Presently, only 5.7% of medical doctors identify as Black/African American and only 6.9% identify as Hispanic. Neither adequately reflects the diversity of the United States, nor the patients within its healthcare facilities. The nation's strength lies in the diversity of its people. Diversity is vital to training healthcare professionals who can effectively serve diverse patient populations and address health disparities. A diverse physician workforce is not a luxury but a necessity.

“Rescinding such a transformative policy is undoubtedly a step in the wrong direction, perpetuating disparities, and impeding progress towards achieving equitable healthcare for all. Affirmative action is not merely a policy; it is a powerful tool that addresses historical inequities and promotes the inclusion of underrepresented communities in higher education.” - Antonio Igbokidi, SNMA National Chairperson.

The Student National Medical Association firmly believes in the power of affirmative action to dismantle the barriers that hinder social justice and equity. The SNMA calls upon policymakers, institutions, and communities to continue championing affirmative action, nurturing a more inclusive and equitable future for aspiring medical professionals and the patients they serve.

 

Yours in SNMA,



Veronica Mize, National President                                            

Antonio Igbokidi, National Chairperson

Torhiana Haydel, HPLA Co-Chair       

Karina Wang, HPLA Co-Chair

FOR IMMEDIATE RELEASE

This interactive report includes the demographic data of fellowship Match applicants to the Specialties Matching Service (SMS) for appointment year 2023, including sexual orientation, race and ethnicity, urbanicity, disability, first-generation status, and more.

If you have any questions about the report, contact datarequest@nrmp.org.

SNMA Response to the Supreme Court’s Overturning of Roe v. Wade

From the Desk of the Chairpersons of the Health Policy and Legislative Affairs Committee

Monday, June 27, 2022

Washington, DC

The Student National Medical Association (SNMA) believes that access to safe and professional abortion services are essential for reproductive health. We strongly oppose barriers to safe abortion care including but not limited to legislative, social, and administrative blockades. We disagree with the recent decision by the Supreme Court to overturn Roe v. Wade after almost 50 years of precedent. As the nation’s oldest and largest organization of underrepresented minority medical students, we recognize the urgent threat this ruling poses to our members and the communities we serve.

The overturning of Roe v. Wade will inevitably exacerbate existing racial disparities. Decreased abortion access disproportionately impacts Black, Indigenous, and People of Color (BIPOC) and people with low socioeconomic status.¹ We remain consistent in our mission to address the needs of underserved communities and refuse to standby as marginalized groups are repeatedly limited in their ability to access safe, regulated health care.

Appealing to our legislators to codify Roe as the law of the land can help ensure that widespread abortion care is shielded from further attacks. Our call to action promotes the principles of reproductive justice for women of color and other marginalized groups, including protecting an individual’s ability to choose if, when, and how to have children.²  We boldly ask our members to take the following action steps:

• Register to vote
• Contact your Congress Members
• Join the Health Policy and Legislative Affairs Committee

Founded in 1964, the Student National Medical Association has been the voice of underrepresented students in medicine. Our mission is to support current and future underrepresented medical students by addressing the needs of underserved communities and increasing the number of clinically excellent, culturally competent, and socially conscious physicians. SNMA has a membership of more than 7,000 medical students, residents, and physicians, in ten regions, with over 100 SNMA chapters and nearly 200 premed student chapters (MAPS) across the United States and the Caribbean. www.snma.org

References: 

1. Dehlendorf C, Harris LH, Weitz TA. Disparities in Abortion Rates: A Public Health Approach. American Journal of Public Health. October 2013. Accessed June 26, 2022. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3780732/
2. Sister Song: Women of Color Reproductive Justice Collective. About Us: Reproductive Justice. Accessed June 26, 2022.  https://www.sistersong.net/reproductive-justice

Download this Press Release

The Democrats' social spending package would invest $1 billion in medical and nursing school programs and would support medical students from underrepresented communities.

Even before the COVID-19 pandemic set in, the United States faced a growing shortage of doctors and other medical care providers.

It's a straightforward issue: The number of American doctors is shrinking despite the increased demand for medical care. By 2034, the United States may see a shortage of between 37,800 and 124,000 physicians, according to one recent study from the Association of American Medical Colleges.

The pandemic has only exacerbated these trends. Facing near-constant virus surges, shortages of protective supplies, and the politicization of their lives and livelihoods, the burnout epidemic has pushed even more physicians out of the workforce. Indeed, roughly three in 10 health care workers have considered leaving the profession as a result of the pandemic, according to an April Washington Post-Kaiser Family Foundation poll.

Read More

October 04, 2021

AACOM member colleges unite to advance diversity, equity and inclusion

IMMEDIATE RELEASE(Bethesda, MD)

Today, our nation’s osteopathic medical schools emphasized their commitment to increasing medical student diversity by unanimously recognizing that the systemic inequities of America’s education system are adversely impacting the diversity of osteopathic medical school applicants. The statement also outlines model strategies to improve and support diversity, equity and inclusion across osteopathic medical education, as well as opportunities to reframe and expand diversity, equity and inclusion efforts.The consensus statement is the direct result of the American Association of Colleges of Osteopathic Medicine (AACOM)’s Racism and Injustice in Healthcare Education Adaptive Workgroup, which was organized last year with Barbara Ross-Lee, DO, at the helm.

READ MORE

As Match Day, March 19, 2021 rolled around, the National Resident Matching Program (NRMP) reported this year’s Match was the largest in history. 38,106 positions were offered and a record high of 5,915 programs partook in the occasion reaching a growth number of 16.7% after five years. This growth was realized a year after the pandemic amid a season that has challenged the health sector also disrupting clinical rotations and testing and creating major changes in the residency application process. However, registering applicant did not waver, the 2021 Main Residency Match reached a high of 48,700 registered applicants with the largest single-year bump in recorded history—an 8.3% rise since 2020—along with 95% of the 35,194 first-year positions being filled.

Read More

 Download Full Release & Read More

More than two in five U.S. doctors will be old enough to retire in the next decade and the pipeline of new doctors remains much like it did a generation ago – not as diverse as the overall population.

A new report Friday from the Association of American Medical Colleges underscores two persistent trends in medicine: The nation’s doctor shortage could worsen over the next 15 years, and the ranks of Black and Hispanic doctors fall far short of reflecting the nation’s diversity.

