Saluting Dr. Ashira Blazer

By Anthony Williams | Feb. 22, 2022 | Updated Feb. 1, 2024

As a trailblazer in rheumatology, Dr. Blazer is encouraged by signs of progress in addressing racial disparities in health care in the United States. She also believes we must be honest about our history so we can fix the many shortcomings that still exist.

She earned her bachelor’s degree in biology at the University of Houston and her Doctor of Medicine at Baylor College of Medicine. While she was studying there, her cousin was experiencing symptoms that sounded a lot like symptoms of lupus Ashira was reading about in her textbook. She helped ensure that her cousin got a confirmed diagnosis of lupus and started on a treatment course.

“I would go to rheumatology clinics and see non-minority patients and note the differences between their journeys and that of my cousin’s,” she says. “I later learned I had other family members who also had lupus, and I became curious about why there were such disparities, and what kind of solutions we could come up with. There was such a huge disparity in health outcomes in what I was seeing with other people compared to the people who were closest to me.”

Today, Dr. Blazer is assistant professor and academic rheumatologist at the Hospital for Special Surgery in New York City, which specializes in orthopedic surgery and the treatment of rheumatologic conditions. For many years before that, she was a rheumatologist, physician scientist and assistant professor at New York University, where she specialized in treating and researching lupus in people of African descent (and where she earned a Master of Science degree).

Dr. Blazer believes progress is being made to address disparities, but more is needed. “A lot of these conversations are being had, and I applaud that,” she says. “Many institutions are starting to understand that racism is a public health crisis and needs to be addressed directly. Major funding organizations are creating applications to come up with Diversity, Equity and Inclusion (DEI)-related solutions. That’s a welcomed shift in priorities. I’ve seen many more academic partnerships with patient advocacy groups; often, they are groups of minorities, representing what minority patients go through. This will give physicians a perspective they may not have had before.”

Dispelling a big myth

Dr. Blazer says there’s a lot in our living history we need to realize. “I think one of the biggest myths that has persisted for over a century is that minorities, particularly African Americans, suffer because there’s some biological difference between the races. And that’s the reason why health outcomes are different. A lot of health professionals and the general public take that notion for granted.

“They don’t understand the dark history of the concept that minorities, mainly African Americans and Native Americans, were designed to suffer, which was created to justify their poor treatment and slavery.”

As co-chair of the DEI committee for the American College of Rheumatology (ACR), she says, “We’re looking at systemic and structural changes to combat disparities.” 

She further describes it this way: “A lot of times, doctors who are white hear that ‘patients don’t trust us because of racism.’ The first thing they may think is, ‘I’m not a racist. I didn’t do any of those things. I became a doctor because I have empathy for patients.’ That may be true, but what they miss is that racism is a structure and a system.

“When a white doctor interacts with a minority patient, that doctor has their own set of experiences, perhaps privileges. The patient has their experiences. Maybe they’ve lost their job. Maybe they were stressed in childhood. Or suffered from poverty. Or grew up being told they couldn’t be something because of who they are or what they look like. All of that needs to be considered in order to build trust.”

“We can’t all progress until we ALL progress.”

“There’s already this power differential between doctor and patient, but also racial dynamics,” Dr. Blazer continues. “Maybe the doctor lectures them about not complying with their prescribed treatment. But maybe that patient, if they’ve lost their job, can’t afford the medication. That patient feels they are being blamed for not doing what they were told to do.

“This principle can be applied to other health behaviors, such as eating healthfully for those who live in food deserts, or walking more for those who live in dangerous neighborhoods. This difference in perspective and power creates a cycle of blame instead of mutual understanding and healing.” 

What needs to be done to attract more minorities, including Black Americans, to the field of rheumatology?

In a survey of rheumatologists, according to Dr. Blazer, fewer than 4% represented minorities and fewer than 1% were Black Americans. 

“Rheumatology is one of the least diverse specialties,” she says. “The pipeline for all medical fields is not very diverse. But thankfully that’s changing. There’s an unprecedented number of African Americans enrolling in medical schools, which is fantastic. But there are still layered structures for people of color to be able to advance in the U.S.

“I think we really have to change what to look for in the next generation of rheumatologists. We must prioritize what we know is going to improve the health of all patients. We’re all healthier when we’re ALL healthier. And we can’t all progress until we ALL progress.”