March 10, 2023
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Floyd’s death, as well as the many that have occured before and after, have continued to highlight the dangerous and violent racism that persists in the USA today. For years, the Black Lives Matter movement has demanded the government to address the structural racism that is ingrained in the USA. One area that is critical to address is the healthcare system, the result of which has led to staggering disparities in health between Black and White Americans.
The racism that Black American communities experience with healthcare is extensive and occurs on all levels from its accessibility to the quality of care and even its direct implications on health. The evidence is clear, however action to address these issues is lacking. In Chicago, there exists a 30 year gap in the life expectancies between black and white citizens living there depending on their ZIP code. In a neighborhood that is predominantly white, life expectancy is around 90 years old, while in another neighborhood that is predominantly black, the average life expectancy is as low as 60 years old. It is vital that the USA address the structural racism that exists in its healthcare system so that Black American communities can begin to rebuild their health and wellbeing.
To begin, it’s important to acknowledge the toll that experiencing racism has on the body and mind. The day-to-day racism that many experience can lead to chronic stress, resulting in elevated blood pressure and weakened immune system which increases the risk of chronic diseases. The violence that black communities experience due to racism also has severe implications for mental health, increasing rates of PTSD, depression, anxiety and more. The impact racism has on one’s body is further compounded by the experiences black individuals encounter when they seek out healthcare.
Although access to health insurance coverage has improved due to the Affordable Care Act, coverage rates remain lower as people of color are more likely to live in low-income families that do not have employer-coverage or are unable to afford private coverage. While Medicaid has been able to cover some of those gaps, many states have created policies that limit its reach, leaving many uninsured or under-insured.
For those that do have insurance, an additional barrier exists to accessing healthcare. Due to resident segregation, a result of Jim Crow laws, redlining, and many other racist policies, areas that are predominantly black are more likely to lack hospitals and other healthcare providers, especially when it comes to primary care and mental health.
The quality of care that Black Americans experience is also vastly different to what white Americans might experience. Implicit bias is rampant in the healthcare system, which can have dangerous implications. One in particular is the bias that black Americans have a higher pain tolerance, a misconception that was born from slavery. As their pains and concerns are not taken seriously, this can mean that a serious issue and the pain they experience can go untreated.
Furthermore, the quality of treatment can be much poorer. A study in the USA revealed that black patients with heart disease were more likely to receive older, cheaper and more conservative treatments than their white counterparts. They were also more likely to be discharged earlier from the hospital, before it was safe for them to leave. A recent survey has shown that 56% reported they had at least one negative experience when seeking care, where either they had to speak up to get proper care or were treated with less respect than other patients.
Due to the culmination of these factors, the health outcomes of black Americans can be significantly poorer. Black Americans are more likely to die from cancer and heart disease and black women are three times more likely to die of pregnancy-related causes than white women. The mortality rate for black children is twice the rate for white infants. Statistics like these are inexcusable and the US government needs to act immediately. While this article has focused on healthcare, it is important to mention that when addressing health disparities, policies must further expand to the social determinants of health. This refers to the wealth gap, poor education, poverty, household income inequality, food insecurity and lack of safe and affordable housing that predominantly impacts black communities and exacerbates health disparities.
In recognition of George Floyd and the Black Lives Matter movement, Doctors of the World will continue to use its platform to fight for health equity and to challenge the current discriminatory healthcare practices that occur to this day. Healthcare is a human right and must be made equal and accessible to all regardless of race, nationality, gender, or sexual orientation.
Black Americans’ views about health disparities, experiences with health care| Pew Research Center
Health Coverage by Race and Ethnicity, 2010-2019 | KFF
How Systemic Racism Continues To Determine Black Health And Wealth In Chicago | NPR
How we fail black patients in pain | AAMC
Racism, Inequality, and Health Care for African Americans | The Century Foundation
What are the effects of racism on health and mental health | Medical News Today