MNT spoke with Dr. Nada Elbuluk, a dermatologist specializing in skin of color, about education, trust, and the underrepresentation of People of Color in research. Photograph by Santi Nuñez/Stocksy .
Disparities and inequities pervade every area of health, and dermatology is no exception. In fact, insufficient visual representation of conditions that affect darker skin, coupled with many other inequities in healthcare, has led to particularly stark disparities in health outcomes for People of Color.
Although skin cancer tends to affect more non-Hispanic white people than non-Hispanic Black or Asian people, when it does affect People of Color, doctors tend to diagnose it at a much later stage.
For example, doctors diagnose around one-quarter of melanoma cases in African American people when the cancer has already spread to nearby lymph nodes. This is according to the American Academy of Dermatology.
The condition is harder to treat at these later stages, resulting in poorer outcomes for People of Color. The 5-year survival rate for people with skin cancer that has not spread to the lymph nodes is 99%, but this drops to 66% if it does spread.
According to the most recent statistics from the American Cancer Society, white adults in the United States with melanoma have a 5-year survival rate of 92%Trusted Source, while this rate drops to just 67% for African American people.
Systemic discrimination and the bias that the medical community displays toward white skin also mean that white people are twice as likelyTrusted Source to see a dermatologist, for example, than Black and Hispanic individuals. This is according to a study from 2018.
Furthermore, the current pandemic has made cancer screenings even more infrequent, which could exacerbate these disparities. For instance, diagnoses of melanoma dropped by more than 67% in 2020 as a result of COVID-19.
In this context, Medical News Today spoke with Dr. Nada Elbuluk — a skin of color expert, practicing dermatologist, and dermatology professor at the Keck School of Medicine at the University of Southern California in Los Angeles — about the causes of health disparities in dermatology and how to remedy them.
We also spoke with Dr. Elbuluk about Project IMPACT. This is a global initiative that she helped launch to reduce racial disparities and bias in dermatology education and medical practice. Dr. Elbuluk is the director of clinical impact for VisualDx.
We have lightly edited the interview for clarity.
Project IMPACT and ending inequities in dermatology
MNT: What prompted you to start Project IMPACT, and how did the idea come about?
Dr. Elbuluk: Professionally, I have been working for years in the space of dealing with diversity- and inclusion-related issues, issues related to skin of color and populations of color, marginalized communities, [and] underserved communities — and then I joined the VisualDx team last summer.
Part of why I joined them was that they were also trying to do really good work in the area of improving health disparities for patients of color, and they were looking to bring on somebody who had a similar passion and experience.
They said, “Look, we have this great platform to educate people, and we’ve been [working] for decades, but we need to get the word out there, and we want to do more — can you help us do that?” So, that’s how I joined as director of clinical impact last August.
When I joined, I was thinking about these issues related to health disparities for People of Color — for dermatology, obviously, because it’s my own field, but even beyond that. What can we do to make a difference in this area? We’re always talking about it, we know the disparities are there, but how can we address them?
That’s how the idea of Project IMPACT came to me because I thought, “Let’s actually start to build a community of people who are like-minded — individuals, organizations, companies, [and] institutions who want to move the needle and make a difference in health disparities and health equity.”
MNT: What are some of the ways in which we can make this difference and improve health disparities?
Dr. Elbuluk: [There] are so many ways that we can improve health equity — we’re trying to do it through medical education at VisualDx, but other people are doing it through other realms: through research, […], through public health measures and educating the public, through educating primary care doctors who interface with many patients before a specialist.
So, there are lots of things we can do, so I thought, “Let’s go bigger than us and […] really create something big and powerful that can make a difference not just nationally, but even globally.”
I like the word “impact” because it’s one simple word, but it carries a heavy meaning. “Impact” is about making a difference, it’s about moving the needle, as I mentioned.
I also wanted to use the word “impact” […] as an acronym, which stands for “Improving Medicine’s Power to Address Care and Treatment.”
And that’s really what we’re trying to do. [The question we are asking is,] “How can we use and leverage the education and tools that we have in medicine to give better care to patients, to give treatment that provides equitable care and better outcomes for all?”
Written by Ana Sandoiu
Article from: Equity in dermatology: Visual representation of darker skin is key (medicalnewstoday.com)
Photo by Godisable Jacob: https://www.pexels.com/photo/selective-focus-photography-of-woman-covering-face-with-brown-leaf-2703029/
