A life-long commitment and focus on health equity and diversity

 

The coronavirus pandemic has awakened many in America to a pervasive problem in modern medicine—that of inequity in health care that manifests in uneven treatment and deep-seated distrust. For one UMass Chan Medical School alumnus, these contrasts are understood. And as a physician, entrepreneur, philanthropist and African American, Imoigele Aisiku, MD’97, MBA, MSCR, is relentless in turning the tide toward fairness.

Fittingly, in a year in which issues of racial equity/social justice rose to the foreground of the national consciousness, he established at his alma mater the Imoigele P. Aisiku, MD’97, Chair in Health Equity and Diversity. This endowed chair supports the new UMass Chan position of vice provost for health equity, which was created to advance all aspects of health equity across research, education and patient care.

Like so many UMass Chan alumni, Dr. Aisiku found his medical school experience to be formative. Yet it was during his residency years that he came to have an even greater appreciation for his UMass Chan education.

“In trading stories with fellow residents, I learned that not all medical schools provided the same high-quality education and environment that UMass Chan Medical School did,” he recalled. “I was well trained and supported throughout my four years here. The bar was set high, and we were consistently encouraged to achieve. It was a truly collaborative environment that supported all students.”

Chief of the Division of Emergency Critical Care Medicine in the Department of Emergency Medicine at Brigham Health, where he also serves as vice chair of diversity, inclusion and health equity, Dr. Aisiku was reconnecting in early 2020 with UMass Chan leaders on alumni gift ideas, such as providing students with access to a summer enrichment program. “But COVID hit, then George Floyd was killed, and it felt like everything was changing,” Dr. Aisiku said.

With so much suddenly altered, and with a more intense spotlight shining on health equity and diversity issues, the conversations about what initiatives he could support shifted accordingly.

“I described to Chancellor Collins the fact that in my first-year class there were four Black students, including me, none in my second year and one in my third year, along with one Latino and one Haitian student,” said Dr. Aisiku. “Even within a supportive department that encouraged us to achieve, there was still a lack of diversity—which is not unique to UMass Chan—and that strengthened my interest in establishing an endowment here. I wanted to make a long-lasting contribution that would support the school’s efforts in this area.

“Ultimately, my journey to this endowment, which is dedicated to supporting the disadvantaged and to addressing health inequity and systemic racism, reflects a life-long commitment and focus I’ve had—from my time as an undergrad in biology to medical school—to a higher, programmatic way,” he explained.

“The national conversation about equity, justice and inclusiveness has informed many discussions on campus about what needs to be done,” said UMass Chan Chancellor Michael F. Collins. “It is clear that prioritizing diversity; ensuring representation; reducing or eliminating health disparities; and creating a safe, inclusive and welcoming community are essential to UMass Chan Medical School’s future success, and are why we created the position of vice provost for health equity. Having this new endowed chair to strengthen that role is crucial to our efforts in these areas. That it was established by Dr. Aisiku, an esteemed member of our alumni who is a staunch advocate for diversity and inclusion, makes it all the more meaningful. We couldn’t be more appreciative of his generosity, vision and faith in our medical school.”

Longtime and highly distinguished faculty member Milagros Rosal, PhD, professor of population & quantitative health sciences, was appointed to the new vice provost role in September 2020 and is the inaugural Aisiku Chair.

“Diversity, inclusion and equity in clinical care and public health service delivery, as well as in medical education and research, is critical to improving health care for all,” said Dr. Rosal. “Having this support from Dr. Aisiku, who is highly respected in the medical community for his vision and tireless work in these areas, is exactly what is needed. I am deeply honored to be the first to hold this chair.”

Increase Diversity, Decrease Inequity

After a year of devastating loss due to COVID-19, with more than 500,000 deaths in the U.S. alone (as of March 2021) and a disproportionate number of them within minority communities, widespread vaccination events are welcome news for many. Yet, others are hesitant about receiving a shot against the life-threatening disease.

