Fola May, MD, PhD, MPhil, brought along homemade black-and-white signs when she took her three young daughters to protest racial injustice on a Saturday in June at Trump National Golf Club in Rancho Palos Verdes.
In capital letters, one message read: “White Coats for Black Lives,” in reference to a movement among the medical community that began in late 2014 in response to the deaths of Michael Brown and Eric Garner.
White Coats for Black Lives also is a calling that Dr. May has embraced since she was a teenager, traveling with her physician father to help with medical trips to Africa, and culminating in her roles as a health equity researcher and director of the Melvin and Bren Simon GI Quality Improvement Program.
Dr. May, a UCLA Health gastroenterologist, has devoted her career to addressing racial disparities in health care, but she says she’s now been handed a megaphone because of the confluence of outcry over systemic racism and the coronavirus pandemic, which disproportionately kills people of color.
“COVID-19 has been able to amplify awareness of health care disparities because, for the first time in all of our lifetimes, the entire world is paying attention to the same health problem,” Dr. May says. “It’s highlighting these long-fostered vulnerabilities that low-income Black and Latino individuals in the U.S. have been facing.”
Dr. May co-authored a 2017 study that examined colon cancer disparities between Black and white patients, concluding that progress had been made but more intervention was necessary to reduce cases and deaths in the Black community.
She recently contributed to a paper published in the journal Gastrointestinal Endoscopy looking at how the pandemic has impacted colon cancer disparities as health clinics serving low-income patients and people of color have been required to cancel colonoscopies to preserve resources and prevent coronavirus transmission. Another recent publication, in Nature Reviews Gastroenterology & Hepatology, discusses how COVID-19 has exploited baseline disadvantages in health.
In addition to her academic research, she offered a personal perspective in an essay on the Healio website about how the academic community can respond to racial injustice.
“I feel that many of my colleagues think they are avoiding undue strain on our relationship by not discussing the current racial climate for fear of being clumsy or even offensive,” Dr. May wrote. “In reality, however, the omission of a stance against racism can be more harmful to the relationship in the long run. There is a problem with silence.”
Early Start
Dr. May grew up along the Palos Verdes Peninsula. Her father moved to the U.S. from Nigeria to attend college and her mother was raised in Mississippi where Dr. May’s grandparents marched for civil rights.
From the time she was young she accompanied her dad, a surgeon, on his trips to Sub-Saharan Africa, where she helped transport patients, deliver supplies and eventually observe surgeries.
“I just became very impassioned about helping people who have access to very little and found great gratitude in doing small things that could change people’s lives,” Dr. May says. “Over time, this is where I really grew a love for helping the most marginalized populations.”
She went on to attend Yale, Cambridge University and Harvard Medical School. She came to UCLA in 2011 for her fellowship training.
Dr. May now runs the May Laboratory and is an assistant professor of medicine. She’s also director of grants and postgraduate research for the UCLA Global Health Program; an assistant director of the UCLA STAR Program, which trains physician-scientists; and member, UCLA Jonsson Comprehensive Cancer Center Cancer Control and Survivorship Program.
‘Unconscious and conscious biases’
Dr. May said Black women comprise only 2% of doctors and she’s routinely reminded of the lack of representation.
When traveling, flight attendants have questioned her credentials when she’s responded to their announcement requesting medical assistance for a passenger. Too often she has walked into a patient’s room, leading her team of medical students, residents and fellows, only to have the patient address the young white male student or resident as “Doctor.”
“I’ve had patients hand me their meal tray and say, ‘Can you take this to the kitchen?’ It’s unbelievable the unconscious and conscious biases you see every day in the workplace,” Dr. May says.
Among Black Americans, she said, explanations of health disparities go beyond an individual’s health status but extend to environmental, educational and economic factors, known as social determinants of health.
“Literally where you’re born can predict your health outcomes,” Dr. May says. “You drive a few miles east and south of here and your life expectancy shortens.”
In the case of the coronavirus, she said it’s misleading to say that African-Americans are more likely to die only because they have higher rates of asthma or heart disease. “That’s true but it’s certainly not the root cause of the inequities we’re seeing in COVID,” she says.
For instance, poverty and racism lead to unfavorable housing conditions, high-risk employment and poor access to care, all of which put Black people at greater risk of contracting and dying from COVID-19.
Dr. May says addressing health disparities and systemic racism requires critical changes in everything from policy to health care. Academic institutions must increase representation and leadership opportunities.
“It’s usually the person of color in the room that is going to notice that the only patients in your study are white or that this drug was never evaluated in low-income communities,” Dr. May says. “It’s about getting more minorities and people of color into health care professions. And we’re not going to do that unless we start at the very beginning, as in kids in elementary school.”
Acknowledging the Problem
Dr. May says she and her husband, Dr. Alvin May, who is a surgeon, discuss race openly with their children, ages 9, 5 and 2. On that recent Saturday in June, their youngest held a protest sign that read, “Black Girls Can.”
“We tell them they have to be careful about what they say and do in public,” she says. “I tell them they won’t be looked at as the smartest kid in the class, even when sometimes they are.”
Dr. May says she would encourage white doctors to start conversations with their Black patients about how they’re feeling about what’s going on in the world, in addition to their own health.
“George Floyd isn’t a one-off. The Black patient they took care of that died unnecessarily from a preventable condition isn’t a one-off,” Dr. May says. “These stories are examples of larger problems that are occurring over and over again in our country. Unless we admit to that problem, we are not going to be able to fix the vicious cycle.”
Courtney Perkes is the author of this article.
