“At this moment, 53 years after [the signing of the Civil Rights Act] I have to ask you, is the glass half empty or half full?” Antonia Novello, the 14th
Surgeon General of the United States, asked a nearly packed crowd in the auditorium at the Smilow Center for Translational Research last month.
The question was asked about halfway through Novello’s presentation, which was part of the Annual Martin Luther King, Jr. Health Equity Symposium, hosted by the Perelman School of Medicine’s Office of Inclusion and Diversity.
Novello, who became the nation’s first female and person of Hispanic heritage to hold the position of Surgeon General when she was appointed in 1990, offered a keynote address which looked back at the more than 50 years since the signing of the Civil Rights Act, pulling wisdom from Martin Luther King Jr. to provide context. She also shared some personal inspiration and offered her own thoughts on how to address some of the issues – like racial disparities in access to education and health care –that continue to plague the nation.
“When I was Surgeon General, I learned that the world owes you nothing. I learned that service is the rent you pay for living, and that service will set you apart,” Novello said.
Novello waxed broadly about Dr. King and his principles, suggesting how the famed civil rights leader might react to the America that exists today, one which Novello said has moved both forward and backward since King’s assassination.
“The triple threats of humanity – militarism, racism and materialism – that he cited near the end of his life have increased rather than diminished,” Novello said. “[However,] the confederate flag is no longer waiving on the South Carolina capitol grounds. Barack Obama has been elected the first black President of the United States, twice.”
Towards the end of her address, the former surgeon general called on the federal government to enact an initiative in the style of the Marshall Plan to empower the nation’s oppressed populations and rebuild communities which continue struggle with blight. If America could rebuild war-torn Europe following the nightmare that was World War II, Novello posited, surely we could do the same for our own neighbors.
Following Novello’s remarks, Penn faculty hosted a panel discussion on the topic. Presenting first, Kevin Jenkins, PhD, the Vice Provost’s Postdoctoral Fellow in the School of Social Policy and Practice and expert in the racial inequities in health care, likened health disparities to “a bad game of musical chairs.”
“When the music stops, people of color, those from vulnerable societies and communities, are left standing,” he said. “Many say we need more chairs, we need more inclusion and diversity, and I don’t disagree with that, but I also think we need to change the DJ.”
Jenkins suggests moving away from the goal of finding a win-win solution and instead focus on a “win when” message, meaning it’s time to stop waiting for a perfect agreement which solves all problems for everyone and start working harder for firm solutions to the nation’s problems in health care inequality.
A major focus of Jenkins’ message was what he called the “indifference narrative,” factors that could cause the public or physicians to complaints from African-American patients less seriously. He said it isn’t enough to know that African-Americans are more susceptible to diabetes and hypertension, but that more researchers should be looking into why that is the case.
“I can’t change the numbers,” Jenkins said. “But, hopefully, I can change the narrative.”
Jaya Aysola, MD, DTMH, MPH, an assistant professor of Medicine and Pediatrics, and Lisa M. Lewis, PhD, RN, FAAN, an assistant professor of Nursing and assistant dean for Diversity and Inclusivity, followed Jenkins with discussions around the importance of diversity and inclusion in an organization like Penn Medicine and racial disparities in medical research, respectively.
As for the rhetorical question at the top of this post, the one which the former surgeon general asked the symposium’s crowd, Novello had an answer, one which calls for more creative discussion around racial progress and to fresh look at the issues facing our communities and patients.
“The glass neither half full, nor half empty,” she said. “The glass is cracked, and its contents are leaking.”