Since the start of the COVID-19 pandemic, Einstein alumnus Utibe Essien, M.D. ’13, M.P.H., has delivered more than 40—mostly virtual—keynotes and seminars to physicians, researchers, and faculty members from Boston to Boise. His one-hour talks encompass COVID-19 and non-COVID-19 topics while focusing on another public-health crisis: racism in medicine. “This topic is reverberating around our communities,” Dr. Essien says. “So we’re seeing a groundswell about health equity, health justice, and antiracism in medicine that we haven’t seen before.”
In one such talk, “Bending the Arc Toward Justice in Health,” Dr. Essien leaves his audience with an imperative known as the five Ds: desegregate healthcare in the United States, divest from racist practice and policy, diversify the medical workforce, develop antiracist medical curricula, and deepen community investments.
Certain patients are overexposed to disease because of where they live or underprotected because of a lack of insurance or bias in care.
—Dr. Utibe Essien
“COVID-19 reminded us that you just can’t put your head down when people are dying across the country and across the world,” says Dr. Essien, an assistant professor of medicine at the University of Pittsburgh School of Medicine and a core investigator in the VA Center for Health Equity Research and Promotion, where he studies racial and ethnic disparities in the use of novel cardiovascular medications and technologies. “And then, after George Floyd was killed, that opened the door even wider to focusing on racism as a direct driver of health. That was such a powerful realization for many.”
The pandemic’s disproportionate impact on Black, Hispanic, and American Indian communities, says Dr. Essien, has spotlighted health disparities and their social determinants. “We’re learning more and more that improving health outcomes is not just about having a doctor who can prescribe medications,” he explains. “It’s about addressing social factors—how certain patients are overexposed to disease because of where they live or underprotected because of a lack of insurance or bias in care.”
Now a recipient of numerous awards—among them the Einstein Alumni Rising Star: Clinical Practitioner Award (2021), the Larry E. Davis Award for Excellence in Race Research (2021), the Milton W. Hamolsky Junior Faculty Scientific Presentation Award (2020), the National Minority Quality Forum’s 40 Under 40 (2019), and the American Heart Association Early Career Investigator Award (2019)—Dr. Essien admits that “physician-scientist” wasn’t always his dream career. Growing up as the son of a family physician, Dr. Essien saw medicine, with its grueling long hours, as more like a nightmare.
“When I was 8 years old, I probably said that I hated doctors,” Dr. Essien recalls, smiling widely. His perspective shifted when he spent a summer working at his father’s medical office in New Rochelle, N.Y., managing administrative tasks, when he was 17. “I was just trying to make a few bucks,” he says. “But I got to see him in action, and it really exposed the difference he was making in the community.”
Dr. Essien developed a passion for health equity—the ideal that every patient deserves and receives personalized, best-in-class care for optimal health—during his time at Einstein. He credits the medical school’s commitment to the community, and faculty mentors, including Cristina Gonzalez, M.D., M.Ed., professor of medicine at Einstein and an internist at Montefiore, and Nilda I. Soto, M.S.Ed., Einstein’s assistant dean for diversity enhancement. “Equity is at the foundation of all we do at Einstein,” Dr. Essien says. “I’m proud to have trained there and to continue that drive beyond the Bronx.” Today, Dr. Essien serves as an active mentor for current Einstein students. He recognizes that guiding the next generation of physicians and scientists and driving equity in healthcare cannot be separated.
As a native New Yorker and son of Nigerian immigrants, Dr. Essien found that attending Einstein came with another perk as well: proximity to his close-knit family. “One of the best parts was that I could drive 15 minutes to do my laundry at home and get my bowl of jollof rice on the weekend.”
Dr. Essien’s entrée into social justice work began when he was a college premed student at New York University, volunteering in the emergency department at Manhattan’s Bellevue Hospital. “The ER was full of folks who looked like me and my family members and who spoke different languages like my parents did,” Dr. Essien says. “That experience stayed fresh in my mind throughout my training.”
At Bellevue, Dr. Essien started asking questions—and never stopped. “I began wondering why people of color always seemed to be the sickest and presenting as the least healthy,” he says.
That was one of many experiences that pushed him toward research on health disparities and advancing health equity during his residency at Massachusetts General Hospital, followed by a fellowship at Harvard Medical School. “I realized that research was a way to move some of those anecdotes toward data collection, and hopefully use those data to inform the policies that could then make real changes for our patients.”
Today he is making progress toward that aim. In July 2021, he and colleagues published a study in JAMA Open Network on how veterans affairs (VA) patients are treated for atrial fibrillation, the most common cardiac arrhythmia. Black patients were found to be 25% less likely than white patients to receive blood thinners. “Our research suggests that this gap exists not just because Black bodies are different from white bodies,” Dr. Essien explains. “It is because Black patients are treated differently and have less access to treatment than their white counterparts.”
Equity is at the foundation of all we do at Einstein. I’m proud to have trained there and to continue that drive beyond the Bronx.
—Dr. Utibe Essien
These inequities are by no means limited to atrial fibrillation, Dr. Essien says. “We see these racial differences in treatment of pain and hypertension, diabetes management, and really across the board.” Now, thanks to a $1 million grant from the VA’s Health Services Research and Development Service, Dr. Essien is expanding his study to find the causes for these disparities and, ultimately, develop interventions to correct the underlying issues.
Dr. Essien is also addressing health equity as the co-producer of the podcast “Antiracism in Medicine”—a series that introduces language that listeners can use to speak about race and racism within academia and clinical spaces.
Dr. Essien says that research into racism’s influence on health and health outcomes should lead to equity and justice. And he’s optimistic. “The medical students coming after us at Einstein and other institutions are pretty uniformly committed to this issue and are not going to just think about antiracism,” Dr. Essien says. “They are going to push for equity, and we’re going to have to come along with them. That’s one of the things that gives me hope.”