Working Toward Equity in Flyover Country: A Tulsa ED Physician’s Perspective

By Joshua Gentges, DO

Tulsa is a beautiful city. From our wonderful art deco architecture to the Gathering Place, a hundred-acre playground called “the best new attraction in the nation” by USA Today, the city is the jewel of Green Country, a region packed with swift rivers, placid lakes, and green rolling hills. It is my home, and I love it with all my heart. When we truly love someone or something, we must be able to see it clearly, blemishes and all. The nation now knows Tulsa much better than ever before, as the protests over the damnable murder of George Floyd and the first rally of President Trump’s 2020 campaign cast a harsh light over our shameful history. The Tulsa race massacre of 1921 is a stain that remains uncleansed, partially because we only began teaching about it in schools here, on a limited and trial basis, in 2018. Let that sink in…Tulsa high school students know more about the worst “Vigilance and a continued commitment to reducing social, economic, and health inequities are necessary to help our city to become a place where all are treated fairly and given the opportunity to live healthily, happily, and without fear that they will be disadvantaged because of the color of their skin.”

racial violence incident ever seen in our country from HBO’s Watchmen than they’ve learned in history. 1921 is a long time ago, surely we’ve become an antiracist, equitable place to live? I would like to cheerlead for my city, to say that we are better, but I cannot; systemic forces continue to generate large health disparities in the city that disproportionately affect Black Tulsans. These disparities are indisputable; from infant mortality to life

expectancy and everything in between Tulsans are more likely to sicken and die needlessly if they are Black. The reasons are systemic: Black Tulsans are concentrated in parts of the city without many doctor’s offices, without many walkable neighborhoods, and without much investment. Food deserts (areas of the city with no access to fresh food) affect thousands of Tulsans, most notably in north Tulsa, where there are no grocery stores. Redlining (designating neighborhoods as bad credit risks) and exclusionary zoning reduced investment and opportunity for Black Tulsans throughout the 20 th century, and the effects continue today — Black Tulsans are denied mortgages at a rate 2.4 times that of whites. The lack of investment in black neighborhoods worsens the economic prospects for those that live there, contributing to poverty and exacerbating health inequities.

Not all is doom and gloom. Tulsa’s leadership is focused on reducing health inequities, led by Mayor G.T. Bynum and the director of the Tulsa County Health Department, Bruce Dart. New medical clinics in north Tulsa in partnership with the Oklahoma University School of Community Medicine are improving access to health care for vulnerable populations, although significant disparities in emergency department use continue and indicate that we are not yet close to equitable access to primary care.

The Tulsa Economic Development Corporation is building a $5 million grocery store in north Tulsa — an important project that will provide better access to fresh food for the 42,000 Tulsans in that area who live a mile or more away from any grocery store. In the meantime, R&G Grocers brings groceries to the people, with an innovative mobile grocery store built into a semi-trailer truck that serves food deserts across the city. The city is also focusing on improving economic and living conditions in disadvantaged neighborhoods, including community development projects, better access to

transportation, and partnerships with non-profit organizations and schools.

Challenges remain, and the road is long, with one of the biggest risks being complacency. Vigilance and a continued commitment to reducing social, economic, and health inequities are necessary to help our city to become a place where all are treated fairly and given the opportunity to live healthily, happily, and without fear that they will be disadvantaged because of the color of their skin.

ABOUT THE AUTHOR

Dr. Gentges is an associate professor and the research director for Oklahoma University’s department of emergency medicine. In his spare time Josh is finishing his MPH and yelling at people who spread COVID-19 disinformation on Twitter. @jgentgesdo