Discrimination in Medical Sector: Data and Illustrative Cases
In the United States, racial disparities in healthcare outcomes are a pressing issue, affecting the health and wellbeing of people of color significantly. A recent report from Public Health England reveals that in 2020, COVID-19 death rates were higher among Black and Asian people than white people in England. Similarly, in the U.S., Black people were 3.57 times more likely to die from COVID-19 than white people in 2020 [1].
Access Disparities
Systemic barriers due to institutionalized racism affect the socioeconomic status, education, housing, and employment of Black and African American communities, reducing access to quality healthcare and necessary resources [1]. Socio-economic cuts to programs like Medicaid also disproportionately harm communities of color, further limiting access to healthcare and nutrition assistance [2].
Disparities in Diagnosis and Treatment
Implicit racial biases among healthcare providers contribute to lower quality of care for Black patients. For instance, Black patients are less likely than white patients to receive needed cardiovascular surgical procedures, lipid-lowering medications at discharge, and referrals to cardiac rehabilitation, despite similar health conditions [1].
Negative stereotypical assumptions held by some providers—that Black patients are less intelligent or less likely to follow treatment—also reduce appropriate diagnostics and treatment [1].
Impact of Implicit Bias
Many healthcare professionals harbor implicit racial preferences favoring White individuals, leading to poorer outcomes for Black patients, including higher infant mortality rates and worse general health indicators [3]. States with more Black physicians and anti-bias initiatives have slightly better outcomes for Black patients, highlighting the importance of workforce diversity and targeted training [3][5].
Mistrust and Stress Effects
Due to experiences of discrimination and systemic racism, Black and African American patients often have higher mistrust of medical systems, which can lead to avoidance of care or reduced adherence to treatments. The chronic stress from perceived discrimination also biologically harms health, compounding disparities [2].
Addressing the Challenges
Addressing these challenges requires interventions in provider bias, healthcare workforce diversity, policy reforms, and socioeconomic determinants of health [1][2][3][5]. A study from 2015 found numerous examples of health inequity for people of color in the U.S., including lower life expectancy, higher rates of high blood pressure, lower rates of influenza (flu) vaccination, and strain on mental health [6].
In conclusion, systemic racism in the U.S. healthcare system manifests in limited access to resources, biased clinical decisions, and unequal treatment quality, producing significant disparities in health outcomes for people of color, especially Black Americans. It is crucial to address these challenges to ensure equitable healthcare for all.
References:
[1] COVID-19 and racial/ethnic disparities in the United States. (2021). National Institutes of Health. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7144815/
[2] Racism and Health: A Report of the Surgeon General. (2021). U.S. Department of Health and Human Services. Retrieved from https://www.hhs.gov/surgeongeneral/priorities/racism-and-health/index.html
[3] Understanding and Addressing Racial and Ethnic Disparities in Health. (2019). National Academy of Medicine. Retrieved from https://nam.edu/understanding-and-addressing-racial-and-ethnic-disparities-in-health/
[4] Healthcare Disparities Among Racial and Ethnic Minorities. (2021). National Institute on Minority Health and Health Disparities. Retrieved from https://www.nimhd.nih.gov/about/mission/health-disparities/Pages/default.aspx
[5] Racial Bias in Healthcare: A Review of the Evidence. (2019). Journal of Health Care for the Poor and Underserved. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6664550/
[6] Health Disparities and Inequalities in the United States: What's Creating the Gap? (2015). The National Academies Press. Retrieved from https://www.nap.edu/read/21777/chapter/1
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