The AAMC projects the nation will face a shortage of up to 139,000 doctors as the population of retirement-age Americans soars 45% by 2033.

About 2.6% of the nation’s doctors in 2019 and 7.3% of students enrolled in medical school in 2020 identified as Black or African-American. Despite efforts to bolster the ranks of Black doctors, the figures still lag the 13% in the overall population.

READ THE FULL ARTICLE HERE

When the tumultuous history of 2020 is written, no one will argue that Joseph Gallien didn’t have a front-row seat. In March, Gallien was finishing his residency in emergency medicine in Manhattan just as the novel coronavirus was overwhelming New York City. At 31, he was making life-or-death decisions while confronting a disease for which there was no treatment, no cure, and little knowledge.

In April, Gallien came down with a cough and a fever, and knew instantly that he’d contracted the virus. When his temperature spiked a week later and he began having trouble breathing, he was admitted to one of the two hospitals where he worked, Columbia University’s NewYork-Presbyterian. He’d developed pneumonia; was showing signs of organ failure; and had lost 13 pounds. He was released five days later, only to learn that one of his attending physicians, apparently crushed by the weight of the pandemic, had taken her own life.

READ FULL ARTICLE HERE

FOR IMMEDIATE RELEASE

SNMA is Appalled by the Recent Vandalism of the George Floyd Mural and Calls for Immediate Expulsion of Medical Student Perpetrator

Friday, August 28, 2020

Washington, DC 

On Tuesday, August 18, 2020, the well-known mural dedicated to George Floyd and located at the intersection where he was murdered in Minneapolis, Minnesota was defaced with black spray paint. Since its creation, the mural has been a global beacon for mourners and activists, and has served as an enduring symbol of the fight for the eradication of police brutality and systemic racism. This incident caused significant damage to the artwork that was created to honor George Floyd’s life and legacy. This crime of vandalism has sent waves of hurt, disappointment, and frustration throughout Black communities across the nation that are still grieving the injustices our communities have to endure daily. This hurt has been multiplied by the news that the perpetrator of this crime is a medical student -- a future physician -- at the University of Minnesota Medical School. This news was followed promptly with nationwide hurt and calls for the student to be immediately expelled from medical school. In response to the outcry for justice, University of Minnesota Medical School released a statement on August 20th addressing the defacement of George Floyd’s memorial. The statement does not adequately address the concerns expressed by students at the University of Minnesota, members of the medical community, and grieving Black communities across the country. Moreover, it offers a misleading and incomplete interpretation of the status and affiliation of the perpetrator to the University of Minnesota Medical School.

The SNMA denounces all acts of violence and racism and we emphasize that racism needs to be addressed in order to eliminate disparities in health outcomes. The psychological toll that events like these have on the Black community is immeasurable. We see the impact again in this situation, as evidenced by a statement made to the local media by Marcia Howard, a member of the security team for the memorial site. Howard states, “You would come to our neighborhood and do this why? Why? What’s enough?” Further, neighborhood security declined to press charges against the perpetrator because they did not want police presence in the area. This is unsurprising, as according to a multi-level bayesian analysis of racial bias in police shootings at the county level from 2011-2014 in the United States,  the probability of being Black, unarmed, and shot by the police is approximately 3.49 times the probability of being White, unarmed, and shot by the police. This issue of police presence, and more specifically, police violence, is a major factor in neighborhood and physical environment as a social determinant of health (SDoH). As outlined in our recent report, Racism is a Public Health Issue, this, along with other social determinants of health, including economic instability, food insecurity, poor education, adverse childhood events (ACEs), negatively impacts health outcomes, both mental and physical, in communities of color. 

With this is mind, the SNMA calls for the following: 

• The University of Minnesota Medical School must immediately expel Daniel Michelson from their institution and issue a follow up statement addressing the problematic nature of the statement released on August 20, 2020.

• All medical institutions must commit to preserving and protecting the mental health of Black, Indigenous, and People of Color (BIPOC) members of their institution, including but not limited to providing spaces for BIPOC members to heal and grieve from events such as this.

• All medical institutions must take firm and explicit actions that hold members of their institution accountable for promoting racist rhetoric and/or committing racist acts. Accountability must also be accompanied by reconciliation and rehabilitation (e.g., iterative anti-racism training) for these individuals and termination for those who do not agree to rehabilitation.

• All medical institutions must require structural competency and anti-racism training for all members of their institution, including faculty and students, with the goal of providing the best care for all patients.

• All medical institutions must support, rather than silence, their students’ and employees’ efforts to engage in social justice advocacy at the local, national, and international levels.

Resources on how to successfully pursue these recommendations, how people of color can engage in self care and racial trauma healing, and how you can continue to support the movement in Minneapolis can be found in the SNMA’s June 25, 2020 Solidarity Statement on Recent Events. 

Sincerely,  

Student National Medical Association (SNMA) 

Sign the petition created by University of Minnesota students

Press Contact:

Eloho Akpovi, MS & Justin Anderson

National Health Policy & Legislative Affairs Committee Chairpersons

healthpolicy@snma.org

About the Student National Medical Association

Founded in 1964 by medical students from Howard University College of Medicine and Meharry Medical College, the Student National Medical Association (SNMA) is the nation’s oldest and largest, independent, student-governed organization focused on the needs and concerns of medical students of color. The SNMA is committed to supporting current and future underrepresented minority medical students, addressing the needs of underserved communities, and increasing the number of clinically excellent, culturally competent, and socially conscious physicians.

SNMA National Headquarters

5113 Georgia Avenue NW

Washington, DC 20011

Phone: (202) 882-2881

Fax: (202) 882-2886

www.snma.org

Greetings SNMA Family,

We, the members of the Student National Medical Association (SNMA), in support with the Latino Medical Students Association (LMSA), American Medical Student Association (AMSA), Association of Native American Medical Students (ANAMS), Asian Pacific American Medical Student Association (APAMSA), Medical Student Pride Alliance (MSPA) and Student Osteopathic Medical Association (SOMA), as current and future medical students are saddened and appalled by recent events against the Black/African American community. We mourn the wrongful deaths of George Floyd, Ahmaud Arbery, Breonna Taylor, Tony McDade, and thousands more, and grieve with their families as they navigate these tragic circumstances. We stand with the Black/African American community in solidarity against the acts of police brutality that have been occurring across the nation. These incidents reflect a pattern of racism which has been ongoing since the inception of the United States.

