Inequalities between different racial groups characterize the American healthcare system. Access to healthcare facilities and health outcomes vary between other racial groups, which impacts various aspects of their lives. African Americans are among the U.S. racial group marginalized in health matters. The marginalization dates back to the American history of slavery and racial segregation that has put the community on the receiving end regarding their health. While health inequality affects various aspects of health, access to healthcare is a significant factor in determining health outcomes. In this regard, multiple factors interplay, leading to challenges in accessing health among African Americans. Therefore, challenges in accessing health care are significant factors contributing to health and healthcare disparities.
Limited healthcare insurance is a significant factor contributing to limited access to healthcare services. When the Obama administration took power, the Affordable Care Act (ACA) was rolled out to increase healthcare coverage for millions of Americans. Since the insurance act was rolled out, the rate of uninsured African Americans has reduced significantly. Despite the large number of African Americans that got insurance coverage through the ACA, members of this population are still highly likely to be uninsured. The main reason for this trend is that although ACA coverage has increased the scope of universal coverage, many insurance options remain high and unaffordable to African Americans (Egede & Walker, 2020). There are many reasons why the insurance programs under ACA remain unaffordable to many African Americans.
One of the reasons is the high rate of unemployment. Historically, African Americans’ unemployment rate has remained high, negatively impacting their financial welfare. Employment remains a crucial source of income for most Americans; lack of it impacts Americans’ ability to pay their bills, including insurance coverage. Inadequate education is one of the reasons that lead to high unemployment. Compared to other racial groups, African Americans have fewer opportunities to advance their education, a factor that affects their competitiveness in the labor market. In addition, racism plays a role in their unemployment. Most businesses in the United States are owned and run by Whites. Racism in business disproportionately affects African Americans (Chen et al., 2021). Inadequate health facilities are the other major factor affecting African Americans’ access to health care.
Despite the increase in ACA coverage among African Americans, healthcare provider shortages remain a barrier to accessing healthcare services. Fewer healthcare facilities are located in areas inhabited by Blacks than in areas where Whites are the dominant population. In addition to inadequate health facilities in Black neighborhoods, the available health facilities are not adequately equipped. For example, the lack of medicine in health facilities is a significant issue in Black neighborhoods. Secondly, the hospitals in the Blacks dominated regions are less likely to provide advanced medical care. In one of the studies conducted to investigate the issue of inadequate access to health care, 49% of Black people cited poor health facilities in their neighborhoods as the main reason for their poor health outcomes (Chen et al., 2021). This means that even when insured, they have limited access to healthcare.
Access to healthcare is also affected by communication problems associated with language or cultural differences in the United States. Less education is one of the primary reasons for communication problems. As noted earlier, African Americans with higher education levels are less than those without. Education is crucial in facilitating communication, especially in health matters. Inadequate education implies that African Americans cannot understand most health issues, which impacts healthcare provision. In addition, most doctors in the United States are whites, which introduces the cultural barrier in healthcare. Different cultures have a different understandings of health issues. This implies that differences in cultural understanding between Whites and Blacks will negatively impact access to healthcare services (Ochieng & Chris, 2021). Studies have also shown that disproportionate representation of Blacks in the health sectors leads to their health issues not being taken seriously.
Members of the Black community have continuously complained that their health issues are not taken seriously. Because the physician-patient relationship is key to the effective delivery of healthcare services, a poor relationship will negatively impact the patient’s health outcomes. A study conducted (by Egede & Walker, 2020) indicated that when it comes to pain treatment, 35% of Black patients complained that their pain had not been taken seriously by healthcare workers. The study also reported that 32% of adults in the Black population complained about being rushed by healthcare providers. Further, some complained that they felt they had been handled with less respect than patients from the dominant races. Whether these are facts or perceptions, they directly impact the healthcare outcomes in the Black population.
Inadequate access to seniors’ nursing homes is another major factor affecting access to health care services. Once people get old, their physical, mental, and social capabilities are limited. In addition, they have increased susceptibility to infections which puts their health at risk. For this particular group of people, living in a nursing home provides them a better opportunity to access healthcare than in their private homes. However, access to nursing homes in the Black community is significantly affected by inadequate financial resources and a lack of adequate governmental sponsored nursing homes in the areas dominated by the Black community. This implies that fewer older adults from the Black community are accommodated in nursing homes compared to the white population (Adebayo et al., 2022). Consequently, their access to specialized healthcare is curtailed.
Digital literacy is another factor affecting access to health services in the Black population. Digital literacy is an adequate understanding of the use of digital devices whose use in healthcare settings has increased. For example, much healthcare information, such as patient history, prescriptions, and health assessment schedules, is being communicated through digital devices. In addition, Covid-19 and the associated restrictions forced a reduction of in-person visits to healthcare services, implying that most health information was being shared through technology. This implies that digital illiteracy among the Black population affects their ability to seek healthcare services through technology (Ochieng & Chris, 2021). Because technology has become a significant part and parcel of health care services provision, digital illiteracy in the Black population affects such access significantly.
Inadequate health information is a significant factor determining access to health care services. This information may include; various diseases in a given region, signs and symptoms, and preventive strategies, among others. Without information such as signs and symptoms, individuals may fail to understand various health conditions, which reduces their probability of visiting a health institution. On the other hand, access to information is directly correlated to literacy levels. The more illiterate an individual is, the less likely they will access health information even in circumstances where it is provided. Since the Black community’s illiteracy levels are higher, their access to health information is lower (Adebayo et al., 2022). Consequently, access to health care services is significantly affected.
Policies and structures are other issues affecting African Americans’ access to healthcare services. Many policies aimed at improving healthcare services are discriminatory, with African Americans as the victims. Examples of such policies include expanding ACA coverage, where the coverage in rural areas inhabited by the Black majority is insufficient. In addition, policies regarding social protection against the effects of covid-19 were not developed in a way that serves all races equally. Policies form the basis of healthcare provision and promote easy access to healthcare services. They ensure the provision of health facilities, equipment, and personnel (Chen et al., 2021). Unfortunately, discriminatory policies have led to the ineffective provision of healthcare facilities and services in Black neighborhoods, which has significantly affected access to healthcare services.
Although the main issues discussed regards racial differences, in health care, an interdisciplinary approach is required to promote racial equality in healthcare. To address healthcare disparities between the Black community and the whites, stakeholders need a more comprehensive effort to take charge. The efforts to address the issues should focus on eliminating healthcare segregation in major societal institutions. The institutions include the education sector, employment, housing, the criminal justice system, and other areas that affect the welfare of society as a whole. This will end the inequality in the Black community, which will directly or indirectly improve their access to health care services.
Adebayo, C. T., Parcell, E. S., Mkandawire-Valhmu, L., & Olukotun, O. (2022). African American Women’s maternal healthcare experiences: a Critical Race Theory perspective. Health Communication, 37(9), 1135-1146.
Chen, K. L., Brozen, M., Rollman, J. E., Ward, T., Norris, K. C., Gregory, K. D., & Zimmerman, F. J. (2021). How is the COVID-19 pandemic shaping transportation access to health care? Transportation Research Interdisciplinary Perspectives, 10, 100338.
Egede, L. E., & Walker, R. J. (2020). Structural racism, social risk factors, and Covid-19—a dangerous convergence for Black Americans. New England Journal of Medicine, 383(12), e77.
Ochieng, J. M., & Crist, J. D. (2021). Social determinants of health and health care delivery: African American women’s T2DM self-management. Clinical nursing research, 30(3), 263-272.