Discrimination is a moral issue that has significantly influenced American institutions, and the healthcare industry is no exception. Discrimination is the state whereby systems, policies, actions, and attitudes generate inequitable opportunities and impacts for individuals. Discrimination in the healthcare setting occurs in the form of health disparities which refer to inequalities in the quality of healthcare encountered by individuals based on social, racial, economic, ethnic, and environmental factors. Health disparities in the healthcare systems lead to inequalities that have disparate effects on the physical and mental health of people of color and other marginalized individuals like low-income. These people of color and low income tend not to receive quality care from doctors, which makes them suffer emotionally or physically, and they may end up dying. Although all doctors take an oath to treat all patients equally, it has been noted from different incidences that not all patients are treated equally well. This scenario becomes a moral issue since its reasons are complicated, but it can be connected to discrimination and failure to adhere to ethical principles and ethics theories. People of color and low-income receive poor quality care from doctors than white people.
Despite the causes of health disparities in healthcare settings being complex, it is true that the healthcare providers, such as doctors, play a significant role in contributing to these disparities. There are different causes of health disparities, but it is essential to concentrate on the substantial and persistent factors like racism and poverty. The racial factor is significantly connected with poverty which is an economic factor; thus, they need to be addressed together for a better understanding of health disparity. The first factor is racism in healthcare settings, affecting people of color, such as African Americans, Hispanics, and Asians. The first factor that makes people of color not get quality care from doctors is implicit bias, which happens inevitably and involuntarily (Baciu et al., 2017). Due to implicit bias, people of color receive lower-quality health care than whites, even when their insurance status, income, and age are similar. The doctors tend to naturally have negative attitudes toward people of color and positive attitudes toward white people. Due to the unconscious attitude toward people of color, they tend to treat them differently from whites. For instance, the doctor might view people of color as more likely to be involved in risky behaviors that cause diseases, thus unwilling to provide medications. Also, due to implicit bias and stereotyping, the doctor might show less attentiveness when attending to the patient, leading to poor judgment.
The second factor that causes racial healthcare disparity is segregation; many people of color are isolated and live in areas with limited social facilities such as healthcare facilities. Limited healthcare facilities mean that the hospitals might not have enough resources to provide quality care, making them receive lower-quality services. Segregation may make people of color be treated differently because the doctors available may not be enough to serve all people leaving some people unaided even where there are no white people. Another factor that prevents people of color from being treated the same as others are the language barrier. Many of these people speak another language other than English which prevents effective between the doctor and patient, negatively impacting the quality of care the patient receives. Due to the language barrier, the patients choose to engage their English-speaking family members to interpret. However, this leads to the risk of miscommunication and mistranslation. The doctor may use language the patient cannot understand, thus making them unable to get treatment instructions.
The second factor of health disparity is low income which is strongly associated with people of color. People who receive low income seem to have no adequate access to essential needs such as healthcare, education, employment, suitable housing, and healthy diets. First, people of color and low income have insufficient insurance coverage, leading to a lack of healthcare. Uninsured individuals have less access to suggested care, get poor quality care, and tend to encounter worse health results to poor care and treatment (Chokshi, 2018). Since these cannot afford medical bills due to their financial status, they can skip the necessary care, such as prevention programs and therapeutic services. Some medications may need to be purchased from outside the healthcare facilities, which forces the doctors to purchase them for those who can afford them. Secondly, these groups of minorities in society are likely not to sufficiently access education, adversely affecting their health. Due to a lack of education, these people tend to have high rates of risky behaviors such as smoking, eating unhealthily, substance use, and low physical activity levels. These behaviors lead to poor health outcomes and make it hard for doctors to control when providing treatment. In addition, minorities are associated with an increased rate of unemployment or underemployment, which make people more adverse in a way that they cannot afford to pay medical bills or even access medical insurance. This factor puts them at a higher risk of poor care from healthcare providers. Generally, minorities fail to afford to access screening, diagnosis, and treatment, which makes them not to receive good care. In addition, people of low income mostly live in rural areas where the healthcare settings are not fully equipped and workforce shortages. This makes them not be treated like those in urban areas since the facilities are not enough, and also, the doctors available might not be enough to attend to all the patients.
