Reflection Questions

1. Think about how you access health care. What are barriers and facilitators for your care. Think about someone with different characteristics that yourself who was attempting to access health care. How would the barriers and facilitators be the same or different?
2. Consider going to a health center or hospital near you. Sit down in a lobby if you can. Watch different people come in and see how the journey goes for them. How would the experience be different for some rather than others?
3. Imagine having to seek care in a different country where English is not the main language. How confident would you feel navigating the health system?

Discussion Questions

1. “What Color are Your Germs?” is a call-to-action. Consider the tone of the writing: is it optimistic or pessimistic? Consider the things that have changed (or have not changed) since 1954, what can we say about Chicago’s progress in terms of racial segregation?
2. Dr. Young’s letter is poignant in its conclusion: “Our nation has broken a compact to achieve human equality. The Law has failed our disinherited.” Do you see his assessment relevant today, does it resonate with contemporary political discourse?
3. Edwin Black’s “Racism in red blood cells” is one of the very important pieces of our Reader that was not originally published in an academic journal. Why is it that academic journals rarely publish articles like this? Are there new journals that you have seen in the literature that cover more activist and politically engaged articles?
4. The Uptown People’s Health Center was based on the principles of social medicine. Consider the Health Center’s philosophy as described by Walter “Slim” Coleman – what is unique about this approach? Consider how the experience of the Uptown People’s Health Center relates to the new (global) Social Medicine Consortium, particularly its “Consensus Statement.”
5. “Transfers to a public hospital” quantities the health effects of “patient dumping”, echoing the concerns of “What Color Are Your Germs”, which was published 30 years before the article by Schiff et al. How did the process of patient dumping work? Consider Schiff et al’s study in conjunction with “I Call It Murder” and Ansell’s 2015 HDSJ keynote address. There was success in changing policy to make patient dumping illegal – yet it still occurs, and is arguably a taken-for-granted feature of the US healthcare system. What facilitates patient dumping today?
6. Marie Crandall talked about her “trauma deserts” article in our Voices of Health Equity interview. She observed: “When I was doing my surgical training, while we pulled off some pretty spectacular saves, it felt like we were doing our patients a disservice because we’d save somebody but we wouldn’t send them out with the skills to prevent it from happening again. …If we were doing that in any other field of medicine, it would be malpractice.” Consider her article in light of her comments in interview – what changes would we need in the health care system to address her concerns?

Solution Finding

1. Imagine that you were Otto J. Kerner, Chairman of the President’s Advisory Commission on Civil Disorders in 1967, and you received the letter from Dr. Quentin D. Young calling out the differences in practices of hospitals regarding obstetrical services provided to pregnant Black women compared to white women. Compose a letter back to address the issues that Dr. Young raises. What would you write?

Further Readings

Elesh, D., & Schollaert, P. T. (1972). Race and urban medicine: factors affecting the distribution of physicians in Chicago. J Health Soc Behav, 13(3), 236-250.

Benjamins, M. R. (2012). Race/ethnic discrimination and preventive service utilization in a sample of whites, blacks, Mexicans, and Puerto Ricans. Med Care, 50(10), 870-876.

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