With the presence of the Black Lives Matter movement in recent years, a topic that has become more relevant for public discussion is the disparity present in healthcare based on race/ethnicity. Different academic studies and personal stories shared by individuals demonstrate a notable difference in how patients of different races/ethnicities are treated by their doctors. Doctors state that overt racism is not common among individuals that decide to work in healthcare, but it is clear that implicit biases still make their presence known as they can be seen in the statistics of health outcomes of individuals of different races (Penner et al., 2010). Though largely unintentional, racism and discrimination still hold a place in our healthcare systems. So what can be done about it? How can we help healthcare providers recognize and work against their implicit biases and/or aversive racism?
When looking at the COVID pandemic in the United States, a study estimated that Black individuals were 3.57 times more likely to die from the virus than white individuals whereas Latino/Latinx individuals were 2 times as likely to die from the virus compared to white individuals. In general, black males and females also have shorter life expectancies and display higher rates of blood pressure than their white counterparts (Rees, 2020). It is important to consider the stress that is caused by systematic racism, along with the social class separation that is often seen when discussing ethnic minorities. Lower quality of life in relation to these social factors will certainly have an impact on an individual’s health outcomes, but these factors go beyond the topic of this discussion. While it is important to mention the systematic differences that can contribute to health problems within ethnic minorities, the statistics mentioned above are significant enough that they are due at least in part to inadequate healthcare.
Gruman et al. (2017) describe aversive racism as an indirect form of racism in which an individual does not recognize that they are racist or have a prejudiced attitude towards any particular racial or ethnic group. Most doctors (and people in general) would likely not describe themselves as having racist biases but may fall into the trap of aversive racism in which they are not consciously aware of their racially based attitudes or beliefs. After all, most doctors take the Hippocratic oath when graduating from medical school, swearing to do no harm to their patients and to uphold ethical standards. While it may initially seem that there is little to do about changing implicit biases as they operate on an unconscious level, there are methods that researchers suggest could prove helpful in reducing the disparity seen in the healthcare system. Specifically, there appear to be promising short-term effects in reducing bias by making medical professionals aware of the potential effects of implicit bias on health outcomes and medical encounters, along with discussing how to correct the biases that these physicians may hold. When looking to improve outcomes in the long term, researchers mention self-regulatory processes that physicians can engage in to reduce even minor occurrences of racially biased decision-making (Penner et al., 2010).
In summary, racial biases are present in the United State’s healthcare system and they often have a negative impact on the health outcomes of people of color when compared to white individuals. Implicit biases and aversive racism can play a major role in negatively affecting the quality of care that physicians provide, even though they are not consciously aware of these tendencies. With the awareness of this issue though, physicians can make a conscious effort to implement intervention strategies to ensure better care is provided for all individuals. When we become mindful of our human tendencies regarding racially based biases (and biases in general), we can make a deliberate change to make the world a better place for everyone.
References
Gruman, J. A., Schneider, F. W., & Coutts, L. M. (Eds.). (2017). Applied Social Psychology: Understanding and Addressing Social and Practical Problems (3rd ed.). Sage Publications, Inc.
Penner, L. A., Dovidio, J. F., West, T. V., Gaertner, S. L., Albrecht, T. L., Dailey, R. K., & Markova, T. (2010). Aversive racism and medical interactions with black patients: A field study. Journal of Experimental Social Psychology, 46(2), 436–440. https://doi.org/10.1016/j.jesp.2009.11.004
Rees, M. (2020, September 16). Racism in healthcare: Statistics and examples. Medical News Today. Retrieved September 29, 2022, from https://www.medicalnewstoday.com/articles/racism-in-healthcare
Thank you for addressing this very important issue. As I am currently taking a class on health disparities within different sects of the United States population, it has become very alarming to me how prevalent these issues are. As you had mentioned the excess death rate of African Americans from Covid-19, I agree with your point about the stress experiencing racism brings negatively affects the overall health of African Americans. I would also like to add another contributing factor to this disparity- that African Americans also have a stronger distrust of vaccines, making them less likely to become vaccinated for Covid. In late November of 2020, only 14% of Black survey respondents said that they trusted the vaccine (Bajaj et al., 2022). In fact, by July of 2022, African Americans were the race/ethnicity with the lowest percentage being vaccinated against Covis-19 (Hill & Ndugga, 2022). Part of this distrust stems from unethical practices in history such as the Tuskegee experiments where Black men were used without collecting informed consent and without being given proper medical treatment (CDC, 2021). All levels of racism have been prevalent in our country for a long time, and unfortunately continue to negatively impact the health of our minorities in various ways.