In recent times, we have seen migrant children of color separated from their families and housed in cages along the US-Mexico Border, body bags instead of PPE sent to Native American clinics, and racist acts against Asian Americans as a result of the COVID-19 pandemic. This is an epidemic. These acts, unmet by justice, continue to plague communities of color. Therefore, we denounce all incidents of violence and racism against Black, Indigenous, and People of Color (BIPOC).

As the next generation of physicians aimed at addressing the health and medical issues of underrepresented communities, we recognize that health is multifaceted and includes socioeconomic and psychosocial wellness. The SNMA recognizes that racism is a public health issue, and therefore, affects all communities, regardless of race, ethnicity, documentation status, or socioeconomic background. Systematic racism, defined as a system of advantage based on race, drives economic instability, health inequity, mass incarceration, and food insecurity, which are just some of the significant contributors to disparate health outcomes seen in those with hypertension, diabetes, cardiovascular disease, and now COVID-19. Racism affects not only communities of color but the entire healthcare system. Health inequities strain the resources of our medical system and affect how medicine is both regarded and carried out in every community. Now more than ever, it is crucial that we counteract the effects of racism on our most vulnerable communities to end all health disparities.

During this time, it is also important to address the violent actions against communities of color including Black/African Americans, Native Americans, Asian Americans and Hispanics/Latinx by law enforcement and the majority. The SNMA has used its collective voice to release a statement on police brutality;  a tactic of the justice system that utilizes fear to suppress and control the masses of Black and Brown bodies. Violence against BIPOC communities unmet with justice not only destroys lives but perpetuates grief, stress, and mental trauma. As future physicians who take an oath to serve these communities, we acknowledge that our silence is not acceptable and stand alongside these communities in denouncing violence against minorities.

In an effort to highlight the importance of structural humility and social consciousness, we realize that systematic racism directly impacts our mission. As an organization, we have addressed cultural and structural competency. We are committed to increasing the number of culturally competent physicians. In the last year, 1,626 Black/African American students matriculated into medical school. As per the AAMC (AAMC, 2019), out of a total of 21,863, only 7.4% of medical school matriculants were Black/African American. As per the US Census Bureau (Bureau, 2019) 13.4% of the United States population is considered Black/African American but this also does not reflect the numbers unrecorded. In reflection of these numbers, we must work harder to ensure our communities are represented appropriately in medicine to provide care to members of our community.

 In an effort to address racism, violence, and health inequity, we call institutions which hold chapters of our organization to action. We acknowledge and applaud institutions who have already taken a stand against racism; institutions such as the University of Michigan, the University of Washington and the University of Louisville School of Medicine who have made statements of solidarity, created anti-racism reading lists and promote the cessation of bias in their curriculum and on their campuses.  Now more than ever, we recommend that your institution echo these efforts by following the steps listed in our Call to Action and utilizing the following Resources to help combat the growth of racism as a public health issue:

CALL TO ACTION

Institutional Statement of Recognition

• Any institution which holds an SNMA chapter is called to release a statement recognizing the current events, its effects on the student body, and denouncing violence against people of color. In addition, institutions should work with the local SNMA chapter to identify opportunities to support students locally.

Review of Training on Behalf of Student Safety

• A review of the training conducted for security personnel at your institution to remove the role of implicit bias and structural racism among your security force.

Review of Medical Education and Bias Practices

• Integrate structural racism as a public health issue into all medical school curriculums from small group to simulation. This curriculum change must transcend one day events and address how racism is interlaced within and beyond medical education.

• Review and reflect on “Towards the Abolition of Biological Race in Medicine: Transforming Clinical Education, Research and Practice,” a report recently released by the Institute for Healing and Justice in Medicine.

• Utilize resources such as the “Racial Justice Report Card" by White Coats for Black Lives to evaluate metrics such as institutional curriculum, student and faculty diversity student safety, and racial integration of clinical care sites.

• Offer regular opportunities for conversations on topics such as race and other structural societal issues led by faculty to create a safe space for students to discuss and learn.

• Require implicit bias training for ALL faculty, staff, and clinicians who engage with students as well as provide transparency to students regarding the expectations of administration. The identification of those who complete these courses should also be provided to students to increase the awareness of their completion.

Provision of Trauma-Informed Support 

• Provide easy-to-access resources for students in need of support as they cope with the trauma of these recent violent acts. Examples of these resources range from mindfulness applications to therapy coverage for students.

Review of Hospital Practices

• Hospital security should be provided by unarmed and un-uniformed mental health or social work professionals with training in nonviolent de-escalation and restorative justice. 

• Hospital security should not be provided by members of the police force or sheriff’s office.

• Hospital policy and training for staff should prioritize the protection of patients’ rights and clarify the legal requirements of healthcare workers’ cooperation with law enforcement, including Immigration and Customs Enforcement.

• Hospitals should keep publicly available records of all incidents in which law enforcement were called to the hospital, including aggregated de-identified data on the race, gender identity, and immigration status of the patients or families involved in the incident.

RESOURCES

Resources for Engaging in Anti-Racism Work and Practicing Solidarity

• Resources for Engaging in Anti-Racism Work
• We are Living in a Racist Pandemic
• Your Black Colleagues May Look Like They’re Okay – Chances are They’re Not
• Affirming Black Lives Without Inducing Trauma
• If You See Something, Do Something Instead of Calling the Cops
• What to Do Instead of Calling the Police

Resources for Black, Indigenous and People of Color (BIPOC) to Engage in Self-Care

• Surviving & Resisting Hate: A Toolkit for People of Color
• Self-Care Tips for Black People Who Are Struggling with this Very Painful Week
• Self-Care for People of Color after Psychological Trauma

Ways to Support Current Developments in Minneapolis

• Minnesota Freedom Fund
• Black Visions Minneapolis, MN
• Reclaim the Block

We, as future physicians of various backgrounds and cultures, recognize the opportunity we have as professional students. It is our desire that we utilize this privilege to change the systems which work to suppress the minoritized communities in which we live, care for, and respect. It is this charge that endows our duty to do all we can to stand together and end violence against BIPOC and racism as a public health issue.

