Many of Bermuda’s Black patients face worse health outcomes than others, a leading physician has said, calling for the island to do better in exploring its health disparities.

Stanley James told the Docs for Dinner quarterly gathering of physicians he had been perplexed by the island’s apparent aversion to tracking healthcare outcomes by race.

“Black and White seems to fire people up,” Dr James told the dinner, hosted by Bermuda HealthCare Services. “That is because it has been dangerous. There are people who lived in fear of their mortgages being pulled in case they were too Black.”

Dr James said Bermuda’s race-based health differences, such as high blood pressure and chronic disease, were not driven by lack of access to medical care but a need for basic change.

Highlighting the correlation between living under stress and higher rates of strokes and certain cancers, he said: “Universal healthcare will not solve the problem. Access is not the problem — we have got to look at systemic change.”

Dr James said the island’s “biggest challenge” was the lack of data, but that candour and self-examination were needed on an individual level.

“We need to be sure that well meaning, good people are sure of their potential blind spots.”

Dr James, who holds a medical degree from Loma Linda University in California, an MA in religion from Andrews University in Michigan and is now pursuing a PhD from the University of Aberdeen, told the gathering his desire to become a doctor had seemed “almost a profane thought to consider” as a young Black man.

He added that he was hindered early in his career by the feeling that the hospital was “a place I could come to, but not a place where I felt like I belonged — a sacred place, a domain I didn’t belong”.

He said: “Health disparities are things we should not have. They are systemic. In other words, they are everywhere.

“We have a moral responsibility to ask why. We cannot simply let people die and ignore it because of fear.”

With so little data broken down by race, Dr James said it would be difficult to make good decisions on reforming Bermuda’s healthcare.

“If we start changing things without data, it’s gambling and guesswork.”

Dr James traced psychological factors underpinning race and sociological trends such as lower income to health outcomes, noting that studies such as the Human Genome Project showed that different races were far more alike genetically than different.

“The greatest determinant of your life span is not your genes,” he said. “It’s your stress.”

Emphasising personal agency, Dr James said: “We have the power to change it because it’s not in our genes if it’s in our behaviour.

“We have choice, and with that collective choosing we can decide to stop practising and unhealthy practice.”

He added: “Get the information. Otherwise we are gambling. We need to study Bermuda and the true determinants of our outcomes.”