Due to racial and economic discrimination, the services provided by healthcare providers are poor and adversely affect the patient. Healthcare providers treat people of color differently from whites and view them as less educated, poor, and less respected. This makes them not prescribe medications as prescribed, assuming that the patients will not take the medication seriously or provide them based on the patient’s type of insurance. The doctor might fail to prescribe them the necessary type of treatment, assuming they cannot afford it due to their race which is linked with poverty. Another occurrence of less care is where the doctors might keep people of color or low income on hold as they attend the white people, which might make those with emergencies suffer adversely. The doctors might also provide care to the patients in a language they do not understand, which shows disrespect. The health outcomes of poor healthcare services are severe. These assumptions in the provision of care tend to make the people of color continue experiencing the adverse effects of the diseases that threaten them, such as heart disease, diabetes, stroke, cancer, higher blood pressure, and sickle-cell disease, among others. There are different health issues in healthcare settings due to race or income, which shows how healthcare providers treat patients from these groups differently. These people tend to have higher mortality rates since they receive quality care. Their consultations, tests, and treatments are done with less concern and seriousness, which leads to complications that might lead to premature death.
Low-income people do not have enough money to seek quality care; thus, they tend to be left unaided in healthcare settings. They do not have money that can cater for consultations, tests, and medications, preventing them from accessing quality care. In addition, lower-income patients feel they are treated with less respect. The healthcare providers handle them with less care, speak rudely, demonstrate physical disgust when touching them, skip some issues, and ignore some concerns that the patients report. Also, the poor tend to be provided with medications they can afford, and the other treatment, even the essential one, is discarded, leaving them unaided. They are given unnecessary medications because they cannot afford the necessary ones. Additionally, since the poor cannot afford health-improving foods, they are provided with any available food, which may prevent them from recovering or cause more health problems. Lastly, those with low income might be put in poorly organized facilities, while those with high income are in good facilities with increased attention. They might feel they are being given less attention by the doctors and are sometimes told that there are no particular medicines since they know they cannot afford them.
People who experience discrimination in healthcare settings due to their color or income level tend to develop some physical or mental health. How one feels when one fails to access quality care due to color or income is unimaginable. First, people who encounter discrimination in healthcare settings have a high risk of developing high blood pressure. They may also develop mental health problems such as stress, insomnia, depression, anxiety, fear, low self-esteem, or post-traumatic stress disorder. Many who have encountered discrimination are like those who have gone through other traumatizing experiences, and they might develop behavioral problems causing stigma and isolation. These mental health issues are associated with suicidal thoughts, attempts, or committing suicide due to the low self-esteem developed due to racism in healthcare services. Socially, victims of racism or economic discrimination isolate their selves from social groups and have lower trust in others, especially those of other races. They also lose confidence in public spaces and struggle to seek medications even when they develop other health problems.
Generally, how doctors treat people of color or low income goes against moral principles like justice, beneficence, and non-maleficence. Making quality care services inaccessible to some people due to their race or economic status goes against morals; thus, there is a need to observe moral principles to avoid harming people. In addition, these actions are against utilitarianism moral theory, which aims to maximize human welfare as the determinant of the rightness of actions. They also go against a deontological theory that calls for treatment with respect and dignity. In conclusion, People of color and low-income receive poor quality care from doctors than white people. Many times, these people are given less attention, mostly assumed, served with less respect, and are never given access to quality care due to their status. Doctors must be morally upright and treat all patients equally, regardless of race or social or economic status.
Baciu, A., Negussie, Y., Geller, A., Weinstein, J. N., & National Academies of Sciences, Engineering, and Medicine. (2017). The root causes of health inequity. In Communities in action: Pathways to health equity. National Academies Press (US).
Chokshi, D. A. (2018). Income, poverty, and health inequality. Jama, 319(13), 1312-1313.