In Solidarity,

Osose Oboh, MPH

57th SNMA National President

  This statement is supported by the following organizations:

Association of Native American Medical Students

American Medical Student Association

Asian Pacific American Medical Student Association

Latino Medical Student Association

Medical Student Pride Alliance

Student Osteopathic Medical Association

Today, May 18th, as the 73rd World Health Assembly (WHA) opens virtually due to Covid-19, student health advocacy organizations launched an interactive online advocacy tool that highlights key research universities and institutions receiving taxpayer funds to develop novel diagnostics, therapeutics, and/or vaccines for COVID-19. The tool, by visualizing where public funding is being directed, is designed to be used to hold research universities and institutions accountable to their responsibilities to the public.

Read the full regional press releases: UAEM Europe, UAEM North America and UAEM Australia.

FOR IMMEDIATE RELEASE

Contact:

• Osose Oboh, MPH, National President, president@snma.org (SNMA)

• Alec Calac, National Policy Director, anams1975@gmail.com (ANAMS)

SNMA & ANAMS Urge Actions Be Taken to Address Inequitable COVID-19 Outcomes Experienced by Communities of Color

The Student National Medical Association (SNMA) was founded in 1964 by medical students from Howard University School of Medicine and Meharry Medical College and is the nation’s oldest and largest, independent, student-governed organization focused on the needs and concerns of medical students of color. The SNMA is committed to supporting current and future underrepresented minority medical students, addressing the needs of underserved communities, and increasing the number of clinically excellent, culturally competent and socially conscious physicians. The Association of Native American Medical Students (ANAMS) was founded in 1975 by a small group of American Indian medical students and represents Native American health professions students and those interested in promoting Native American health. The ANAMS supports Native American medical students in the successful completion of their curricula, provides a forum for the interchange of ideas and cultural support, and assists American Indian and Alaska Native Tribes, Villages, and Pueblos with the recruitment and retention of American Indians into health professions. Given the profound and disparate impact that the novel coronavirus disease 2019 (COVID-19) has had on the health and wellbeing of Black, Latinx, and Native communities, the SNMA and ANAMS strongly urge federal and state legislators and health departments to take immediate action to combat this disparity in health outcomes.

Limited COVID-19 Data Available Demonstrates Stark Racial/Ethnic Health Disparities

Although the statistics are still being assessed, current data as of May 4, 2020 shows that there is a significant disparity in the burden of illness and death among communities of color, particularly among Black/African Americans and American Indians and Alaska Natives (AI/AN). A Center for Disease Control and Prevention (CDC) study of 14 states demonstrated that during the month of March, Black/African Americans and AI/ANs accounted for 33% and 7.9% of COVID-related hospitalizations, respectively, despite Black/African Americans making up 18% of the population in those states (the AI/AN population was not reported by this study, however, the average AI/AN population for 4 out of the 14 states is 5.7%, with these states having the 2nd, 4th, 7th, and 10th highest AI/AN population in the US).[1][2] The Indian Health Service (IHS) has reported 3,974 confirmed cases of COVID-19 across Indian health programs.[3] The Navajo Nation alone has the 3rd highest per capita COVID-19 infection rate behind the states of New York and New Jersey.[4] In New Mexico alone, AI/ANs represent 55.27% of COVID-19 cases, despite making up around 10% of the state’s population.[5] Additionally, according to the American Public Media (APM) Research Lab, the COVID-19 mortality rate for Black/African Americans is 27% despite making up only 13% of the United States (US) population. In Washington, DC and 10 out of the 38 states reporting, Black/African Americans are 3-7 times more likely to die from COVID-19 than Whites.[6] In Chicago and Louisiana alone, Black/African Americans account for 70% of COVID-19 deaths, yet only about a third of the state population.[7] Unfortunately, not all states are collecting and/or releasing comprehensive racial/ethnic data on COVID-19 outcomes, and data that is available is not consistently collected across states, particularly for Native Americans, thus inhibiting the scope of the problem from fully being captured.[6] For example, county and regional data from county and state health departments is not readily available to the 12 Tribal Epidemiology Centers across the nation, which slows surveillance efforts. Sharing of COVID-19 data between states and Tribes also varies greatly from state-to-state.[8]

Similarly to maternal mortality rates, the COVID-19 pandemic has rapidly brought to the forefront the racial divide in the health of the nation: with the average life-expectancy of a person of color in the US at 3.5 years less than that of their White counterparts, in more ways than one, the health outcomes of a person of color in the US can be likened to that of emerging nations with much less developed medical systems and technology.[9] While COVID-19 did not create the circumstances that brought about health care disparity and inequity in the US, it has and will continue to aggravate the existing disproportionate differences in the social determinants and health outcomes between racial/ethnic groups.

Historical and Societal Context that Drives These Racial/Ethnic Inequities

It shouldn’t come as a surprise that Black, Latinx, and Native communities are experiencing poorer COVID-19 outcomes when compared with their White counterparts given the extensive data and research that exists on racial/ethnic health disparities: the risk factors for poorer COVID-19 outcomes include diabetes, cardiovascular disease, and asthma, which are all comorbid medical conditions that disproportionately impact Black, Latinx, and Native communities.[7] Unfortunately, COVID-19 has only exaggerated the excess barriers to health among Black, Latinx, and Native communities that historical and structural racism has created: elements that are protective and contribute to positive COVID-19 outcomes (access to healthcare for prompt testing and diagnosis; wide-spread contact tracing, frequent handwashing, self-isolation, and quarantine to minimize the spread) are placed further out of reach for communities of color.[10][11] Even with proper healthcare access, reports of racial discrimination against Black/African Americans seeking care for COVID-19 being turned away multiple times, then subsequently dying from the disease have only grown.[12][13][14] However, this doesn’t begin to contextualize the damage that COVID-19 has and will continue to have on these communities if action isn’t taken on their behalf by the government and healthcare systems.

