Patient Discrimination and Inequality Issue in Healthcare

Introduction

Every healthcare professional is expected to care for everyone that comes through his or her door, and “above all, do no harm. ” However, not every healthcare professional may realize they are causing harm; by discriminating minority patients. Receiving poor health care can vary from reason to reason, the patient could be too gone to save, a person of color, or a high school dropout. In our American society, we tend to believe that we are all free of biases when it is at the hand of treating people the same as us, or different from us.

We like to take pride in being an “open society” where we treat everyone equally. That is not the case, and as we move forward as a society and a community, we need to become more aware of the racial discrimination that is happening around us. In 2017, TIME published Racism is Part of the Health Care Debate, by Dr. Sandro Galea, which outlines the most recent health care events with the past presidential election and its effect on the U.

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S. population, as well as healthcare for people of color, and minorities. “While doctors can no longer legally turn patients away because of race, pernicious gaps in treatment continue to undermine the health of black populations” (Galea, n. p. ).

Injustice and Discrimination in Healthcare

The nation’s conversation about health, and healthcare, rarely ever acknowledges how injustice shapes the health of communities. We are culturally conditioned to think of poor health as being a consequence of a poor decision because of how we view health.

We view health as being fitness, doctor’s office visits, and the amount of medicine we take in. We only see health as being our individual behavior, and our lifestyle. Unhealthy populations are linked to those who live in poverty, primarily the reason being, they cannot afford to see the doctor, and they will experience harsh racism that will prevent them from receiving the care they deserve. “Am I saying that in order to have healthy populations, we must somehow cure racism and poverty? That we must change our society at the structural level, shifting entrenched norms, often in the face of powerful political resistance? Yes, I am” (Galea, n. p). Galea told a story of a black man named Blind Willie Johnson who caught malaria and refused to go to the hospital because he was black and would not receive care no matter how sick he was. Johnson eventually died, but if he had received care, and became well again, he would have had to return to the same conditions in which he caught malaria in the first place. If somehow our wellbeing dramatically improves, if there is still marginalized groups at a disproportionate risk of preventable diseases and problems, we have failed to meet our obligations to one another.

Access to Healthcare by Those in Poverty and Minorities

Author Rose Weitz dives deeper into poverty and illnesses, in her book The Sociology of Health, Illness, and Health Care. “One important reason why poorer persons suffer worse health than do wealthier persons is because poorer persons experience more stress and have less control over that stress” (Weitz, 52-53). Stress amplifies health risks in everyday aspects of lower-class life. Work available for poorly educated people can cause illnesses and even death. As well as their jobs, their environmental conditions also give way to poor health. “Chemical, air, and noise pollution all occur more often in poor neighborhoods than in wealthier neighborhoods both because the cheap rents in neighborhoods blighted by pollution attract poor people and because poor people lack the money, votes, and social influence needed to keep polluting industries, waste dumps, and freeways out of their neighborhoods” (Weitz, 53). The pollution in these neighborhoods can cause cancer, leukemia, high blood pressure, and other health problems. Yet, 52 percent are less likely to visit the doctor due to the fear of prejudice doctors and nursing staffs (Weitz, 57). Doctors are less likely to refer African American people to transplant programs, put them on a transplant waiting list, and more often than not reject African Americans as transplant patients because “they lack transportation to hospitals and aftercare facilities” (Weitz, 57).

This is race-based medicine. Which is also racism at its finest, people of color are less likely to receive health care due to their skin color. Dorothy E. Roberts covers all of the problems surrounding racial discrimination when it comes to medicine in her article, Is Race-Based Medicine Good for Us? : African American Approaches to Race, Biomedicine, and Equality. Throughout her article, she compares the many instances where the use of race in medicine have been detrimental, and a few where it was somewhat beneficial to the patient. Roberts explains how the use of race in medicine to address differences in communities does not look at the social and environmental causes of why certain diseases affect certain races more than others. She views this as a way of legitimizing race in biology even though it is purely constructed (Roberts, 538). Roberts writes about the ways that race was used as a way of uplifting some while hindering and mistreating others, and the effects of these practices on our society today. “By making black people’s subordinated status seem natural this view provides a ready logic for the staggering disenfranchisement of black citizens, as well as the perfect complement to colorblind social policies” (Roberts, 539). By having race so engraved in our society, Roberts suggests that we are blind to the institutional racism that negatively impacts people that belong to certain races, which then leads to our society not questioning the validity of race in medical science.

