Inequities of health care past and inequities of health care present

April 28, 2021, 11:13 PM UTC

Good afternoon, readers.

If there were one word to boil down the second and final day of Fortune‘s 2021 virtual Brainstorm Health conference, it’s “inequity.”

It’s not easy to single out a specific panel from this conference among a plethora of rich, incisive conversations about the state of American health care. We had the CEOs of Pfizer, Johnson & Johnson, Moderna, CVS Health, Abbott, Gilead, and Kaiser Permanente on the line, just to name a few.

But one conversation that truly stuck out for me was between three extraordinary brothers: The Churchwell siblings, a trio of Black health care leaders who have dedicated themselves to social justice in medicine.

This is a family that includes André Churchwell, a physician who serves as the vice chancellor for equity, diversity, and inclusion and as the chief diversity officer of Vanderbilt University, and his brothers, Keith Churchwell and Kevin Churchwell, the president of Yale New Haven Hospital and CEO of Boston Children’s Hospital, respectively. Their father, Robert Churchwell, has been described as the Jackie Robinson of journalism after becoming one of the first journalists of color ever to be hired by a white-owned southern newspaper. That historic lineage lives on in the brothers’ current work.

The Churchwells spoke to the enduring legacy of institutional racism and how it influences the social determinants of health, whether that be the air you breathe, the food or medicine you have access to, or educational and socioeconomic opportunities afforded to you. Those issues are all inextricably linked, as proven by the lack of minority representation in the medical community. Black men are still not given the opportunity to shine in medicine and the life sciences due to institutional barriers.

“The African American, Hispanic, Native American, Pacific Islander workforce [in medicine] has not changed that much over the last 10, 15, 20 years,” said André Churchwell at the conference. “In 2020, there were fewer African-American men applying to medical school and being accepted than there were 10, 15 years ago.”

This matters because trust is key to setting up a positive doctor-patient relationship, and underserved communities tend to trust people who actually look like them due to a history of medical negligence in the United States. That legacy is still alive today. The question is: What do we do about it? And we’ll address some ideas on that tomorrow.

We’ll also have plenty more to say about our conference in the coming days, so make sure to follow all past and ongoing coverage on Fortune.com. (Hey, here’s a handy link to lead you to all Brainstorm Health-related content.)

In the meantime, read on for the day’s news.

Sy Mukherjee
sy.mukherjee@fortune.com
@the_sy_guy

DIGITAL HEALTH

Breaking the COVID conspiracy theory fever. My colleague Jonathan Vanian breaks down the conspiracy theories surrounding COVID vaccines (you know, like the whole 5G, microchip thing) and highlights the whisperers who are trying to break through the fever. The American Health Care Association (AHCA), a group which represents more than 14,000 U.S. nursing homes, is on the front lines of that effort and has launched an aggressive campaign to dispel the notion that a vaccine is unsafe or going to be used to track your every movement. “This is a new vaccine, and so understandably families, residents, and health care workers all had questions about it,” AHCA chief medical officer David Gifford tells Jonathan. “We want to make sure they have accurate information when making a decision about getting the vaccine.” (Fortune)

INDICATIONS

Gilead CEO: Remdesivir is used to treat one out of every two hospitalized COVID patients. Now here's a stat: One in two hospitalized COVID patients are receiving remdesivir, as Gilead CEO Daniel O'Day recounted during a session at today's Brainstorm Health. But Gilead's journey is the real story, and the roadmap which could dictate the company's future. Infectious diseases are a specialty for the big biotech, but they take years upon years of work in order to lay a foundation for growth. “Three out of four HIV patients around the world are on a Gilead medicine,” said O'Day. That doesn't happen by accident. And the firm says it continues to focus on new therapeutics such as cancer drugs. A dollar down now may well lead to a groundbreaking therapy in the future, the thinking goes. (Fortune)

THE BIG PICTURE

What to watch in President Biden's big address tonight. President Joe Biden will deliver his first address to a joint session of Congress this evening. The White House has forecasted a multi-trillion dollar proposal that hits on everything from a transformation of education to expanded support for families - and, unsurprisingly, to bolster the health care safety net in the midst of a pandemic. For instance, Biden is proposing a national paid family and medical leave program that would, in and of itself, cost nearly a quarter trillion dollars. And then there's the extra $200 billion meant to boost subsidies and lower out-of-pocket costs, permanently, for Americans who receive insurance through the Affordable Care Act. The fate of these measures is clearly in question with a closely divided Congress. But the markers will be officially set tonight. (Associated Press)

REQUIRED READING

Some say the U.S. is closer to 'peak food.' What does that mean? by Marco Quiroz-Gutierrez

Why Patagonia CEO Ryan Gellert doesn't shy away from divisive issuesby Fortune Editors

55% of U.S. adults have gotten a COVID vaccineby Erika Fry & Nicolas Rapp

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