Racial Gaps in Healthcare are Failing Black and Brown People
There is an ongoing lack of diversity among healthcare professionals within the United States.
According to the Association of American Medical Colleges, only 36% of active physicians are female. While Black people comprise 13% of the U.S population and Latinos comprise 18%, less than 5% of physicians identify as Black or African-American, and fewer than 6% of physicians identify as Hispanic or Latino.
People of color are vastly underrepresented and because of this, many Black and Latino Americans do not trust their healthcare providers to act in their best interest — leading to poor treatment or compliance with recommended treatment plans. The truth is, Blacks and Latinos who have the same diseases or health concerns as their white counterparts, are more likely to die sooner. For example, Blacks are three times more likely to die of asthma than white Americans and have a 25 percent higher cancer death rate than White women.
Similarly, there is a Black maternal health crisis in the United States. In fact, a dedicated calendar week, Black Maternal Health Week, focuses on initiatives to advance health equity across the country for racial and ethnic minorities. Governing healthcare authorities in the US report statistics that Black women are dying at disproportionate rates in comparison to other racial groups when reviewing maternal health outcomes.
These disparities have been primarily tied to the lack of diversity in healthcare professionals, which plays a large part in getting Blacks and Latino patients the care they need. Additionally, lack of trust in the US healthcare system and non-POC healthcare professionals, coupled with a lack of coordinated care and the reluctance to believe Black and Hispanic people due to negative biases, systemic racism and discrimination, has widened the gap among positive health outcomes among people of color.
Ultimately, patients need to have a good rapport with their doctors in order to feel safe and comfortable to follow treatment plans and to seek help before conditions advance. Otherwise, it can be challenging and traumatizing to seek the medical help one might need.
How Did We Get Here?
We’ve normalized wrongdoings. Sure it’s not all hospitals nor is it all healthcare professionals, but it is enough for Black and Latino health to be in jeopardy. Too often when Black and Brown Americans share their concerns, they are told by healthcare professionals that the pain medication is causing confusion or that our symptoms are routine and normal. Even with persistence, tests aren’t always ordered and additional complications arise as a result.
For mothers-to-be, the discrepancies aren’t only in the delivery room, but post-birth as well. Once the baby is born, Black mothers are often dismissed and sent home without the proper information about potential symptoms. The result? A higher risk of death for Black mothers at the labor, delivery and postpartum stages — regardless of income or education level. The underlying root — whether consciously or self-consciously: healthcare professionals believe Black and Latinos less. This dangerous bias against listening to our concerns adds significantly to the problem and it is difficult to know what the motives of these health institutions are, whether financial, physical, or emotional.
Hesitation Around the COVID-19 Vaccine
Currently, this has created skepticism and hesitation around the Coronavirus vaccine.
Although healthcare professionals are urging Americans to get the vaccine to protect against the virus, with this trust divide, Black men and women don’t feel safe or confident in trusting healthcare providers with their well being when it has seldom been of importance.
It’s not surprising then that only 42 percent of Black Americans said they would be willing to take the vaccine in November 2020. Michael Che, a star from Saturday Night Live, described it perfectly when he said, “I’ve got mixed feelings about the vaccine. On the one hand, I’m Black, so naturally I don’t trust it. But on the other hand, I’m on a white TV show, so I might actually get the real one.”
Blacks and Latinos have and are dying at disproportionate rates from the Coronavirus. This is due to the lack of vaccinations in their communities, lack of trust for the vaccine and healthcare providers. Vaccinations were also slow to arrive in states with large Latino populations like Nevada, California, Arizona, Florida and Illinois. This fostered even more loss of faith in healthcare providers among Black and Latinos populations.
Why We Need Diversity
It’s critical that healthcare organizations improve diversity for all socioeconomic backgrounds, races, ethnicities, sexual orientations, and gender. According to former President Barack Obama, “Research has shown that diverse groups are more effective at problem solving than homogenous groups, and policies that promote diversity and inclusion will enhance our ability to draw from the broadest possible pool of talent, solve our toughest challenges, maximize employee engagement and innovation, and lead by example by setting a high standard for providing access to opportunity to all segments of our society.”
By improving the diversity in the healthcare system we will also improve the comfort levels of Black and Latino Americans. Research has shown that students who train at diverse schools are more comfortable and equipped to treat patients from different ethnic backgrounds. It will also improve communication; with a diverse cross-section of healthcare professionals, colleagues and patients will have a better understanding of multiple belief systems. Diversity could also provide comfort to patients with limited English proficiency. And most importantly, it could help to restore the trust they have in the entire system.
Where Do We Go From Here?
As a coping mechanism to under-resourced facilities, pre-existing conditions, and access, some Blacks and Latinos find themselves code-switching to counter implicit bias. They’ll dress up for doctor visits, speak in “professional” tones, and practice minimal push back when things don’t go as planned. These unfortunate yet necessary tactics are dehumanizing.
We want to see more initiatives like the one with Pfizer, who partnered with clinical research sites in communities of color and helped restore trust to encourage Black patients to participate in COVID-19 vaccine trials. We need more authentic programming that helps to convince Black and Latino patients to accept the vaccine.
We need healthcare providers to exercise empathy. At Kaiser in Northern California, senior leaders made it mandatory to undergo the Effective Communication without Confrontation training program that encouraged and taught doctors and nurses the challenges and barriers that people of color face, instead of dismissing their concerns as if they are conspiracy beliefs. Doctors and nurses gained a deeper insight to the hundreds of years of institutional racism that people of color face that have directly impacted our feelings of distaste towards the healthcare community. By listening to their true concerns, they were able to provide information with a different approach, while building up trust. As a result, Kaiser doctors were able to see the overarching goal: to protect.
The effects of racism on health are significant and the solution would be to hire more people of color and to train the existing healthcare leaders. Hospitals and clinics need to get specific about internal practices and implement change. If protest culture has taught us anything over the last year, it’s that the world is done tolerating shortcomings — especially when there is a high risk of fatality.
This work will start with mass awareness and the understanding of the systemic policies in place that impact Black and Latino health. Our hope is that the exposure of health inequities during the pandemic will spur real change and improve the quality of care for Black and Brown Americans.