Listen Up, America. Now is the Time to Address Racism in our Healthcare System
by Brittney Gedeon, Rising Junior and Presidential Scholar at Boston College and MHQP Summer Intern
(June 8, 2020)
The senseless death of George Floyd at the hands of four police officers in Minneapolis has shocked and outraged millions of people throughout the country. As a nation, we should condemn the racial injustices we see in policing and support those who are out on the streets in every state of this great country, voicing their frustrations about the systemic racism that affects every facet of our lives.
At the same time we are mourning the life lost due to excessive police force, we are still entrenched in the public health crisis created by COVID-19, which has taken over 100,000 lives and counting in this country. We have seen great loss of life in Black and brown communities, as Black Americans are twice as likely to die from the virus in comparison to their White counterparts (Mays & Newman, 2020). The astonishing disparities we see in mortality rates from COVID-19 emphasize how social determinants spur such inequities in health outcomes and also shines a harsh light on the racism that is deeply embedded in our current healthcare system. While COVID-19 is a devastating worldwide public health crisis, we must address racism as a public health issue that affects Black, Latinx, and Indigenous communities.
The disparities we see in Black and White communities are not unique to just COVID-19, but are seen in many different cancers, cardiovascular and kidney diseases. According to the American Cancer Society, Black women are 42% more likely to die from breast cancer than White women and are more likely to be diagnosed earlier in their lives with a more aggressive form of disease (Williams et al., 2016). Black Americans are twice as likely as Whites to die from preventable heart conditions and strokes (Ferdinand et al, 2017). According to the American Diabetes Association, Black adults have a 77% increased risk of developing type-2 diabetes in comparison to Whites (Meng et al., 2016). These are just a few of the numerous jarring statistics from hundreds of epidemiological studies highlighting the health disparities between White and Black people in this country.
To address the health disparities we see in our country, we must make healthcare more accessible and affordable to everyone. In 2013, Black households in America on average made 59 cents for every White household (Williams et al., 2016). Because of this substantial socioeconomic disadvantage, many Blacks cannot afford the high costs of important screenings and procedures. Even if they are insured, there may be high prescription, deductibles, or surgical costs that are not fully covered by insurance. Many Black Americans have to make the tough decision to either go deep into debt in order to undergo procedures and treatments for aggressive cancers and diseases, or to risk their health. No American, Black or White, should have to make this choice of life and death for financial reasons. We must make healthcare equitable and affordable for all people.
Systemic barriers that have persisted from decades of racial oppression also contribute to disparities in health outcomes for Black Americans. Some Black patients in this country do not trust their doctors, partly due to the legacy left by the infamous Tuskegee Syphilis Study. In this case, hundreds of black patients were misled for about 40 years by doctors and nurses who knowingly failed to give them treatment for an illness that was treatable, leading to many preventable deaths. While the study ended in 1972, it still stands as an important event in the history of healthcare in America, leading to some not completely trusting their doctors. Mistrust leads to not listening to medical advice, not following up on appointments, and not filling prescriptions, all important factors that contribute to various health complications.
Additionally, the suboptimal care that Black patients receive can be due to the conscious or unconscious biases that physicians hold. Some physicians assume that their Black patients lack health knowledge and are therefore less likely to recommend preventative screenings such as mammograms and smoking cessation programs (Feagin & Bennefield, 2014). Black patients are also less likely to receive quality pain management due to physicians taking their assessment of pain too lightly and not accurately recording it (Feagin & Bennefield, 2014). If physicians do not recognize the biases they have, Black Americans will continue to have second-rate healthcare that neglects their physical and mental wellness.
The racial injustices we have witnessed recently are not at all unique to our criminal justice system. They are deeply ingrained in every corner of our society, including healthcare. To fix the disheartening disparities in healthcare in this country, patients, physicians, and policy makers must work together to create a system that roots out systemic racism, so we can reach people of all walks of life, not just the privileged few. Additionally, we must address the cultural racism and biases that we hold, so we can truly understand each other on a deeper level, and know that no matter where we come from, we all want to lead happy, and healthy lives.