A Note from the Editor
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Carter G. Woodson, whose work gave rise to Black History Month, wrote several invaluable histories of African Americans and, especially, the education of African Americans in the centuries before and the decades after Emancipation.1–4 Woodson documented the lives of individuals who achieved great things, against overwhelming odds. Among them are a number of physicians, including Dr. James Durham, born into slavery in 1762, who went on to prominence as a practitioner in New Orleans, where he saved more yellow fever victims during an epidemic than any other physician (he lost only 11 of 64 patients treated). Others were Dr. John V. DeGrasse, of New York, and Dr. Thomas J. White, of Brooklyn, who completed their medical studies at Bowdoin, in Maine, in 1849; Dr. William Taylor and Dr. John H. Fleet, who completed their medical education in Washington, D.C. prior to Emancipation; and two other African American physicians, who graduated from Berkshire Medical School in 1858. We are also reminded of Dr. James McCune Smith, who graduated as a physician from the University of Glasgow in 1837; Nurse Susie Baker (later known as Susie King Taylor), born into slavery in 1848, who became the first African American U.S. Army nurse during the Civil War; and Dr. Rebecca Lee Crumpler, the first African American woman to earn a medical degree, who graduated from New England Female Medical College in Boston in 1864. Woodson's captivating accounts serve as a welcome reminder of the importance of knowing the history of those who went before, especially those who, having stared down inconceivable adversity, dedicated themselves to the underserved.
Happily, we have the opportunity to do that in JHCPU's Heroes and Great Ideas Column. This issue's column recounts the story of three generations of Black dentists, father, son, and grandson: Drs. Alexander Adolphus Dummett (1874–1949), Clifton O. Dummett Sr. (1919–present), and Clifton O. Dummett Jr. (1944–2006). Dr. J.W. Jamerson, of Savannah, Georgia, gives us a moving and detailed account of this extraordinary family's achievements.
We also feature in this issue a commentary by Bailus Walker and Melvin Span on the importance of having under-represented minorities in the ranks of environmental health professionals, as well as on a long-term effort on the part of the National Library of Medicine to bring this about. Our second commentary also concerns environmental health. Nicholas Freudenberg and colleagues throw down the gauntlet for corporations to take at least some responsibility for reducing cancer health disparities by changing their practices in such areas as product design, marketing, retail distribution, and pricing.
This rest of the issue continues by tracing a course through health matters in the lives of racial and ethnic minorities. This theme has two major tributaries.
The first tributary carries the problem, establishing the persistence of differences, [End Page vii] disparities, and discrimination along racial and ethnic lines in large population studies in the North and Central American region of the world.
Vijay Kumar Bhandari and colleagues evaluate the quality of anticoagulation control (important for traumas such as stroke) among people of low socioeconomic status, diverse racial and ethnic backgrounds, and/or limited English proficiency. They find that the time in therapeutic range (TTR) is significantly lower for African Americans than for Whites and also lower for Spanish-speaking Hispanics than for English-speaking Hispanics.
Robert Levine and colleagues examine the relationship between the implementation of Medicare coverage for mammograms in 1991 and racial disparities in breast cancer mortality. They find that, post-implementation, breast cancer mortality declined faster among White than among Black elderly (65 years and older) women. No excess deaths occurred among Black elderly compared with White elderly through 1990; over 2,459 have occurred since.
Andrew Ryan and colleagues investigate whether self-reported racial/ethnic and gender discrimination were associated with lower rates of diabetes management. They find that self-reported racial/ethnic discrimination is associated with a roughly 50% lower probability of receiving a hemoglobin A1c test, foot exam, and blood pressure exam, while accounting for physician-patient concordance (in gender and race/ethnicity) and other factors. Self-reported gender discrimination was...
