Writer: Manasvi Kattekola
Editor: Adhitya Vasudevan
Healthcare is quite the controversy in the United States. There are plenty of things that are wrong with our system: medical errors, overworked physicians, high costs of treatment, etc etc. But one thing that is vastly overlooked in this whole mess is the part that race plays. Whether we like it or not, discrimination exists in America, primarily towards minority groups. But how do these preconceived notions affect the effectiveness of our healthcare?
According to a study done by the International Socio Economics Laboratory, minority groups are more likely to be dissatisfied by their healthcare experience. They found that black patients are the least satisfied by the wait times in different medical facilities by gathering and comparing 403 responses from residents in New York and Los Angeles, asking for details such as their races, and household incomes, to gain a more holistic picture of their lifestyle. Another recent study done by the University of Pennsylvania shows that 1 in 10 black patients admitted that their race negatively affected their healthcare in comparison to the 2 in 100 white patients that said the same thing. Black people are more likely to rate their local healthcare facilities as fair or poor in comparison to white people.
According to David R. Williams, “Throughout the history of the United States, non-dominant racial groups have, either by law or custom, received inferior treatment in major societal institutions. Medical care is no exception.” A study done by AMJ Public Health shows that 14/15 studies indicate that healthcare workers have low- to moderate biases against people of color. In these studies, around 42-100% of the members had biases against primarily black people. The research was collected by searching numerous databases that measured healthcare worker’s implicit biases towards patients, and then comparing and calculating the implicit biases found in all of them. According to another study, white medical students were more likely to assume that black patients had “thicker skin and smaller brains” and that they were less prone to pain than others. Even medical students have the same biases. A survey given to over 4,500 students from 49 different allopathic medical schools shows that 74% hold implicit racial biases against racial minorities.
Racial biases like this can stop black Americans and other people of color from getting the proper healthcare they need. Implicit bias towards certain groups of people negatively affects the quality of their healthcare experience, leads to poorer communication between the patient and the provider, and lower prescriptions of narcotics and other painkillers than necessary. This is due to the fact that medical providers often do not proceed with the best intentions of the patient in mind if they have internal biases. A study consisting of 3,756 students from 49 US medical schools showed that the higher the measured biases they had, the lower their student intentions to provide adequate care for those who they had biases against.
Because most of these prejudices originate from the racial disparities in society, not much will change until the U.S’s racial climate cools down. Certain measures can be taken however to minimize the amount of inconvenience people of color face from the healthcare system. Some suggest additional research on people of color, to avoid any undercoverage bias which might result in people of color not getting adequate care. Other interventions also include medical students taking a required class on prejudice and its effects on healthcare, and lessening the cognitive load on healthcare providers, as that leads them to take less biased decisions. All of these are well thought out solutions that can benefit everyone. But the main issue is the mindset of healthcare providers, and that mindset can’t be changed by these interventions alone. In the end, it is up to the healthcare providers themselves to make sure not to harbor any negative biases that might affect a patient's healthcare experience.
Citations
Caballo , Brian, et al. "The Effects of Socioeconomic Status on the Quality and Accessibility of Healthcare Services." Across the Spectrum of Socioeconomics, vol. 1, no. 4, 2021, p. 15, https://doi.org/10.5281/zenodo.4740684.
Tachibana, Chris. "Text Messages to Ask Patients About Health Care Experiences." University of Pennsylvania, 1 Feb. 2023, ldi.upenn.edu/our-work/research-updates/text-messages-to-ask-patients-about-health-care-experiences/#:~:text=In%20U.S.%20health%20care%2C%20the,is%20associated%20with%20higher%20mortality.
Becker, Gay, and Edwina Newsom. “Socioeconomic status and dissatisfaction with health care among chronically ill African Americans.” American journal of public health vol. 93,5 (2003): 742-8. doi:10.2105/ajph.93.5.742
Williams, D R, and T D Rucker. “Understanding and addressing racial disparities in health care.” Health care financing review vol. 21,4 (2000): 75-90.
Hall, William J et al. “Implicit Racial/Ethnic Bias Among Health Care Professionals and Its Influence on Health Care Outcomes: A Systematic Review.” American journal of public health vol. 105,12 (2015): e60-76. doi:10.2105/AJPH.2015.302903
Vela, Monica B et al. “Eliminating Explicit and Implicit Biases in Health Care: Evidence and Research Needs.” Annual review of public health vol. 43 (2022): 477-501. doi:10.1146/annurev-publhealth-052620-103528
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