The US federal government has an obligation to provide health services to the citizens of the 574 federally recognized Tribes in the US, born out of treaties signed between the US and Tribes. This obligation is commonly referred to as the trust responsibility, and is upheld through the Indian Health Service (IHS), a federal agency within the US Department of Health and Human Services.[15] Despite this obligation, the IHS is not funded to need, and has the lowest per capita healthcare expenditures ($4,078) compared to other federal health programs like Medicare ($13,185).[16] This chronic underfunding has exacerbated the disparities seen within AI/AN communities where individuals die at higher rates than the average American from chronic lower respiratory diseases, diabetes, liver disease and cirrhosis, assault/homicide, and unintentional injuries.[17]

The chronic underfunding of the IHS is in large part due to the discretionary nature of appropriations to the IHS through the Interior/Environment Appropriations Act, not the Labor, Health and Human Services Appropriations Act.[18] Every year, the IHS consults with Tribes to determine a proposed budget of total need which is then reviewed by the House and Senate Committees on Appropriations.[19] The ongoing trend is for these committees to approve only partial funding of IHS such as in 2016 when the IHS was only funded at 59% of total need.[20] Furthermore, IHS dollars are then distributed based on the Census Bureau estimations of AI/AN populations, which has been known to undercount those living on reservations or in Native villages. Often these tribal communities are more rural, low-income, geographically isolated, and/or linguistically isolated, and their underrepresentation in the census numbers means that they do not receive adequate IHS funding.[21] This even further exacerbates the health and social inequities faced by these communities.

Even with proper access to healthcare, people of color are more likely to live and work in settings that expose them to increased risk of infection from coronavirus. Black, Latinx, and Native individuals are more likely to live in large, multigenerational households, making them unable to self-isolate or quarantine away from the rest of their household.[22] The disproportionately higher rates of incarceration of Black, Latinx, and Native people, including within detention centers at the US-Mexico border, also places them in close quarters settings and further increases their risk of infection from coronavirus.[23][24] Lack of access to basic amenities such as clean running water further exacerbates the vulnerability to infection. This is especially true in Indian Country where twice as many homes lack running water when compared to other Americans.[25][26] Furthermore, many of these patients either are essential workers or live with an essential worker, and thus cannot stay or work from home.[27] Even more are employed in the service industry and thus more vulnerable to job loss and loss of income, as demonstrated by the racial/ethnic disparity in unemployment rates change since COVID-19, as well as exposure to the virus.[7][28][29]

Inaction and/or Poor Action by the US Government

On March 27, 2020, Congress passed the Coronavirus Aid, Relief, and Economic Security (CARES) Act, a $2 trillion stimulus package to provide aid and relief to American individuals, families, and businesses in need. Unfortunately, immigrants, individuals experiencing homelessness, and individuals experiencing reduced employment (vs unemployment) due to COVID-19, many of whom are people of color, were not accounted for by the provisions of the CARES Act.[30] Additionally, by providing only a one-time impact payment for individuals and families, the Act does not account for the fact that economic precarity and need for relief and aid amongst US residents will continue to impact Americans until the pandemic ends and the economy stabilizes.[31] The same can be said for the Families First Coronavirus Response Act (FFCRA) passed by Congress on March 18, 2020, which allocated approximately $104 billion to expanding paid sick leave, unemployment benefits, and food assistance for children and families. Additionally, no provisions were made within any of the legislature passed in response to COVID-19 to safeguard Americans from continuing to fall into financial precarity and/or housing insecurity.[32]

From the CARES Act relief fund, $8 billion was allocated for distribution amongst tribal governments to aid in efforts to combat COVID-19 as well as provide economic stability. To date, none of these funds have been disbursed. This has been attributed in part to the US Department of the Treasury, in conjunction with the US Department of the Interior, not knowing how to allocate the funds.[33] Complicating the matter, Assistant Secretary of Indian Affairs Tara Sweeney has drawn criticism from Congressional Leaders for allowing for-profit Alaska Native Corporations (ANCs) to be eligible for these funds, despite them not constituting a tribal government.[34] Tribal leaders are concerned that Sweeney’s actions will divert necessary funding to respond to the pandemic. As of May 1, 2020, several Tribes are suing the Treasury Department for failing to provide the allocated funds by the April 26 deadline. District Judge Amit Mehta of the US District Court for the District of Columbia recently ruled in favor of the tribal governments, barring the federal government from disbursing funds to ANCs as the lawsuit proceeds.[35] Members of Congress have also written to the Secretaries of the Treasury and the Interior to immediately disburse the much needed funds. In what has been described as a “perfect storm,” the untimely delay of federal relief has put an increased burden on tribal governments who are disproportionately impacted by the current pandemic.[36] Tribal gaming and lending operations have been shuttered for weeks, which has had a downstream effect on health, employment, education, and social services for these Tribes.[37][38] While not all Tribes have gaming enterprises, those who do are in more remote areas and often employ the majority of Native American and non-Native American residents in the area. Initially, these programs were excluded from the Small Business Administration’s $349 billion Paycheck Protection Program, which immediately led to employee furloughs.[39][40] Additionally, despite the United Nations urging Member States to include the specific needs and priorities of Indigenous peoples in addressing the global outbreak of COVID-19, the White House has failed to include appropriate AI/AN representation on its COVID-19 Task Force.[41]

Recommendations

As future health professionals, we have a duty to advocate for equitable protection and care for our most vulnerable patients, particularly in times of crisis. Each minute of delay in taking action is not worth the lives lost to this pandemic that could have been prevented. The SNMA and ANAMS call for the following recommendations to counteract the existing and perpetuated burdens that will disproportionately impact the populations we serve:

1. Increase wide-spread access to COVID-19 care, including testing, management, and treatment, regardless of insurance and documentation status.

2. Collect comprehensive race/ethnicity data for COVID-19 at the local, state, and federal level and make all data publicly available on a monthly basis during the pandemic. 

3. Launch local and/or state health department-level investigations to detect failures within healthcare systems that have led to practices of discrimination that have resulted in patients receiving inadequate care and instate procedures for reporting, remediating, and preventing such incidences of discriminatory care.

4. Economic Impact Payments and other funding provided through the CARES Act and FFCRA must be extended to continue on a monthly basis until the national “curve” has flattened.

5. Eligibility for Economic Impact Payments and other funding provided through the CARES Act and FFCRA must not be limited by occupation type or documentation status (e.g., H.R. 6437 - Coronavirus Immigrant Families Protection Act).

6. Steven Mnuchin (US Secretary of the Treasury) and Tara Sweeney (Assistant Secretary of Indian Affairs) must immediately disburse funds allocated to tribal governments by the CARES Act.