Reference:
Bajaj, S. S., Others, S. C. and, S. Honda and T. Kawasaki, & Others, L. T. (2022, September 16). Beyond tuskegee – vaccine distrust and everyday racism: Nejm. New England Journal of Medicine. Retrieved from https://www.nejm.org/doi/full/10.1056/NEJMpv2035827
Centers for Disease Control and Prevention. (2021, April 22). Tuskegee Study – Timeline – CDC – NCHHSTP. Centers for Disease Control and Prevention. Retrieved from https://www.cdc.gov/tuskegee/timeline.htm
Hill, L., & Ndugga, N. (2022, July 14). Latest data on covid-19 vaccinations by race/ethnicity. KFF. Retrieved from https://www.kff.org/coronavirus-covid-19/issue-brief/latest-data-on-covid-19-vaccinations-by-race-ethnicity/
Thank you for this informing post. I have never thought of race of a human being consider in the eyes of health care, in my naive world I would never imagine that the race or income of the individual would be consider when they are in medical need until recently. In recent years I found that African American women are three times more likely to die during childbirth. “Health status found not only that racial identity is independently associated with lack of health insurance but also that “low-income [minority people] with bad health had 68% less odds of being insured than high-income [White people] with good health.” These facts are appalling and the finically status and race of an individual should not stop the lack of care. In my founding many companies are doing trainings and starting the conversation about this issue. Hopefully through increased knowledge and advocacy this problem will continue to decrease of the years.
References
Williams DR, Lawrence JA, Davis BA. Racism and health: evidence and needed research. Annu Rev Public Health. 2019;40:105–25. Crossref, Medline, Google Scholar
3 Yearby R. Structural racism and health disparities: reconfiguring the social determinants of health framework to include the root cause. J Law Med Ethics. 2020;48(3):518–26. Crossref, Medline, Google
Scholar
Gruman, J. A., Schneider, F. W., & Coutts, L. M. (Eds.). (2017). Applied Social Psychology: Understanding and Addressing Social and Practical Problems (3rd ed.). Sage Publications, Inc.
Centers for Disease Control and Prevention. Risk for COVID-19 infection, hospitalization, and death by race/ethnicity [Internet]. Atlanta (GA): CDC 2021 Jul 16 [cited 2021 Dec 10]. Available from: https://www.cdc.gov/coronavirus/2019-ncov/covid-data/investigations-discovery/hospitalization-death-by-race-ethnicity.html Google Scholar
“Black Women over Three Times More Likely to Die in Pregnancy, Postpartum than White Women, New Research Finds.” PRB, https://www.prb.org/resources/black-women-over-three-times-more-likely-to-die-in-pregnancy-postpartum-than-white-women-new-research-finds/.
Hi,
I agree that physicians must make a conscious effort for everyone’s health. A study shows that physicians’ implicit bias affects the quality of relationships with minority patients. Physicians with a great implicit bias toward black patients provide less patient-centered care to black patients (Blair et al., 2013). Proving low quality of care to black patients may lead to less follow-up with their doctors and may lead to less healthy outcomes. So, physicians should be aware of the power of implicit bias and consider implementing interventions to prevent patients from getting long-term adverse effects.
Resources
Blair, I. V., Steiner, J. F., Fairclough, D. L., Hanratty, R., Price, D. W., Hirsh, H. K., Wright, L. A., Bronsert, M., Karimkhani, E., Magid, D. J., & Havranek, E. P. (2013). Clinicians’ implicit ethnic/racial bias and perceptions of care among black and Latino patients. The Annals of Family Medicine, 11(1), 43–52. https://doi.org/10.1370/afm.1442