Racial discrimination has been one of the most significant challenges faced by the healthcare system in the United States for an extended period. Some causes of racism in the healthcare system include non-inclusive laws, discrimination against other individuals, and personal interests, which have hindered the proper provision of reasonable care to all individuals regardless of race. Specifically, the healthcare department in America is beset with inequalities that disproportionately affect black Americans. Such inequalities contribute to poorer health effects, lack of equal opportunities, and disparities in comprehensive medical insurance among people of color in the US. It is, therefore, essential to examine the impacts of racial discrimination on the black community if this issue is to be addressed. The study confirms that racial discrimination significantly affects the black community, thus causing disparity in health outcomes and health care. This paper seeks to address the research question: Does the American healthcare system discriminate against black people based on race, and if yes, how does it influence health outcomes and the quality of care provided to black Americans?
Racial discrimination in the united states is a deep-rooted issue that has been a point of contention and controversy for many years. A slight majority of people argue that racial discrimination contributes to healthcare problems faced by the black community in the country. Conversely, many people and studies argue that disparities in access to treatment and poor quality care faced by African Americans are caused by factors other than racial discrimination. This paper seeks to answer this research question as to whether racial discrimination is a major contributor to these disparities. The study concludes that racial discrimination significantly influences health outcomes and the quality of care provided to black communities, resulting in their lack of trust in the system.
The paper will have three supporting points evidenced by primary research in interviews, surveys, and a secondary literature review of previous studies. The first point shall be disparities of treatment, where issues of stereotyping and communication barriers shall be addressed. The second main point to prove the thesis shall focus on the limited access to quality healthcare that the focus group has to deal with. Finally, the issue of mistrust by the American black community of the system will be discussed, and possible solutions to overcome the problem will be addressed. The study will foster a comprehensive understanding of racial discrimination in the black community and how to mitigate the problem by evaluating the research questions using primary and secondary sources.
Disparities in Treatment
Stereotyping Bias by Healthcare Professionals
One of the main reasons there are disparities in the quality of care provided to blacks compared to their white counterparts is that some medical professionals stereotype individuals based on race and color. This bias, also commonly referred to as implicit bias, is known to influence the decision-making process of healthcare providers, ultimately affecting the quality of care (Schnierle et al., 2019). Studies show that medical professionals with high implicit bias will likely make decisions unrelated to evidence-based practice (Gopal et al., 2021). This decision-making, therefore, results in sub-optimal treatment outcomes for people who belong to particular racial and ethnic minorities. Examples of ways doctors and other healthcare providers demonstrate stereotyping bias are by underestimating the severity of symptoms among blacks, overprescribing medicines because they believe the medication will be ignored, and seeing no need to take healthcare preventive measures.
Numerous examples confirm that the healthcare quality provided to the African American community is negatively influenced by implicit bias. A notable example is the well-documented undertreatment of back pain for people of color compared to whites. Marcelin et al. (2019) say that medical providers are more likely to underestimate the pain experienced by black patients, thus not taking appropriate pain management measures. Another assumption that medical providers have about African Americans is that they are less likely to follow their medical prescriptions. This superstition results in the doctors not being attentive to the patients or extremely thorough, which has negative impacts.
Interview and survey responses on personal experiences confirmed that the conclusions in the cited literature were true. Most black interviewees reported being treated disrespectfully, having doctors schedule rush appointments, and being given inadequate explanations on critical issues. In contrast, fewer white respondents and people of other minority racial groups did not report such experiences. Some black respondents also commented that the healthcare providers had prejudiced opinions of their socioeconomic status. Many believed that the patients could not afford certain recommendations, while others assumed that the respondents lived an unhealthy lifestyle and thus had substandard recommendations.
Communication Barriers Between Patients and Healthcare Providers
Another cause that contributes to the disparities in the quality of healthcare provided to the members of the black community is communication barriers. Most medical professionals are not of black ethnicity and lack cultural competence skills for interacting with people from different backgrounds. Cultural competence is crucial for ensuring quality healthcare for all patients, black or otherwise (Handtke et al., 2019). African Americans deserve culturally competent medical care providers, who are currently unavailable. Therefore, communication barriers caused by these cultural differences have serious negative consequences for the patient. For example, medical experts do not consider this problem and thus write prescriptions full of medical jargon ununderstandable to the patient. Cultural incompetence also contributes to the medical provider misdiagnosing the patient based on their symptoms. These errors could result in inappropriate treatments, further exacerbating the medical problems.