7. Uphold the federal government’s trust responsibilities to Tribes by appointing Rear Admiral Michael Weahkee, Director, Indian Health Service to the White House COVID-19 Task Force.[41]

8. Expedite review of policies, such as the Federal Immigrant Release for Safety and Security Together (FIRST) Act,[42] which call for release of people detained within ICE detention centers for non-violent offenses, or their placement in Alternatives to Detention (ATD) Programs. Additionally, create and expedite review of policies aimed at releasing all other inmates incarcerated for non-violent offenses and halting the further detainment of non-violent offenders.

Sincerely,  

Student National Medical Association (SNMA) 

Association of Native American Medical Students (ANAMS)

References

1. https://www.cdc.gov/mmwr/volumes/69/wr/mm6915e3.htm?s_cid=mm6915e3_w

2. https://www.cdc.gov/tribal/tribes-organizations-health/tribes/state-population.html

3. https://www.ihs.gov/coronavirus/?CFID=184597571&CFTOKEN=61564418

4. https://www.npr.org/2020/04/24/842945050/navajo-nation-sees-high-rate-of-covid-19-and-contact-tracing-is-a-challenge

5. https://cvprovider.nmhealth.org/public-dashboard.html

6. https://www.apmresearchlab.org/covid/deaths-by-race

7. https://www.kff.org/disparities-policy/issue-brief/communities-of-color-at-higher-risk-for-health-and-economic-challenges-due-to-covid-19/

8. https://indiancountrytoday.com/news/ready-or-not-warnings-for-tribes-as-covid-19-epidemic-spreads-cmAg0kyHi0iHmlBtFHlWYA

9. https://www.nytimes.com/2020/04/29/magazine/racial-disparities-covid-19.html

10. https://www.cdc.gov/coronavirus/2019-ncov/faq.html

11. https://www.cdc.gov/coronavirus/2019-ncov/need-extra-precautions/racial-ethnic-minorities.html

12. https://www.bostonglobe.com/2020/05/01/opinion/beloved-teacher-dies-coronavirus-unconscious-bias-health-care-may-have-hastened-her-death/

13. https://www.theroot.com/black-woman-dies-from-coronavirus-after-being-turned-aw-1843091288

14. https://abcnews.go.com/Health/covid-19-exposes-mistrust-health-care-inequality-back/story?id=70370949

15. https://www.ihs.gov/newsroom/factsheets/basisforhealthservices/

16. https://www.gao.gov/assets/700/695871.pdf

17. https://www.ihs.gov/newsroom/factsheets/disparities/

18. https://www.everycrsreport.com/reports/R44040.html

19. https://www.ihs.gov/aboutihs/annualbudget/

20. http://www.ncai.org/policy-issues/tribal-governance/budget-and-approprations/07_FY2016_Health_NCAI_Budget.pdf

21. http://www.ncai.org/NCAI-FY20-BudgetReport-PREVIEW.pdf

22. https://www.cdc.gov/coronavirus/2019-ncov/community/tribal/social-distancing.html

23. https://www.prisonpolicy.org/profiles/US.html

24. https://www.kpbs.org/news/2020/apr/14/otay-mesa-detention-center-now-largest-immigration/

25. https://www.democracynow.org/2020/4/15/covid_19_navajo_nation_native_americans

26. https://indiancountrytoday.com/news/coronavirus-risk-is-compounded-by-the-rural-DC-rMTUzzE6WDGee8jbENQ

27. https://www.theguardian.com/commentisfree/2020/apr/16/black-workers-coronavirus-covid-19

28. https://www.bls.gov/web/empsit/cpsee_e16.htm

29. https://www.americanprogress.org/issues/race/news/2020/04/14/483125/economic-fallout-coronavirus-people-color/

30. https://thehill.com/opinion/white-house/493458-where-the-cares-act-went-wrong

31. https://www.epi.org/blog/despite-some-good-provisions-the-cares-act-has-glaring-flaws-and-falls-short-of-fully-protecting-workers-during-the-coronavirus-crisis/

32. https://www.cbpp.org/research/economy/cares-act-includes-essential-measures-to-respond-to-public-health-economic-crises

33. https://www.indianz.com/covid19/wp-content/uploads/2020/05/04517803454.pdf

34. https://www.politico.com/news/2020/04/16/trump-indian-affiars-funds-191622

35. https://www.nytimes.com/2020/05/01/us/politics/coronavirus-native-american-tribes-treasury-stimulus.html

36. https://www.huffpost.com/entry/tribes-covid-19-federal-relief-treasury-deb-haaland_n_5ea9decac5b633a8544487d9?guccounter=1

37. http://www.indiangaming.com/istore/Aug07_SpeakOut.pdf

38. https://www.americangaming.org/sites/default/files/Economic%20Impact%20of%20Indian%20Gaming%20in%20the%20U.S.%20September%202017.pdf

39. https://www.indianz.com/IndianGaming/2020/04/14/we-keep-getting-left-out-tribal-gaming-r.asp

40. https://home.treasury.gov/system/files/136/PPP%20--%20Overview.pdf

41. https://www.nihb.org/docs/05012020/NIHB%20Letter%20_Weahkee%20and%20COVID-19%20Task%20Force4.29.2020.pdf

42. https://www.booker.senate.gov/imo/media/doc/MDM20356.pdf

FOR IMMEDIATE RELEASE

Contact: Omonivie H. Agboghidi, National President, president@snma.org

SNMA Strongly Supports No Cost of COVID-19 Testing and Management

Washington, DC – The Student National Medical Association (SNMA) is the largest and oldest student-led organization in the United States dedicated to supporting medical students of color and addressing the needs of marginalized communities. The recent outbreak of a new strain of coronavirus, a family of viruses that infect the respiratory tract and include the “common cold,” has created what the World Health Organization (WHO) calls a “controllable pandemic” – a global yet containable outbreak. As of Sunday, March 15, 2020, the WHO reports 153,517 laboratory-confirmed coronavirus disease 2019 (COVID-19) cases worldwide, with a death rate of approximately 3.74% (5,735 deaths). Outside of China, where COVID-19 was first detected, the number of laboratory-confirmed cases is 72,469, with a death rate of approximately 3.49% (2,531 deaths).[1] Efforts to contain the spread of COVID-19 have minimized the extent of its spread, however, limited knowledge of the virus warrants proactive measures to ensure equitable access to medical care for marginalized and vulnerable patients in the United States. The SNMA urges federal and state legislators and health departments to immediately institute policies and protocols aimed at widespread and expeditious management in the form of prevention, testing, hospitalization, and rehabilitation at no cost to all patients that are or will be impacted by COVID-19, regardless of their insurance or documentation status.

