19 pandemic laid bare the issues facing the nation. We asked Shah about the historical roots of the connections between race and wellness. 

Are racial health inequities mainly a legacy of medical pedagogy? Are they also cultural?

Well, you can't separate the two. Racism shows up in a number of ways. There's interpersonal racism, which can be explicit but almost always is tacit. These are the biases that we carry around with us in our daily interactions. And then there is institutional racism. One of my really close friends lost his wife after having a C-section; he had been raising alarm bells because she didn't look quite right. But in hindsight, one of the things he worries about is that he could have advocated more strongly for her, but also, as a Black man, he didn't want to be perceived as a threat at the front desk. This is such a clear example of how implicit racism can operate. Racism operates in really any environment, and shows up in the hospital. Health care is not immune from the injustices that pervade society more broadly, including racism.

You’ve pointed to longstanding deficiencies in medical education, including a lack of representation.

Yes. This has been true throughout the history of medical training, but even in 2022 it remains uncommon when you’re learning about rashes in dermatology to see representation of melanated skin. Similarly, a common way to know that certain patients are unwell—perhaps they’re bleeding internally, causing anemia—is if they’re pale. But if you’re brown or Black, that may present differently.