When I first considered pursuing a career in the field, I could not see how to reconcile a largely lab-based field like pathology with my passions for global health and addressing healthcare disparities. The revelation that not only do the fields readily reconcile but are in fact inextricably linked emerged for me after months of career exploration and literature review this session presented by doctors Carlos de Rio and Sherif Zaki offers the same lesson in a 1-hour package.
Dr. Rio’s primary focus is the profound ethnic and socioeconomic disparities that have been laid bare by COVID-19. For example, he reveals that mortality rates in indigenous, African American, and Hispanic communities are nearly 3x those of the white population. He goes on to quantify this excess death by explicitly pointing to the fact that if the rates of minority groups were equivalent to that of the Caucasian population; 20,000 fewer African Americans and 10,000 fever Hispanic patients would have passed away. His presentation regarding disparities flows very naturally into a discussion of global health topics given the unique position of immigrants both on the frontline treating patients with COVID-19 and through a combination of poor infrastructure in detention facilities and aggressive deportation policies as potential vectors for carrying the illness back to their home nations. Dr. Zaki the chief pathologist for the Centers for Disease Control and Prevention more explicitly places his collaborator’s assertion in the context of Pathology pointing to the fact that pathologists, particularly those who perform autopsies, along with our veterinary and infectious disease physician colleagues often are the first to see novel diseases. It is this unique perspective that yields the data fueling Dr. Rio’s arguments, reinforcing a lesson I learned from research on diagnostic disparities in Amyloid. This approach also demonstrates why “back to normal” is an unacceptable future goal. The centrality of pathology to understanding and addressing health disparities in the context of an increasingly globalized world offers a robust argument for efforts to mitigate bias within the field and have more health care professionals who come from and resemble those populations who have long been hampered by institutional and implicit biases.
While the arguments seem intuitive the existent of this session at a major conference is a significant advance in my opinion. As already stated in a much earlier post of mine even as a motivated aspiring pathologist, I significantly underestimated the potential for pathologists to conduct global and public health directed work. Misconceptions of this type on the part of those in training are likely a key reason why pathology and laboratory medicine remains a “neglected cornerstone” of global and public health.