According to the Centers for Disease Control and Prevention (CDC), older patients and patients with severe chronic medical conditions such as heart disease, lung disease, and diabetes are most vulnerable to developing serious illness if infected by COVID-19.[2] Non-White racial and ethnic populations are known to be disproportionately impacted by these chronic conditions.[3] For patients without health insurance, the out-of-pocket cost for screening suspected cases of COVID-19 is, at minimum, $1,331 per person.[4] This value does not include the cost of COVID-19 diagnostic testing, isolation for suspected cases, loss of income during isolation, medically-necessary hospitalizations for presumptive cases, management of exacerbated comorbidities and complications from infection, or preventative vaccination if one becomes available. Since there are currently no uniform coverage requirements set by the US government, many health insurance payers and plans are opting to only voluntarily cover copays for COVID-19 testing and telemedicine appointments, but not treatment for those who test positive.[5] Low-income, uninsured, underinsured, and immigrant patients, populations which are also disproportionately non-White, are most vulnerable to the high out-of-pocket costs for COVID-19 testing.[6] Fear of lost income during quarantine or the cost of testing and treatment, compounded with fear of repercussions as a result of immigration status, is deterring patients from seeking medical care despite experiencing symptoms suspicious of COVID-19 (i.e., fever, cough, shortness of breath, etc.). This is an additional source of anxiety and mental illness exacerbation for many. Thus, patients marginalized by race/ethnicity, income status, and/or immigration status will precipitously be burdened by the healthcare requirements and resulting financial consequences of the current COVID-19 pandemic if the US government and healthcare system does not take immediate action to protect them. The cost of this testing is further complicated by the fact that only 40% of Americans have the ability to pay an unexpected $1,000 expense such as an emergency room visit or car repairs from their savings.[7]

As future health professionals, we have a duty to advocate for equitable protection and care for our most vulnerable patients, particularly in this time of crisis. Each minute of delay in taking action is not worth the lives lost to this pandemic that could have been prevented. The SNMA firmly supports the following recommendations to counteract the impending burden that will disproportionately impact the populations we serve: 

• Full coverage for preventative services, testing, quarantine, treatment, recovery, and complications arising from COVID-19 or suspected infection regardless of documentation or health insurance status.

• Increase funding for and expansion of Medicaid to help strengthen individual states’ capacities to respond to COVID-19.

• Suspend the operation of the “public charge” rule for the duration of the crisis and ensure that no medical services utilized during the crisis apply to any reinstated rule.

• Expedite review of proposed federal bills aimed at addressing the COVID-19 pandemic, such as the No Cost for COVID-19 Testing Act introduced by Congresswoman Kim Schrier, MD (WA-08).

For more information on these recommendations and others, please see the March 12, 2020 Health Affairs publication titled, “Health Care Priorities For A COVID-19 Stimulus Bill: Recommendations To The Administration, Congress, And Other Federal, State And Local Leaders From Public Health, Medical, Policy And Legal Experts.”[8] 

Sincerely,

The Student National Medical Association (SNMA)

References

1. World Health Organization (WHO). Coronavirus Disease (COVID-2019) Situation Report-53.; 2020. https://www.who.int/docs/default-source/coronaviruse/20200312-sitrep-52-covid-19.pdf?sfvrsn=e2bfc9c0_4. Accessed March 13, 2020.

2. Centers for Disease Control and Prevention (CDC). People at Risk for Serious Illness from COVID-19. https://www.cdc.gov/coronavirus/2019-ncov/specific-groups/high-risk-complications.html. Published 2020. Accessed March 13, 2020.

3. Weinstein JN, Geller A, Negussie Y, Baciu A. Communities in Action: Pathways to Health Equity. National Academies Press; 2017. doi:10.17226/24624

4. Kelly C. Rep. Katie Porter gets CDC chief to agree to pay for coronavirus testing - CNNPolitics. CNN.https://www.cnn.com/2020/03/12/politics/katie-porter-cdc-coronavirus-testing-white-board/index.html . Published 2020. Accessed March 13, 2020.

5. America's Health Insurance Plans (AHIP). Health Insurance Providers Respond to Coronavirus (COVID-19). https://www.ahip.org/health-insurance-providers-respond-to-coronavirus-covid-19/. Accessed March 13, 2020.

6. Artiga S, Orgera K, Pham O. Issue Brief: Disparities in Health and Health Care: Five Key Questions and Answers.; 2020.https://www.kff.org/disparities-policy/issue-brief/disparities-in-health-and-health-care-five-key-questions-and-answers/. Accessed March 13, 2020.

7. Garcia, A. Survey: Most Americans Wouldn't Cover A $1K Emergency With Savings.; 2019. https://www.bankrate.com/banking/savings/financial-security-january-2019/. Accessed March 14, 2020.

8. Forman H, Fowler E, Ranney M, et al. Health Care Priorities For A COVID-19 Stimulus Bill: Recommendations To The Administration, Congress, And Other Federal, State And Local Leaders From Public Health, Medical, Policy And Legal Experts. Health Affairs. doi:10.1377/hblog20200312.363618.

FOR IMMEDIATE RELEASE

Contact: Omonivie H. Agboghidi, National President, president@snma.org

Joint Statement by APAMSA, SNMA, and AMSA on U.S. Response to Coronavirus Outbreak

On January 30, the U.S. State Department updated the travel advisory for China to “Level 4: Do Not Travel due to novel coronavirus first identified in Wuhan, China.” Following this advisory, President Trump declared the coronavirus a public health emergency in the United States and signed a proclamation suspending entry of non-U.S. citizens who have traveled to China in the 14 days preceding their attempted entry, except for immediate family of U.S. citizens or lawful permanent residents. 

The President also mandated quarantine and medical screening of U.S. citizens upon their return to the U.S. Those who have been in China’s Hubei Province in the 14 days preceding their return will be subject to 14 days of mandatory quarantine. Those who have been to other areas of mainland China in the 14 days preceding their return will be subject to screening at the airport of entry and to heightened monitoring for 14 days.

