Because I recently attended the college graduation of our middle daughter -- who wants to enter medical school in another year -- I admit to more than casual interest in a disturbing report about the nation's medical schools. While some black medical schools are still struggling for a lifeline, it seems that predominantly white medical schools are accepting fewer qualified minority applicants.
It was just a week ago that I joined other proud family members and friends at Yale University to watch Melissa walk down a grassy path to be handed her diploma. Magnificent Tudor and Georgian buildings were an apt setting for the sun-drenched celebration. But with the cost of a four-year Yale education now at nearly $58,000 and rising, the happy occasion was also a sober reminder of financial sacrifices some parents make for their children.
But as middle-class parents struggle to afford tuition (even at more reasonably priced schools), and low-income families see college slip totally beyond their grasp, few of us expected the current hurdle facing blacks who qualify for medical school.
According to the Princeton-based Robert Wood Johnson Foundation, the proportion of blacks enrolled in U.S. medical schools fell from 6.3 percent to 5.7 percent although minority applicants are better qualified than ever. Moreover, black students with average or better medical school admissions test scores were less likely to get accepted to medical school than white students with the same scores.
While the report declines to blame this situation on racism, it's clear that the commitment of medical schools has plummeted as federal money for minorities has dropped and national pressure for equality has diminished.
And while a national surplus of physicians is projected, a continued scarcity of black health professionals will remain the norm.
Furthermore, because low-income areas are the most underserved, the dearth of doctors is directly linked to the continuing black-white health gap in the United States. The deaths of about 60,000 minority group members each year can be traced to the lack of adequate medical care, according to Dr. David Satcher of Nashville's Meharry Medical College. Satcher says black doctors are crucial to the black community because "they are twice as likely as whites to practice in underserved areas and more likely to accept poor and low-income patients."
As predominantly white medical schools retreat from their commitment to equality, more pressure is placed on predominantly black institutions. Indeed, three predominantly black medical schools -- Howard, Meharry and Morehouse -- account for about 20 percent of the nation's black medical students, and close to three-fourths of Meharry's graduates work in underserved areas.
Yet minority medical schools are always struggling for survival because so many of their students come from relatively low economic backgrounds. From 1977 to 1987, Meharry had to turn to federal distress grants to survive. During that period, the school upgraded medical standards, gained key hospital affiliations and attracted prominent board members such as White House chief of staff Howard H. Baker. Comedian Bill Cosby is spearheading a major fund-raising drive.
Now Meharry and several other black medical institutions want to be designated as "centers of excellence for the health professional education of minorities and health care for the poor" -- in the same way that white universities are routinely designated as centers in nutrition or cancer -- to qualify for continuing federal grants. Although Sens. Edward M. Kennedy (D-Mass.) and Albert Gore Jr. (D-Tenn.) and Reps. Louis Stokes (D-Ohio) and William H. Boner (D-Tenn.) and others recently introduced bills in Congress, the effort has been languishing in committee.
But schools like Meharry deserve help. What's at stake here is more than career opportunities for blacks; it's the deteriorating quality of health care for low-income people -- a problem the nation has an obligation to address. Moreover, medical schools across the country should again reach out to qualified minority candidates. For, make no mistake about it, in helping underserved communities, these doctors are filling a national need -- one that is silently crying to be met.