Janet L. Mitchell

Janet L. Mitchell (born 1950) is an African-American physician known for her advances in perinatal HIV/AIDS treatment. During the early days of the AIDS epidemic in the U.S. Mitchell developed protocols for health treatment of pregnant women who were HIV positive or at risk for developing AIDS. She advocated against mandatory testing and testifying before Congress, she advocated in favor of an inclusive approach to health care and social services. One of her innovations derived from a study which saw a 70% decrease in HIV transmission to babies when AZT was administered to their mothers during the pregnancy.

Early life and education

Born and raised in the housing projects of Lexington, Kentucky, Mitchell attended Mount Holyoke College for her undergraduate education, graduating with a bachelor's degree in 1972. She then attended Howard University College of Medicine, where she graduated in 1976. She returned to school later in her career and earned a master's of public health at Harvard University, graduating in 1987.[1] During this time, she was appointed in 1983 to serve on the newly formed New York State AIDS Advisory Council. She was involved in developing policy for controlling infection via procedures written for healthcare workers.[2]

Career

In 1988, Mitchell became the department head of obstetrics and gynecology at Harlem Hospital Center, a position she held until 1996. During this time, she was responsible for its perinatal drug addiction program, the largest in New York City. Mitchell cared for uninsured and HIV-positive patients.[1] In 1994, she was commissioned to write a paper for the Institute of Medicine evaluating the disparity of inclusion of minority women in AIDS research. While she noted that all women were routinely omitted from clinical trials, she successfully argued that when women were included in studies, women of color were routinely underrepresented. Her lobbying was successful in a policy shift by the National Institutes of Health to ensure the inclusion of black women in ongoing drug trials for HIV/AIDS in pregnant women.[2] Her research has been primarily in this area; she studied perinatal AIDS education and prevention with the Centers for Disease Control from 1988 to 1992, and pregnancy in African-American women.[1] She served as an assistant Professor of Obstetrics and Gynecology at Columbia University and chair of the Consensus Panel at the Center of Substance Abuse within the supervision of the Department of Health and Human Services and the Public Health Service. The panel developed a Treatment Improvement Protocol in 1993 for pregnant women who were also substance abusers.[2]

In the early days of the AIDS epidemic many programs were tried and Mitchell was often consulted to review solutions. She was called as an expert witness to testify before Congress on children and HIV infection in 1989[3] and again in 1990 to discuss underrepresentation of minorities and drug abusers. She and others recommended coordinated services between health care and social and psychological help as a means of stemming the epidemic.[4] As a means of confirming this recommendation, Mitchell conducted a study from 1989 to 1992 which evaluated three separate groups of women and the way that health services and education about HIV transmission was delivered to them. Her findings concluded that risk is most successfully reduced if education is incorporated into a routine clinical program meeting the basic health needs of patients.[5]

One of her innovations was the result of a study conducted in 1986 which administered AZT to pregnant women to reduce transmission rate to their babies. The study showed almost 70% reduction in transmission rates for women when started between 13 and 34 weeks of gestation. As a result of her study, use of AZT became the standard of care for at risk and HIV positive mothers.[2] Mitchell kept statistics and performed maternal death reviews for New York City during her tenure at the hospital. During the decade of her employment, maternal deaths in the United States showed that for every 5,102 births, one black mother died, compared to one white mother in 18,868.[6] Mitchell was strongly against policies of mandatory AIDS testing, believing that it was an attempt to identify a problem, rather than take action on the problem. [7]

Personal life

Mitchell married Arthur Glass Jr. a vice president at the Jackie Robinson Foundation of New York City in 1991,[8] but they later divorced. Mitchell developed early Alzheimer's disease and was placed in long-term care. In 2007, Mitchell was a featured subject in a Nightline program which explored the vulnerabilities of people with early onset dementia.[9]

Honors and awards

References

  1. 1 2 3 "Changing the Face of Medicine | Dr. Janet L. Mitchell". www.nlm.nih.gov. Retrieved 2016-03-06.
  2. 1 2 3 4 Frere, Maxine; Wallace, Barbara C. (February 2014). "Working in the Trenches with HIV Infected "Boarder Babies"—Values, Skills, and a Prescription for Working with Stigmatized Populations throughout Epidemics" (PDF). The Journal of Equity in Health. New York, New York: Star Spirit Press, Columbia University. 3 (1): 66–88. Retrieved 2 August 2016.
  3. ↑ United States. Congress. House. Committee on Government Operations. Human Resources and Intergovernmental Relations Subcommittee (1989). Children and HIV Infection: Hearings Before the Human Resources and Intergovernmental Relations Subcommittee of the Committee on Government Operations, House of Representatives, One Hundred First Congress, First Session, February 22 and 23, 1989. 4. Washington, D.C.: U.S. Government Printing Office. pp. 26–28.
  4. ↑ United States. Congress. House Committee on Government Operations. (1990). AIDS treatment and care, who cares?: fourteenth report. Washington, D.C.: U.S. Government Printing Office. pp. 39–42.
  5. ↑ Umeh, Davidson Chukwuma (1997). Confronting the AIDS Epidemic: Cross-cultural Perspectives on HIV/AIDS Education. Trenton, New Jersey: Africa World Press. pp. 217–218. ISBN 978-0-86543-527-8.
  6. ↑ Stolberg, Sheryl Gay (August 8, 1999). "Black Mothers' Mortality Rate Under Scrutiny". New York City, New York: The New York Times. Retrieved 2 August 2016.
  7. ↑ Quindlen, Anna (June 13, 1994). "Requiring AIDS testing of moms is wrong". Santa Cruz, California: The Santa Cruz Sentinel (Reprinted from The New York Times). p. 13. Retrieved 2 August 2016 – via Newspapers.com.
  8. ↑ "Dr. Janet Louise Mitchell Is Married". New York City, New York: The New York Times. December 21, 1991. Retrieved 2 August 2016.
  9. ↑ Scott, David; Mabrey, Vicki; Sherwood, Roxanna (July 5, 2007). "Adding Insult to Injury: Alzheimer's Patient Loses Home". New York City, New York: ABC News. Archived from the original on August 28, 2007. Retrieved 2 August 2016.
  10. ↑ "MHC Medical Pioneers Featured in National Exhibit". Mount Holyoke Alumnae Quarterly. South Hadley, Massachusetts: Mount Holyoke College. 90 (3): 32. Fall 2006. Retrieved 2 August 2016.
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