The Occurance of Rase-Based Discrimination in Healthcare

In the article, Perceptions of Race/Ethnicity-Based Discrimination: A Review of Measures and Evaluation of Their Usefulness for the Health Care Setting written by Nancy Kressin, Kristal Raymond, and Merideth Manze, study the perceptions of discrimination held by minority groups, primarily African Americans, from health care providers. The main goal of the study was to figure out whether or not discrimination occurs and its effect on the patients’ treatment from their providers. Three levels of racism were used as measures to record discrimination, which were personally meditated, institutionalized, and internalized racism (Kressin, Raymond, & Manze, n. p). Their main focus for the study was personally meditated, which was as subtle as not giving certain patients the full scope of treatment plans due to beliefs and stereotyping. “The perceived instances of discrimination included disrespect, being given poorer service in general and being treated with less courtesy than was given to members of other races, being treated as incompetent, and as being disliked by the provider (Kressin, Raymond, & Manze, n. p). It was proven that everyday discrimination had a greater impact on the health status of the patient than less frequent but major instances of discrimination.

All of these findings led to the acknowledgment that racism and discrimination by healthcare providers is an ongoing issue that affects the overall health of the patients In the article, Perceived Discrimination in U. S. Healthcare: Charting the Effects of Key Social Characteristics Within and Across Racial Groups written by Corey Abramson, Manata Hashemi, and Martin Sanchez-Jankowski outlines race shaping perceived discrimination net of other factors, accountability by an individual and the system, and interaction with providers have a powerful effect on perceptions of discrimination. “Health services researchers have increasingly recognized the importance of directly examining the effect of psychosocial pathways—in particular examining the direct and indirect influence of prejudice, stereotyping and discrimination in clinical encounters, experience, health behaviors and health” (Abramson, Hashemi, & Sanchez-Jankowski n. p). Negative perceptions healthcare in general, and perceptions of discrimination in general, influence how and when people seek care, whether they engage in health protective behaviors, their willingness to follow medical advice and their levels of psychological distress, self-esteem, and mental health (Abramson, Hashemi, & Sanchez-Jankowski, n. p).

The Effects of Discrimination in Healthcare on a Person

Discrimination shapes the way an individual will identify with healthcare, the Institute of Medicine said in 2003 that in the United States minorities will receive worse care than their white counterparts. Abramson, Hashemi, and Sanchez-Jankowski conducted a survey in California to see which races in the randomized database received the most discrimination. Before other factors were included such as; level of education, emergency room visits, adjusted income, and being in worse health were each associated with increased perceptions of racial discrimination. 9. 7 percent of African Americans, 8. 1 percent of Native Americans, and 7. 5 percent of Hispanics believed they would have received better medical care if they had been a different race, while 2. 3 percent of whites had reported the same. “On average those who reported having a hard time understanding the doctor were roughly 4. 5 times more likely to report being the target of racial discrimination” (Abramson, Hashemi, & Sanchez-Jankowski, n. p). Regardless of what social and economic factors that surround someone, receiving poor healthcare due to discrimination, is not something that anyone should stand for.

So many factors play into the healthcare field and whether or not a patient will receive decent attention from their trusted provider, income, education, race, ethnicity, religion, and many other factors when in reality the only factor should be their health. In the United States, Americans talk about healthcare. Healthcare has become increasingly more talked about with this past presidential election and years passed. Thousands upon thousands of Americans fear the loss of their healthcare insurance and providers. However, what we do not come to think of is those who fear going to the doctor to become racially discriminated against. While not every patient who visits the doctor is going to experience racism, vast majorities already have, which is where Roberts talks about her race-based medicine. African Americans are less likely to be considered for anything related to transplants due to several stereotypes behind their skin color. 9. 7 percent of African Americans in California stated they would have received better medical care if they had been another race. Science has shown that every human is made up of the same genes, yet we still do not receive the same kind of medical attention as our white counterparts.

Conclusion

Several factors lie around discrimination in the medical field. In addition, these factors are only prevalent when compared between racial groups, not every factor is the same for each race. Each race has different factors related to education, income, and health statistics, which is shown in the Abramson, Hashemi, and Sanchez-Jankowski study, and how that relates to their discrimination levels. Our doctor’s office is supposed to be a safe place where we can trust our provider with our information and we trust them to care for us in the best way that they possibly can. Yet not every human being receives this respect. Resolving this issue in hospitals and doctor’s office alike is not an easy task. One cannot be forced into respecting anyone, but a doctor cannot turn a patient away for their own personal reasons. The resolution lies with helping those in poverty come out of poverty to become healthier and to prevent hazards. As well as fixing the raging issue of racism in America.