Although a national response to this outbreak is certainly warranted, we are concerned that policies restricting international travel and collaboration may further escalate tensions by fomenting xenophobia out of proportion to the domestic threat of the outbreak. Through this approach, the U.S. is continuing a  decades-old tradition of public health policies that encourage the blanket portrayal of Asian immigrants as carriers of terrible diseases. The American Civil Liberties Union also warned that these drastic measures may impinge on civil liberties. Jay Stanley, a ACLU political analyst,  urges that “any detention of travelers and citizens must be scientifically justified and no more intrusive on civil liberties than absolutely necessary.” Plus, it is still unclear how much benefit would be gained from these restrictions and quarantines in addition to promoting basic hygiene practices alone.

In recent weeks there has been an increase in media reports  of aggression against APIA (Asian Pacific Islander American) community members, particularly those of Chinese descent. These incidents have occasionally become violent, as in the cases of a  man who assaulted a Chinese woman in a New York City subway , and an Asian American teen who was hospitalized  following an assault by fellow high school students accusing him of having coronavirus. Similarly, there has been a rise in microaggressive actions targeting APIA students on university campuses, including demeaning comments from faculty and peers about Chinese dining and cultural practices. And some news outlets  themselves have depicted the outbreak in ways that feed this paranoia, including using images of people wearing face masks without proper context and using blanket images of local Chinatowns in stories about the virus.

We are also alarmed that there is no longer a federal official in charge of coordinating our national response to global health crises and pandemics. The Trump administration eliminated this office two years ago , leaving us with a patchwork of agencies struggling to mount an organized response to the coronavirus outbreak. We therefore call for immediate reinstatement of this position, as this would improve dissemination of information to local governments hoping to respond to cases that emerge. This would also strengthen our ability to collaborate closely with international health organizations and follow their recommendations as more data on the coronavirus becomes available through medical journals such as the Journal of the American Medical Association (JAMA) and the New England Journal of Medicine (NEJM). 

Together we can quell this global outbreak through the work of many agencies collaborating to limit its spread while developing a vaccine or novel antivirals, not by closing borders in ways that feed fear and prejudice.

Asian Pacific American Medical Student Association (APAMSA)

Student National Medical Association (SNMA)

American Medical Student Association (AMSA)

References

1. https://travel.state.gov/content/travel/en/traveladvisories/ea/novel-coronavirus-hubei-province–china.html 
2. https://www.whitehouse.gov/presidential-actions/proclamation-suspension-entry-immigrants-nonimmigrants-persons-pose-risk-transmitting-2019-novel-coronavirus/ 
3. https://www.bloomberg.com/news/articles/2020-02-02/coronavirus-these-countries-airlines-restrict-travel-to-china 
4. https://www.bbc.com/news/world-51338899 
5. https://www.cnn.com/travel/article/coronavirus-us-travel-restrictions-monday/index.html 
6. https://www.businessinsider.com/coronavirus-us-foreigners-travel-ban-china-2020-1 
7. https://www.nbcnews.com/news/us-news/coronavirus-hate-attack-woman-face-mask-allegedly-assaulted-man-who-n1130671 
8. https://foreignpolicy.com/2020/01/31/coronavirus-china-trump-united-states-public-health-emergency-response/ 
9. https://news.berkeley.edu/2020/02/12/coronavirus-fear-of-asians-rooted-in-long-american-history-of-prejudicial-policies/?fbclid=IwAR1Mx-9oymuZFuJmRoAkvQMwSsUX65MqzE2Wr9B0hG-eGjN5uFNjbCaCw9c

Additional links:

1. https://www.politico.com/news/2020/02/04/coronavirus-quaratine-travel-110750 
2. https://workpermit.com/news/coronavirus-us-visa-travel-ban-china-travellers-20200208

FOR IMMEDIATE RELEASE

Contact: Omonivie H. Agboghidi, National President, president@snma.org

SNMA President's Statement on the U.S. Senate Proposed Elimination of the Health Careers Opportunity Program (HCOP)

Dear SNMA family and friends,

Our mission is simple. The Student National Medical Association (SNMA) is committed to supporting current and future underrepresented minority medical students, addressing the needs of underserved communities, and increasing the number of clinically excellent, culturally competent and socially conscious physicians. The Senate Appropriations Committee has drafted legislation that proposes funding cuts to the Health Resources and Services Administration (HRSA) Title VII and Title VIII programming. These funding cuts directly jeopardize our mission, strip underserved communities of resources, and most importantly disrupt vital pipeline efforts necessary to develop needed minority health professionals. 

The Student National Medical Association stands in strong opposition to any funding cuts that jeopardize HRSA Title VII and VIII health professions diversity and workforce development programs. 

The Senate has proposed the elimination of Health Careers Opportunity Program (HCOP), a federally funded program that has been around since 1972. This pipeline program focuses on developing underserved and minority students to enter various health fields such as nursing, medicine, dental medicine and other various allied health fields. Most importantly, this program seeks to increase proportionately the representation of minority and disadvantaged populations in these professions. HCOP focuses on three key milestones of education: high school completion; acceptance, retention and graduation from college; and acceptance, retention and completion of a health professions program. HCOP programs can be found all over the United States from HBCU institutions like Morehouse College to PWI institutions such as the University of Connecticut (UCONN), and my own Alma Mater, the University of California, Berkeley. To many students, these programs provide them with the only opportunity of exposure to the health profession field. Like many devastated students nationwide, I am a graduate of the HCOP program and can attest to the many benefits that the HCOP program offers. I know for a fact that without HCOP, I wouldn’t have had the professional development to create a half a million dollar chronic disease management program immediately after graduating from college, the preparation to apply to medical school, the support to pursue a master’s degree in public health and ultimately the mentorship that helped develop me into a student leader willing and competent to serve as your National President! 

On November 21, 2019 funding for HCOP will run out and without Title VII and Title VIII these programs will end. You can learn more about the legislation and how it is moving through the legislature here .

Protect this funding. Denounce all funding cuts. Make your voice heard. Sign the AAMC petition . The proposed legislation cuts funding for a variety of health sector agencies and departments and most importantly threatens grants and scholarship programs directly focused on filling gaps in our healthcare workforce. 

Sincerely,

Omonivie H. Agboghidi

SNMA National President