Even though she grew up in a small, historically black community in Mississippi, Kimberly Johnson heard plenty of conversations about racism and discrimination.
Her family was very focused on education, and she was a high-achieving child. Johnson attended a historically black university, and she did not really feel like a minority until she got to medical school. Her goal was to become a doctor and return to her hometown to work in a community health center to help underserved and underinsured populations. But when she started her internship at Duke University, she fell in love with academic medicine.
Johnson ultimately became a clinical investigator who studies health disparities in hospice use and other end-of-life healthcare needs. She is an associate professor of medicine in the division of geriatrics and a senior fellow in the Center for the Study of Aging and Human Development at the Duke University School of Medicine. Host Frank Stasio talks to Johnson about her work now trying to close racial gaps in healthcare.
Johnson on growing up in an all-black community:
From a very, very early age I was pressed to achieve. And I think as I've moved out of Mound Bayou and had connections with others, I find that people who were in communities where they were actually the minority often describe instances of discrimination or concerns related to race that I never had to deal with growing up in that community.
On the messages from her parents about race:
I think the messages early on — even though I wasn't directly exposed — also reinforced the idea that there were potential barriers outside of my community to my success. And so like many of my colleagues, my parents always told me that you have to be twice as good as white people to achieve the same level of success, on the one hand. On the other hand, I was told you can absolutely do anything that you want to do if you work hard enough.
On her father’s death:
My father was killed during my freshman year. It was right after the start of the second semester. I remember it distinctly because it was Superbowl Sunday. The year was 1990, and Dillard's band was performing in the Superbowl.
On only staying home for a week after her father was killed:
Looking back on that, I think that was absolutely the right thing. One, it certainly was a way to most respect the memory of my father who would have never wanted me not in school for absolutely any reason. And the other piece is having something to do and focus on really helped me to at least move past that time in a way that I don't think I would have been able to do it I had stayed in my small community and just sat there.
What it was like to be a minority in medical school:
It feels like one: I need to be twice as good — this message is still there. I still felt like I could achieve anything if I tried, but there is also this burden of feeling like my accomplishments and my failures are not my own. And so that anything I did, correctly or not, would be seen as a reflection on other African-Americans, and I certainly still feel that but certainly felt an additional burden about whether my actions might reduce opportunities for others.
On her research into why African-Americans are less likely to use hospice care:
We learned that there were issues related to trust. African-Americans — for a very good reason based on past injustices and ongoing disparities — trust the health system less. Hospice really focuses on comfort rather than cure. You might imagine that if you're concerned about the quality of care you've received when cure may have been possible, you're less likely to access a service which focuses on comfort only.