minority health care 
advocate 
gets her start at WSU

By Anita Lienert

Dr. Moncrease is trying to increase opportunities for minority medical students and health professionals.

Dr. Anita Moncrease’s first lesson in improving access to care for minorities came in the bitter winter of 1962, when Detroiters were besieged by the Hong Kong flu.

She was only six years old then. Dr. Moncrease recalls her mother struggling to get her five small children – two of whom were feverish and ill – on a bus bound for Children’s Hospital of Michigan. Once in the emergency room, a physician treated the two sick children and then inquired about the other three. Shouldn’t he examine them, too?

Dr. Moncrease remembers her mother hesitating. While they weren’t impoverished, the African-American family struggled to get by. Her father worked midnights in a Detroit factory. Skimping on extras was a way of life.

“The doctor smiled and said, ‘Since you’re already here, I’ll look at them – no charge,’” Dr. Moncrease recalled. “As is turned out, I had a temperature of 106 degrees that day. Nobody realized I was sick.”

She adds: “That story bears on access to care. The doctor understood there was a barrier, even though we had insurance. The barrier was money. At that moment, I wanted to be the kind of doctor that this doctor was.”

Dr. Moncrease, 44, a former Wayne State University faculty member and medical school graduate, continues to charge into barriers and craft a national reputation as a minority-health care advocate and expert. As a graduate of WSU’s post baccalaureate program, a national model which supports students from disadvantaged backgrounds, Dr. Moncrease understands how important it is to increase enabling opportunities for minorities.

This summer, Dr. Moncrease was appointed to head the U.S. Department of Health & Human Services Bureau of Health Professions’ Division of Health Professions Diversity in the Health Resources and Services Administration (HRSA). Her new role focuses on improving minority recruitment into health professions.

Through grants to colleges and universities, the division provides opportunities to disadvantaged and minority students and faculty to enhance their academic skills and get the support needed to graduate. The division manages the Health Careers Opportunity Program (HCOP), Centers of Excellence and Minority Faculty Fellowship Program.

There is a critical need for minority health-care providers. While minorities represent 25 percent of the total U.S. population, they comprise only 10 percent of the nation’s health-care workforce.

“When I was practicing medicine, I used to see patients and emphasize preventive medicine,” said Dr. Moncrease in a phone interview from her new office in Rockville, Md. “I was doing it one person at a time. But now, I feel like I’m in a position where I can make an impact on the country – not just Detroit.”

Among her goals: urging medical schools to include “cultural competence” programs in the curriculum and encouraging universities to become actively involved in the Health Careers Opportunity Program, which gives disadvantaged students a chance to learn about health careers through six-week summer programs, plus post-baccalaureate programs and year-round educational training.

Her alma mater, the Wayne State University School of Medicine, is committed to such cultural programs and pioneered programs to expand access to medical careers among minority and disadvantaged students. Furthermore, Dr. Charles Whitten, founder and leader of the nationally recognized post baccalaureate program, continues to support minority health care professionals and address their underrepresentation in the field. “At WSU, we have used our resources to expand the pool of black students who could be successful in medical school.”

“I want the universities to come out and seek government support,” Dr. Moncrease said. “But to be truly successful in addressing the issue of health-care disparity, we have to address the issues within our own ranks. Our research has shown that people who come through these programs are more likely to practice in disadvantaged areas.

“When you talk about eliminating health-care disparities, one piece is developing a workforce to address those issues. We have all this technology, yet if you are an African-American male, you are destined to die 10 years younger than a European-American male because of the color of your skin.”

Sometimes, Dr. Moncrease said, just learning how to listen to minority patients can be the key to improving health care.

“I inherited a patient who complained about breast pain,” she recalled. “She was getting yearly mammograms and had been seen by an endocrinologist and a breast-cancer specialist. Finally, I delved more deeply into her life. It turns out the pain began after a  break-in at her house. She was home and somebody kicked in the door. So at night she’d sleep in a chair, facing the door and holding a gun. She had to prop her head up on her arm – and that was causing the pain. Part of access was understanding what she had to go through.”

Dr. Moncrease’s new position is a natural evolution in a career that began with dual bachelor’s degrees in urban development and medical technology from Michigan State University. After receiving her medical degree from WSU in 1984, she completed a residency in internal medicine and pediatrics at WSU and Children’s Hospital of Michigan in 1988. Dr. Moncrease also has a master’s degree in public health from the Harvard School of Public Health, where she was one of the first recipients of the Commonwealth Fund Fellowship in Minority Health Policy.

Dr. Moncrease has been on the frontlines of urban medicine, working for a time as director of Detroit Northwestern High School’s clinic and directing the medical ministry program at Hartford Memorial Baptist Church here.

She also spent time working in medical clinics in Ghana, battling malaria and starvation. And it was in those clinics – with their lack of running water and patients who waited from sunrise to sunset to be seen by a physician – that access problems in American came into even sharper focus.

“My impression was that this (Ghana) is a Third World country, so I can understand the lack of medication and the lack of medical care,” she said. “But I can’t understand it back home. If you have untreated high blood pressure in Ghana, I can begin to understand it – and leave medications. Here, there’s no excuse. We have the medications available. They should be affordable. There should be a universal health plan.”

Dr. Moncrease’s research interests include cancer screenings for African-American women and hypertension among African Americans. She was one of three physicians to be awarded a 1999 Senior Health Policy Field Internship from HRSA. It’s a career path that has taken her far from her roots and one she said she never envisioned for herself.

“I had no intention of ever leaving Detroit,” said Dr. Moncrease. “I love Detroit. But I’m a religious person. I decided not to fight where God is trying to lead me. As I sit here today, I’m just blessed. I’ve always wanted to work with people who are going to make a difference. I can see it happening already.