This study designed interview questions to have the respondents rate their healthcare providers’ cultural competence. The results showed that an overwhelming majority are dissatisfied with the level and quality of medical care their healthcare providers provide. The comments given by the respondents included the complaint that healthcare providers did not listen, failed to take black people’s cultural beliefs into account, and made assumptions based on stereotypes. The results reveal a need for more cultural training to be provided to healthcare providers for improved quality of medical care. Another solution would be providing an environment that harbors empathy, respect, and understanding of the patients regardless of their racial or ethnic backgrounds. All healthcare providers should be informed about the substandard care they and their colleagues provide for racial minorities and be asked to rectify it to ensure equality and equity in society.
Limited Acess to Quality Healthcare
The study sought to find out the level of satisfaction with the black community’s healthcare systems based on surveys. The results from the questionnaires and the interviews demonstrated that most African Americans were unsatisfied with the quality of healthcare they received. Commonly mentioned reasons for the dissatisfaction were long wait times for treatment, inadequate resources to cover medical services, and lack of enough qualified healthcare providers in the region where a person resided. The survey findings conveyed a need for the governments and other relevant stakeholders to step in and ensure better healthcare services for this minority ethnic group.
A direct correlation exists between the quality of healthcare a person receives and health outcomes. For example, Artinga et al. (2019) found that individuals with limited healthcare services provided to them were more likely to experience lower health outcomes resulting in a lower life expectancy. This study has been backed by several other studies that reveal that getting poor-quality healthcare could result in unfavorable outcomes (Gravlee, 2020). Since it has been proved that the black community is more likely to receive poor quality health care, the group is more vulnerable to certain ailments such as hypertension, certain cancers, and diabetes, which are less associated with white people.
Income Disparities
People of African descent in the US are known to get poor quality healthcare, a problem contributed by several factors. First, people of African descent are likely to receive fewer incomes than their white counterparts; therefore, they have no alternative but to seek substandard healthcare options. This argument is supported by research, as studies reveal that black people are more likely to live in poverty when compared to people of other ethnic backgrounds (McCrea et al., 2019). This poverty significantly affects their ability to access quality healthcare as they cannot afford deductibles, copays, and out-of-pocket expenses to cover their medical expenses. Furthermore, most black people cannot get insurance cover for employer-sponsored insurance coverage, further inhibiting the quality of medical care they receive.
Moreover, many African Americans cannot afford basic healthcare insurance coverage, which is critical to high-quality healthcare. Unlike their white counterparts, many African Americans are likely to lack insurance coverage (Gangopadhyaya & Garrett, 2020). They thus are forced to go for expensive medical care alternatives when they have healthcare concerns. Studies show that most African Americans forgo their healthcare costs, making them be avoided medical institutions, especially when not with ready cash (Gangopadhyaya & Garrett, 2020). However, Insurance problems do not only affect uninsured Americans, as most people of this racial minority group are known to be underinsured. Thus, their insurance only covers a few basic health problems, but the covers avoid critical medical complications, which are often life-threatening.
Geographical Location
Geographical location and the demographics of a particular region significantly influence the quality of healthcare provided in a particular region. Studies show that most black people live in areas of low income, particularly rural areas and highly populated low-income urban centers (Rader et al., 2020). These regions are associated with shortages of doctors and nurses, limited access to specialized healthcare providers, and limited transportation alternatives, all of which limit timely and quality healthcare. It is worth noting that only a minority of white people live in the regions mentioned above. Limited access to quality healthcare is a major contributor to the poor healthcare quality received by African Americans. Addressing the barriers such as geographical, insurance, and income would help mitigate the issue, thus reducing morbidity and mortality rates of African Americans.
Mistrust of the Healthcare System
Historical Context of Mistrust
The strong mistrust of the community towards the system evidences the healthcare system’s discrimination against black minorities. The system has discriminated against the black community through unethical practices which take the community as a minority group. A well-known case of this unethical practice is the Tuskegee case study, where a group of African American men was knowingly left out untreated for the disease so that its progression could be analyzed (Alsan et al., 2019; Tobin, 2022). There are many other unethical practices against the black community, such as the HeLa cell line case, where the cancer cells of an African American woman were taken without her consent (Klitzman, 2022). These and many other cases have made black people wary of the healthcare systems and practices, contributing to poor quality medical services.
