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Alabama, kidney transplants, and minority health – What’s the connection?

By Carlton J. Young, MD, FACS

Carlton J. YoungDr. Young leads activities for the Alabama Alliance to Transform the Health Professions. Based at the University of Alabama at Birmingham (UAB), Dr. Young is Professor of Surgery in the Division of Transplantation, Director of Pancreas Transplantation, Director of Pediatric Kidney Transplantation, and Assistant Dean for Medical Student Diversity and Inclusion.

As the lead representative of The Sullivan Alliance’s newest state alliance, I am honored to share my thoughts about why I’m in Alabama at UAB, why I’m a transplant surgeon, and how I hope my work will inspire more minority students to become health professionals.

The UAB kidney transplant program has been in existence since 1968. It was started by Dr. Arnold G. Diethelm, a native New Yorker, who, despite the prevailing attitude of the time, sought to transplant African-Americans equally. More than 40 years later, the program has transplanted more African-Americans than any other program in the country. That spirit of equality, promulgated by Dr. Diethelm resonated with me when I arrived at UAB in 1997.

Waiting List for Kidney Tranplants in AlabamaAlabama is a state that is plagued by very high rates of hypertension, obesity and diabetes. Hypertension and diabetes are two of the leading causes of kidney diseases. Unfortunately, African-Americans are disproportionately affected by these conditions and subsequently are at greater risk of developing kidney disease. African Americans constitute approximately 30% of the state’s population; however, they comprise almost 50% of the waiting list. This disproportionate burden of disease impacts the African American community in a very negative way. Moreover, this burden of disease has resulted in UAB having the second longest kidney waiting list in the country. In an effort to reduce the long waiting list, our organ center works diligently to educate the population about the need for organ donation. Community programs, television advertisements, and ongoing interaction with numerous groups have improved those waits to some degree, but much more needs to be done.

One of the many issues I have encountered during my time at UAB, is the often lack of cultural sensitivity of some physicians towards African American patients. While understanding and cultural competence have improved dramatically since I first began, it is not uncommon for me to talk to a patient who laments the lack of interaction with their referring physician. While there are numerous reasons why this may occur, one glaring problem is the lack of minority physicians caring for African American patients. UAB and many other Alabama academic institutions have partnered with The Sullivan Alliance to work assiduously to increase the number of minority physicians. The UAB School of Medicine (UABSOM), the Dean, and my Office of Diversity and Multicultural Affairs are committed to making physician disparities evaporate. The effort will be large because the problem is large. Nevertheless, UABSOM along with The Sullivan Alliance will continue to forge new inroads to bring improved quality of care not only to the residents of Alabama but also to the entire United States.

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