Systemic racism in healthcare

By Maya Marathe

The discrimination and racism faced by black Americans in the US affects almost all aspects of their lives, including quality of healthcare.  As we gain a more in-depth understanding of the systemic racism that exists in this country, we should be working towards dismantling these systems and moving towards equality. These efforts should also be extended towards the medical field.  

The existence of slavery, and the original American economy’s dependence on it has been the backbone for the development of many of the racist systems that still exist in our country.  The history of racism in healthcare also began with slavery.  White doctors often were not willing to treat slaves.  Even if they were, they followed many popularized misconceptions about the difference in care for slaves and white people.  The dehumanizing nature of slavery led to beliefs that the medical treatment of black people was fundamentally different than that of white people.  This led many to believe incorrectly that black people had a higher pain tolerance, and slaves were often used for medical experimentation. The freeing of slaves and reconstruction efforts had little to no effect on the treatment of black people by doctors, but it did allow for slightly better access to healthcare, though it was still extremely limited.  

  Segregation, redlining, housing discrimination, job discrimination, and the many more policies that forced black people into densly populated, low income areas decreased their access to quality healthcare. In addition, racism from white doctors blaming high black mortality rates on racial differences reduced efforts to combat the problems.  In the late 1800s, black medical schools were being funded which increased the number of black physicians in the US.  Black doctors faced a lot of discrimination back then, and they still do, but they have a very important role. It has been shown that black patients are more likely to trust black physicians, and are more likely to seek preventive care if it is recommended by a black physician.  For this reason, it is so important that we work towards increasing black representation in medicine and help non-black physicians acknowledge and reduce their implicit bias.  

 

All of this history considered, we should have made significant progress since then. However, that doesn’t seem to be the case. Even today, these alarming statistics show how little progress has been made, and action needs to be taken. 
 

  • Black women are 3-4 times more likely to die of a pregnancy related illness or during childbirth than white women. 

  • Black men have a 50% higher premature mortality than white men

  • The infant mortality rate for children of Black mothers is the highest in the US, currently at around 11.11 infant  deaths per 1,000 live births, almost double that of mothers of other races.  

 

Whether or not specific cases are the result of implicit bias on the part of the doctor, or due to other factors, many repeated studies and trials show a clear discrepancy in the outcomes of black people as compared to other races in the US. We should be working to close this gap by addressing the systemic racism in medicine and in other parts of society.  It is long-overdue.  

 

Sources: 

https://www.cdc.gov/nchs/data/hus/hus15.pdf 

https://www.health.harvard.edu/blog/racism-discrimination-health-care-providers-patients-2017011611015 

https://www.ted.com/talks/mary_bassett_why_your_doctor_should_care_about_social_justice/transcript 

https://www.nejm.org/doi/full/10.1056/NEJMe2021693 

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2571643/?page=4