The Association of Minority Health Professions Schools.

Abstract

The Association of Minority Health Professions Schools David Chanoff, PhD (bio), Louis Wade Sullivan, MD (bio), and Ronny Lancaster, JD, MBA (bio) Disparities in health care between minority and mainstream Americans go back well beyond the beginning of formal record-keeping on race differences in morbidity and mortality. One reason that stands out historically for the still disconcerting state of Black health is the relative paucity of Black physicians and other health professionals. A hundred plus years ago there were shockingly few Black doctors attempting to care for a large, mostly rural Black population, and though the country's Black community today is far different from what it was at the turn of the 20th century, there is still a marked lack of African American physicians, dentists, and pharmacists and still alarming disparities. Another reason is that as recently as the 1980s the mainstream health establishment turned a blind eye to the whole subject of disparate care, which precluded the development of ameliorative policies and practices. In the late 1970s four predominantly Black health professions schools (Meharry Medical College, Morehouse School of Medicine, Xavier College of Pharmacy, and Tuskegee School of Veterinary Science) banded together as the Association of Minority Health Professions Schools (AMHPS) in order to find desperately needed resources to keep themselves alive and grow their capacity to train Black health professionals. For a tiny lobbying group composed of financially precarious institutions they were, over time, astonishingly successful at creating and bringing to fruition legislation that strengthened themselves, the sister minority schools that joined them along the way, as well as traditionally White health institutions that served impoverished and medically neglected populations. In the process AMHPS brought the existence of health inequities to national attention and precipitated the creation of NIH's Institute on Minority Health and Health Disparities. This commentary highlights the story of this obscure association, how it brought essential resources to the development of minority medicine, and how it triggered a nation's engagement with the devastating consequences of inequitable health care. ________ [End Page 1] Three quarters of a century before the creation of AMHPS the national conversation was not about the problem of health disparities and how to ameliorate them, it was on the coming extinction of the Black race. "Black people have a race proclivity to disaster and death," wrote Frederick Hoffman, the leading statistician of the early 20th century, an irrefutable conclusion he believed, based on objective and exhaustive research and analysis of the available data. African Americans were, simply put, biologically inferior to Whites, and their inferiority was leading them inevitably down the road of racial collapse. "The Indian is on the verge of extinction," he wrote, "… the African will surely follow him."1 That was the conclusion of Hoffman's comprehensive study, The Race Traits and Tendencies of the American Negro, published in 1896 by the authoritative Journal of the American Economic Association, which gave his words credibility as an accurate scientific determination. Hoffman's extinction argument dominated the racial discussion of his day and propelled him to international prominence. Hoffman had his critics, including famed Black sociologist and historian W.E.B Du Bois, who pointed to the flaws in Hoffman's study: his lack of data on similarly impoverished White groups who were clearly not in a state of racial collapse and his failure to account for the ravages occasioned by social determinants such as poor nutrition, inadequate housing, subpar education, and the absence of medical care, which caused the disastrous morbidity and mortality numbers—though even numbers so appalling did not indicate an inevitable slide into extinction.2 Hoffman responded to Du Bois with certainty: "It is not in the conditions of life," he wrote, "but in the race traits and tendencies that we find the cause of excessive mortality."3 Time proved Hoffman's extinction thesis a myth. African Americans did not die out. The 1910 census found that the 8.8 million African Americans counted in 1900 had grown in 10 years to 9.8 million, an increase of 11%. But although African Americans were not doomed to extinction, the numbers Hoffman had based his calculations on were not by themselves misleading. It was...