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March 02, 2021 | Farah Jassawalla

Racism in America’s Care Delivery

Cura4U aims to provide fair and impartial healthcare to all its customers. As an organization, we are aware of the shortcomings in our system and aim to address them.

 America’s healthcare system has its faults, ranging from the internal to the external, and one of the issues plaguing it is racism in healthcare provision and the treatment of people of color within the healthcare circuit itself. Racism is very much relevant today to the way the system operates.

In the context of the pandemic, the virus impacted African Americans harder than the rest of the population. According to amfAR, nearly 58% of CoVid-19 deaths are from 22% of U.S counties that are black. CDC found that 33% of the hospitalized patients were black even though they constituted 18% of the community being tested.

While it has been suggested that disproportion is due to factors like urban conditions of African Americans, working at riskier occupations, limited access to healthcare, and underlying health conditions – there are other elements at play.

However, it must be noted that similar inequalities are mirrored in African American communities that have better access to healthcare and hail from upper economic classes. Reports indicate that a massive number of cases rose out of Maryland, which is home to the wealthiest section of the African American community. In comparison, caucasian communities were relatively unaffected. In a similar vein, Latinos are twice as likely to die from CoVid than caucasian people (Medical News Today).

This elevated risk for people of color in America is also true besides CoVid 19. It is well-known that African American women are more than twice as likely to die from childbirth in comparison to Caucasian women (The News). And even these women were wealthy and educated, and they were more likely to die from childbirth than poor and uneducated white women (Howland et al.).

Moreover, it has been found that healthcare workers belonging to marginalized communities were reluctant to address concerns about CoVid testing and lack of personal protective gear in the early stages of the pandemic (Public Health Report).

The Ways Racism Impacts Healthcare

The existence of racism in the healthcare system can lead to doctors neglecting and actively discriminating against patients.

  • Treatment of pain: A study conducted in 2016 found that white medical students believe that black people have a higher tolerance of pain than white people. Nearly 73% of the sample also held one false belief about biological differences between white and black people, such as black people having stronger immune systems and thicker skin.

This leads to dismissal of pain, as a study reveals whereby black children with appendicitis are less likely to be treated swiftly and adeptly in comparison to white people (Hoffman et al.).

  • Emergency care: There is evidence that suggests that racial bias also prevents POC from receiving swift emergency care. According to Frontiers in Pediatrics, doctors in emergency departments tend to discriminate in their treatment of trauma patients.

While the study does not examine the causes, it found that doctors are less likely to classify black and Latino children as requiring emergency care, admitting them to the hospital after receiving it, and order blood tests, CT scans, or X-rays for these children (Zhangu et al.). On the other hand, it has been found that between 2005 to 2016, doctors were 10% less likely to admit a black patient to the hospital in comparison to white patients.

  • Pregnancy: There are racial disparities between groups in terms of infant mortalities and the care of pregnant people. Black people tend to face higher risks in pregnancy than white people.
  • Chronic Illness: Chronic illnesses severely impact the quality of people’s lives. A study conducted in 2019 found that black people between the ages of 51 and 55 were 28% more likely to have chronic illnesses in comparison to white people. In addition, Latino people in the same age bracket also accumulated chronic illness faster than white people. There may be several reasons for this, ranging from chronic stress to lower rates of insurance coverage.
  • Addiction: Asian Americans may be underdiagnosed in alcohol dependence. Doctors are less likely to diagnose Asian Americans with alcohol addiction in comparison to white people. This is primarily due to the model minority stereotype, which sees Asian Americans as self-reliant. This bias may prevent the minority from getting the help they need.

However, it must be noted that healthcare inequalities are also influenced by a range of other factors.

Other reasons for inequalities 

  • Economic Reasons: Racism has a profound impact on the mental and physical health of people of color. It can also make it difficult for people to access healthcare services. There is heavy evidence of healthcare inequity put forth by the U.S. Department of Healthcare Services.

In general, black people have lower average life expectancies than white people. Black men and women also have higher blood pressure in comparison to their white counterparts. In addition, there are lower rates of influenza vaccination amongst black and Latino people – with only 60% getting the vaccination in comparison to caucasian people’s 70%. Furthermore, Asian Americans, Latinos, and Black people experience a greater strain on mental health and increased stress, anxiety, and depression on a larger scale. These disparities are influenced by economic inequalities, which makes it difficult for people to get health insurance and freer access to medical care.

  • Issues of location: Neighbourhoods that have a dense population of POC, particularly black people, tend to have lower access to healthcare because of short-staffing. A study conducted on residential segregation and the availability of primary care physicians found that neighborhoods with predominantly black zip-codes were 67% more likely to have a shortage of primary care physicians (Gaskin et al.).   

Cura4U and Healthcare

Healthcare provided by Cura4U is meant to be fair for all. The company aims to be equitable and impartial in its treatment of all patients, extending quality healthcare to all people.  

References:

https://www.ama-assn.org/delivering-care/population-care/why-african-american-communities-are-being-hit-hard-covid-19

https://www.nbcnews.com/health/womens-health/u-s-finally-has-better-maternal-mortality-data-black-mothers-n1125896

https://link.springer.com/article/10.1007/s10995-018-2682-z

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3416972/

https://www.pnas.org/content/113/16/4296

https://www.frontiersin.org/articles/10.3389/fped.2019.00525/full

Farah Jassawalla

Farah Jassawalla is a graduate of the Lahore School of Economics. She is also a writer, and a healthcare enthusiast, having closely observed case studies while working with Lahore's thriving general physicians at their clinics.