According to an analysis by Press Ganey of more than 100,000 outpatient surveys conducted between October 2020 and January 2021 with questions related to COVID-19, the importance of health care provider advice was the highest-performing question for Black/African American patients, while trust in the effectiveness and safety of the vaccine was lower in this group than in all others surveyed.

Consider that in the U.S. in 2018, according to U.S. physician workforce data collected by the American Association of Medical Colleges, 56 percent of physicians identified as white, 17 percent identified as Asian, 5.8 percent identified as Hispanic and 5 percent identified as Black or African American (see the complete physician workforce data here: https://www.aamc.org/data-reports/workforce/interactive-data/figure-18-percentage-all-active-physicians-race/ethnicity-2018). Yet, people are more likely to choose a health care provider who looks like them, shares a similar background and/or is more knowledgeable of their particular needs. The numbers and reality don’t match up, and that imbalance may cause patients to delay care or not seek it at all.

Coupled with past transgressions against Black Americans, Dr. Aisiku affirmed that “the hesitancy toward today’s vaccine took decades to create, and we can’t wipe away those years of concern, even though the pandemic is scary. I see it as a Venn diagram with mistrust at the intersection of systemic racism and the coronavirus. We must acknowledge the past and forge forward by taking the time to reach out and have multiple conversations.”

"We couldn’t be more appreciative of [Dr. Aisiku's] generosity, vision and faith in our medical school." -Chancellor Michael F. Collins

Dr. Aisiku has become a trusted advocate for his own patients, but noted that at Worcester State University (WSU), where his foundation for becoming a physician was built, his biology class was small with only a handful of graduates moving on to medical school. “Even in my case, exposure to medical school was happenstance,” he said.

After graduating in 1992 from WSU, Dr. Aisiku seemed to single-handedly challenge the status quo with his next wide-ranging steps: he earned an MD at UMass Chan in 1997, an MS in clinical research and an MBA from Emory University, and completed fellowships in emergency medicine, internal medicine-critical care and neurocritical care. Tapping into his health care expertise and entrepreneurial spirit, he foresaw tremendous opportunities in the emerging telehealth field and established a successful telehealth company.

“I did find it ironic when telemedicine took off with the pandemic, because I remember trying to explain it to those who said there were too many barriers,” he recalled. “We still have a way to go. Health equity efforts could drive it in rural areas, but health care at home won’t advance if people don’t have homes to begin with.”

Recruit, Retain, Repeat

In 2017, when looking back to where he started, Dr. Aisiku established The Aisiku STEM Center at WSU to expose disadvantaged undergraduate students to science, technology, engineering and mathematics through pre-graduate school research experiences.

“I noticed how things might be improved, what was missing,” he said. “I wanted to have an impact and give back, so I started with research scholarships, promoting science and collaboration. The programming grew and called for more support.”

In addition to encouraging student retention and success in science and technology programs in preparation for careers in health care, the STEM Center partners with Dr. Aisiku’s emergency medicine department through the Brigham-WSU Bridge to Excellence Program. Physician-educators offer students career mentoring, lectures, classes and shadowing opportunities.

Based on his experience as a leader in Brigham’s diversity, inclusion and health equity efforts, particularly around recruitment standardization and diversity within the ranks of faculty and residents, Dr. Aisiku is enthusiastic about the possibilities his UMass Chan endowment brings.

“We dedicated a lot to resident and faculty recruitment, and realized we needed diversity within the ranks of other health care providers as well,” he said.

In addition, Dr. Aisiku has supported initiatives around upstander training, microaggression prevention, and morbidity and mortality rounds, revealing disparities in care. These efforts educated hospital staff about the ways in which physical pain can be expressed and the special considerations required upon discharge for continued care at home and in the community.

“After George Floyd was killed, I wrote an internal message to my Brigham department, reminding members that, for many of us, we’ve experienced inequity for years,” he said. “We’ve got great national attention now, but it took the loss of a life. We have to remember that those lost before matter, too.”

“I am really looking to UMass Chan Medical School to do great things,” Dr. Aisiku said. “This endowment was the right thing to do.”