Running head: RACIAL ISSUES WITHIN HEALTHCARE 1

SOLVING AMERICA’S RACIAL ISSUES WITHIN THE HEALTHCARE SYSTEM

Pamela Avila

Arizona State University

SOLVING AMERICA’S RACIAL ISSUES WITHIN THE HEALTHCARE SYSTEM 2

Abstract

This essay entails the racial issues appearing in the healthcare system. The conflict is introduced

through an explanation of past racism in America and its hidden existence in today’s day and

age. Counter arguments included the belief of other factors taking responsibility for the health

disparities of African Americans and the lack of an accurate tool to measure racism. These

arguments were refuted by a three-scale measuring tool and the acknowledgement of healthcare

being one of the factors responsible for premature deaths of black Americans. Racism in

healthcare acted as the conflict, the poor health of African Americans acted as the effect, and the

solutions were not forgotten but instead proposed in the completion of this essay.

Keywords​: racism, black Americans, African Americans, healthcare, medical professionals

SOLVING AMERICA’S RACIAL ISSUES WITHIN THE HEALTHCARE SYSTEM 3

Solving America’s Racial Issues Within The Healthcare System

In recent discussions of discrimination in America, a controversial issue has been

whether racism occurs within the healthcare system. On the one hand, some argue that there are

other factors resulting in the premature deaths of black people and if racism is occurring, it can’t

be properly measured. On the other hand, however, others argue that racism is present in the

United States, especially the healthcare system, and that it must be measured to find solutions to

this conflict. When it comes to this issue, attention must be paid to the past, present, and future.

My opinion is that racism within the healthcare system has decreased since earlier years but it

continues to exist and without proper way to measure its effect then it will be negatively

affecting the health of future black Americans.

For decades, America has been operating in a racist system that has taken a toll on the

lives of black Americans. Their emotional, physical, and social well-being was affected by the

recurring discriminatory events throughout these years. Despite historical milestones such as

Brown vs. Board of Education, the Montgomery Bus Boycott, the Civil Rights Act of 1964 and

many more, there continues to be a visible difference between the lives of black and white

Americans in this country. Taking a closer look into systemic racism within areas of our society,

such as the American health system, may provide a transition into a time of minimal

discrimination in the United States. A glimpse at medical centers around the country may have

less preventive medical treatment, low-quality care, communication conflicts, relation of

negative terms regarding black patients and similar issues. This may be one of the reasons for the

conflicting racial biases medical carriers take on. Throughout this essay one may take on the
SOLVING AMERICA’S RACIAL ISSUES WITHIN THE HEALTHCARE SYSTEM 4

view that there are other factors affecting the health of black Americans such as housing,

income, education, and unemployment. Another argument that is presented is that racism is

difficult to measure and forcing an inaccurate measuring tool may lead to mistaking evidence of

racism.

A proportion of our population believes the negative influence on the lives of African

Americans is not due to racially biased treatment from medical providers but instead includes

factors such as unemployment, income, education, and residential areas. Living in a residential

area that reflects one’s economic status has the ability to influence the support given to

low-income households, which was seen in a study done with Philadelphia residents over a ten

year period. During this period of time, the study concluded that physician offices where less

reliant to the families, leading to the difference in health between black and white communities

depending on their income (Hussein, 2016). The education one receives in their earlier years of

life will have an effect on the field of work they reside in, which eventually decides their salary.

Salary ends up deciding the level of expertise people receive and more specifically whether or

not you can depend on your physician. Some believe minorities and black communities are not

experiencing racism but instead are subject to the medical care low income groups receive.

Contrary to this belief, it is seen that the same factors stated above affect the dependence

on physicians but do not take responsibility for all of the health disparities in black communities.

In the same study by Hessein (2016), “a low-income neighborhood was associated with lower

reliance on physician offices by ∼4 percentage points”, meaning this concept exists but not to an

extreme point. Being in a low-income family can influence the health of black Americans.This is

a factor that compensates for some but not all statistics displaying the premature deaths
SOLVING AMERICA’S RACIAL ISSUES WITHIN THE HEALTHCARE SYSTEM 5

happening around the country, meaning that if statistically residential segregation was to be

erased, income and education between blacks and whites would decrease by about two-thirds,

with one-third still unaccounted for (Williams 2016). That one-third is most likely a result of

biases held by medical providers in experiences that include “stressful interactions with all levels

of staff, unmet information needs, and inconsistent social support” (Mclemore, 2018). The

counterclaim stating there are other factors which result in the health differences between black

and white Americans are true but only to a point; other data suggests that African Americans are

indeed subject to racial biases by medical providers which is a reflection of the societal biases

that are held by people in America but not acknowledged.

On behalf of the groups arguing against the living concept of racism in healthcare, they

describe racism to be immeasurable due to the numerous interpretations of “racist behavior”.

Jesse Singal’s article on implicit association tests (IAT) examines biases held by people through

an algorithm which is formed from the results from the test. The conflict stated by Signal is that

the IAT changed from 48% to 27%, with “this change being due solely to the researchers’

change in definitions.”(n.d.). The test shows that experimenters have not yet found the testing

methods to accurately represent the implicit biases held by people. The change in definitions and

implicit bias correspond to the doubts held by the people who refuse to believe medical

professionals hold racial biases.