The unethical medical practices of the past have had a lasting effect on African Americans’ attitudes toward the healthcare system and have remained indifferent. Today, healthcare providers have to bear dealing with clients who view them as perpetrators looking for ways to exploit them. This negative belief towards the healthcare system results in limited healthcare quality as black people could either postpone, delay or give censored information when dealing with a healthcare professional. The mistrust could also make African Americans less compliant with the instructs given by healthcare providers.
In this study, primary research was conducted to assess black people’s trust in healthcare providers. The respondents said they greatly mistrust the healthcare providers, citing issues such as mistreatment, lack of ethics, and discrimination. Almost all the respondents said they had witnessed discrimination in the healthcare system either directly or through observation. They confirmed that more discrimination was directed toward the back community than their white counterparts. The median level of trust that the black community had towards the healthcare system was 3, portraying a huge concern. Additionally, the majority of people said that they were very dissatisfied with the current state of the healthcare system in the US. A significant number of respondents wrote that discrimination was the biggest contributor to disparities in the healthcare system.
Strategies to Deal With Mistrust in Healthcare System
Key stakeholders in the healthcare industry could take various strategies to address the issue of mist by African Americans in the healthcare system. One of the most effective strategies is actively trying to reach all African Americans through community engagements. Black Americans are known to be social with other community members. Therefore, by holding joint forums, meetings, and workshops, the stakeholders can get a chance to share insights. Community engagements open doors for open dialogues that can promote and rebuild the trust between healthcare systems and the black community, thus providing better quality healthcare. Similarly, the stakeholders in the healthcare industry should seek to ensure culturally competent care is provided for the black community. The providers have to know and respect the community members’ values, beliefs, and norms.
Trust could also be built by promoting accountability and transparency in all healthcare practices. The system’s managers should take all the relevant measures to ensure that the system does not discriminate against nor violate the rights of anybody. Procedures that ensure ethical practices, particularly in research, should be established and followed. Healthcare providers should be open to all their patients, black or otherwise. They should not have preconceived notions about anybody unless they have evidence. All practitioners should use evidence-based decision-making since it may be difficult for doctors to avoid stereotyping while doing their work. In addressing mistrust and ethical concerns, healthcare institutions can increase their chances of providing better healthcare services for all.
Conclusion
Racial discrimination significantly influences the quality and outcomes of healthcare services provided to African American people in the US. This discrimination results in black people mistrusting the system, disparities in the care given, and a reduction in the number of people who frequent the institutions. This paper has explored the main ways that discrimination influences health outcomes in US hospitals, limits access to the hospitals, and how causes disparities in the quality of treatment. The study suggests that the problems could be solved by setting up various healthcare policies, educating the black community, and ensuring that the doctors dealing with black patients are culturally competent. Furthermore, the stakeholders need to plan for better and cheap healthcare coverage. Addressing the root issues that cause healthcare disparities could improve the overall well-being of Americans of African descent.
References
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Gangopadhyaya, A., & Garrett, A. B. (2020). Unemployment, Health Insurance, and the COVID-19 Recession. SSRN Electronic Journal. https://doi.org/10.2139/ssrn.3568489
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Appendix
Interview Questions
- Can you describe your experiences with racial discrimination either personally or through observation?
- What is your opinion on how racial discrimination impacts healthcare outcomes in the black community?
- What are the main factors that bring disparities in the healthcare provided to African Americans and other racial groups?
- How do black American health outcomes differ from other groups?
- Why is there a general mistrust by black Americans in the healthcare system?
- What are the best practices for treating blacks?
- How could medical care disparities be addressed?
Survey Questions
Have you ever experienced racial discrimination in a healthcare setting
- Yes
- No
On a scale of 1-10, how much trust do you have in your healthcare provider to give you the desired health outcomes and understand different cultural needs?
What is your satisfaction level with the quality of healthcare provided for your community?
- Very satisfied
- Somewhat satisfied
- Neither satisfied nor dissatisfied
- Somewhat dissatisfied
- Very dissatisfied
Do you think racial discrimination affects the quality of healthcare African Americans receive?
- Strongly agree
- Somewhat agree
- Neither agree nor disagree
- Somewhat disagree
- Strongly disagree
Based on your personal experience, which of the following factors contributes most to healthcare disparities
- Bias and stereotyping in healthcare institutions
- Communication barriers between healthcare providers and patients
- Limited access to quality healthcare Other (please specify)
write