Although this is a rational counterargument, Doctor David R. Williams has found a

possible way to measure racism through the use of three scales. The first scale focuses on the

occurrences black Americans face that are considered significant which include being fired for

unfair purposes, being stopped by the police, or in medical-related cases, putting the health of a
SOLVING AMERICA’S RACIAL ISSUES WITHIN THE HEALTHCARE SYSTEM 6

person at risk. For the second scale, also referred to as the Everyday Discrimination Scale,

Doctor Williams recognizes the less far reaching but not less prominent occurrences. This scale

“captures experiences like where you're treated with less courtesy than others, you receive poorer

service than others in restaurants or stores, or people act as if they're afraid of you”,

apprehending components such as respect and dignity as well as attitude that differ between

blacks and whites (2016). The third and final scale recognizes the perspective of racism in a

larger more influential level, one that is affecting all African Americans, known as institutional

racism. This includes the residential segregation which determines the safety, education,

employment and ideas relating to stereotypes. With the data provided from the three scales

Doctor R. Williams considers them evidence that is more than suitable for the measuring of

racism.

Given these points one should be able to recognize that racism is affecting the lives of

African Americans in medical facilities regardless of other factors and that there is not one but

three scales established by Doctor William with the sole purpose of measuring racism. Now that

these points have been demonstrated the means of finding racism in healthcare to be true, what

will be evaluated next is the conflict. In the words of Yancy C., the problem begins with “the

general awkwardness surrounding racial issues in our society bleeds into medicine”, in other

words the discussion of racial biases within the healthcare field reflects our society’s refusal to

speak on racism in the United States. While medical professionals are not talking on what is

currently happening in healthcare facilities, the negative circumstances which black patients are

under will continue. An example of this comes from a study done by the University of Virginia,

which found that black Americans are under-treated for pain because a number of medical
SOLVING AMERICA’S RACIAL ISSUES WITHIN THE HEALTHCARE SYSTEM 7

students/residents held beliefs about biological differences between black and white people

(Williams, 2016). Although medical providers may not purposefully be racist towards black

people, there is unintentional discrimination done by these same individuals. With this in mind,

the lack of discussion will prevent acknowledgement, understanding, and solution to the

problem.

All conflicts include negative effects, and within this argument the effects of racism

contribute to the health disparities betweenAfrican Americans and white Americans. This is

shown in primary, secondary, and tertiary care which includes numbers of medical providers

with varying services. In obstetric care, it is said that African American women are more likely

to lose their child in the first year of life compared than any other race or ethnicity. When

speaking in general and not about a particular specialty, it is said that “every 7 minutes a black

person dies prematurely in the United States” (Williams, 2016). This statistic represents the

negative outcomes that come with racial bias existing in medical care as well as the lack of

communication on this problem. When taking a look into a doctor who specializes in obstetrics

or one that is a general practitioner, they have a responsibility to abide by the hippocratic oath

and follow ethical standards. Under the hippocratic oath it is fair to say holding implicit bias on a

black individual or the black community is unethical. The role of communication is so important

in healthcare especially with the issue of racism and its negative determinants on the lives of

black people.

Finally, although the main purpose of the previous statements was to inform and argue

for the acknowledgement of racism in healthcare it is not without the development of solutions

that the conflict will be solved. Greater attention to birth plans, better communication among
SOLVING AMERICA’S RACIAL ISSUES WITHIN THE HEALTHCARE SYSTEM 8

multiple healthcare providers, more attentively listening to patients during clinical encounters,

increased support for social programs, was proposed by the numerous women of color in the

study where they experienced what they perceived to be racism (McLemore, 2018). Paying more

attention to what patients are saying whether it be about pain or what they need is essential to the

process in limiting racial bias. Another important factor is the existence of social programs have

long-run effects on the health of minorities, evidence for this is Medicaid and Head Start which

have made progress with the health of elderlies and children in middle childhood. Overall, the

solutions are based on the conflict, so it is up to each and every citizen to at least recognize the

issue. Having these components alive and running in social programs or in individual facilities

can make a step towards lessening premature deaths of black Americans.

Since the 1900’s discrimination in America has socially, economically, and politically

disavantaged the lives of African Americans. Today By this point, there have been many efforts

to lessen the effects of past racism. Although there has been progress on this conflict an issue

still remains, discrimination continues to appear especially in medical care. So is racism in

medicine still present? Some believe there are factors unrelated to medicine which are putting the

health black Americans at risk and refuse to consider the existence of an accurate measuring tool

for racism. A study done in Philadelphia and the three scale measuring device by Doctor David

Williams refute these ideas by concluding that besides institutional racism affecting causing poor

health in African Americans, it does not account for all disparities. David Williams divided made

an intricate but general tool that pays attention to different levels of racism which can be used

throughout the healthcare field. Conflict and the effect of the problem are acknowledged in this

essay, with the conflict being the ignorance of racism and the effects of this problem that are
SOLVING AMERICA’S RACIAL ISSUES WITHIN THE HEALTHCARE SYSTEM 9

emitted by health professionals. Finally, the purpose of this information is to rely on each other

to build solutions but not before acknowledging the problem taking place in the medical field.

Racism in America and the circumstances which black Americans live in is properly recognized

by Supreme Court Justice Thurgood Marshall when he said “We must dissent because America

can do better, because America has no choice but to do better." (2016).

SOLVING AMERICA’S RACIAL ISSUES WITHIN THE HEALTHCARE SYSTEM
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