Recently, significant attention has focused on racial disparities in health care and health status in the medical community. Epidemiology and risk distribution are important for a wholesome medical education, and risk distribution by race can inform a clinician's diagnosis. However, when health care professionals identify race as a risk factor for certain diseases, that information may be disingenuous if the authors misperceive race with income, education, or behavior. In other words, many other factors besides race affect disease prediction, and are, in some cases, stronger predictors of disease and disease outcomes. In a study done by Sheets et al., evaluating the “validity of attributing race as a risk factor in a widely used pathology book… …show more content…
about two-thirds of the assertions that different risk factors exist for African Americans… could not be supported by the published literature.” This means that while some diseases may have race as a predictor, most diseases have other factors that may or may not be associated with race, and may even be more accurate predictors of diseases risk. http://journals.lww.com/academicmedicine/abstract/2011/10000/Unsupported_Labeling_of_Race_as_a_Risk_Factor_for.33.aspx) For example, it is a well-trusted belief in the medical community that the African American community bears a higher burden for cardiovascular diseases (CVD). Thomas et al. discovered higher CVD mortality rates among Black men, which were largely mediated by risk factors and income. While black men were at an overall higher risk than white men to develop CVD, income is a strong predictor of CVD mortality. “Adjustment for income level reduced the Black-to-White CVD hazard ratio from 1.35 to 1.09. This suggests that low income may be associated with decreased access to or use of health care services, lower quality of services, or detrimental health-related circumstances, behaviors, or beliefs.” (http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1449375/) Another connection possibly overlooked is that racism and the classification of race affects minorities and their health negatively. As written by Jason Silverstein in his article for The Atlantic, “stress [of race] leads to poorer mental and physical health. This burden of being a minority race along with the inequality in quality of care when accounted for adds to the burden of mortality and disease brought on by race (How Racism Is Bad for Our Bodies - Health - The Atlantic). Unlike explicit bias, which reflects the attitudes or beliefs that one endorses at a conscious level, implicit bias is the bias in judgment and/or behavior that results from implicit attitudes and stereotypes that often operate without intentional control.
Physicians routinely make crucial decisions about medical care for patients whose lives hang in the balance. In the face of such high stakes, it may be surprising to think that automatic associations can unknowingly bias professional decision-making. One study compared implicit racial bias between White American doctors and Black American doctors and found that “African American doctors, on average, did not show an implicit preference for either Blacks or Whites…” The implicit racial biases of White physicians also seem to play a role in predicting how positively or negatively Black patients respond to the medical interaction (http://www.ncbi.nlm.nih.gov/pubmed/19648715) (Penner, Dovidio, West, Gaertner, Albrecht, Daily, & Markova, 2010), (Penner, L., Dovidio, J., West, T., Gaertner, S., Albrecht, T., Dailey, R., & Markova, T. (2010). Aversive racism and medical interactions with Black patients: A field study- Journal of Experimental Social Psychology, 46, 436-440). Organizations can do many things like providing training implicit bias and diversity; seek to identify consciously the differences between different groups and individuals; and increasing emphasis on the education of social issues such as stereotyping and …show more content…
prejudice. Simply being aware of unconscious bias can significant help physicians provide more equal care to people of all races. Quality improvement efforts directed at the identification and elimination of disparities cannot proceed without relevant data.
Most health care plans do not collect socioeconomic or racial/ethnic data on their plan members. The recognition of disparities in health care as a quality issue has far-reaching implications for reducing socioeconomic and racial/ethnic disparities in health care. It is difficult to isolate racial/ethnic disparities in health care due to socioeconomic disparities because race and socioeconomic position are so closely intertwined, especially in the United States. However, socioeconomic position appears to be the more powerful determinant of health, as mentioned above. Fiscella et al. proposed five principles for addressing disparities, some of which were- 1) “disparities must be recognized as a significant quality problem”; and 2) “an approach to disparities should account for the relationships between both socioeconomic position and race/ethnicity and morbidity. Consideration should be given to linking reimbursement to the socioeconomic position and racial/ethnicity composition of the enrolled population.”
(http://www.ncbi.nlm.nih.gov/pubmed/10815125/) Healing is the central theme and purpose of medicine, yet its fundamentals are limited to the level of tissue repair.
Race-based medicine is not meant to divide people, but rather to give better medical help to people of a certain demographic. Race-based medicine is created based on knowledge of predispositions of any given race. For example, it is a fact that heart disease is the leading cause of death for racial groups including African-Americans, Hispanics, and whites in the United States. When medical experts have this knowledge, the process of making diagnoses is
Oliver, M. N., Wells, K. M., Joy-Gaba, J., Hawkins, C. B., & Nosek, B. A. (2014). Do Physicians' Implicit Views of African Americans Affect Clinical Decision Making? The Journal of American Board of Family Medicine, 27 (2), 177-188. Retrieved from www.jabfm.org
The disparities in the healthcare system contribute to the overall health status disparities that affect ethnic and racial minorities. The sources of ethnic and racial healthcare disparities include cultural barriers, geography differences, or healthcare provider stereotyping. In addition, difficulties in communication between health care providers and patients, lack of access to healthcare providers, and lack of access to adequate health care coverage
Health disparity is one of the burdens that contributes to our healthcare system in providing equal healthcare to everyone regarding of race, age, race, sexual orientation, and socioeconomic status to achieve good health. Research reveals that racial and ethnic minorities are likely to receive lower quality of healthcare services than white Americans.
Studies have analyzed how African Americans deal with an enormous amount of disease, injury, death, and disability compared to other ethnic group, and whites, Utilization of health services by African Americans is less frequent than other ethnic groups in the country. This non utilization of services contributes to health disparities amongst African Americans in the United States. Current and past studies have shown that because of discrimination, medical mistrust, racial/ethnic background, and poor communication African Americans tend to not seek medical care unless they are in dire need or forced to seek professional care. African Americans would rather self –medicate than to trust a doctor who might show some type of discriminatory
Large disparities exist between minorities and the rest of Americans in major areas of health. Even though the overall health of the nation is improving, minorities suffer from certain diseases up to five times more than the rest of the nation. President Clinton has committed the nation to eliminating the disparities in six areas of health by the Year 2010, and the Department of Health and Human Services (HHS) will be jumping in on this huge battle. The six areas are: Infant Mortality, Cancer Screening and Management, Cardiovascular Disease, Diabetes, HIV Infection and AIDS, and Child and Adult Immunizations.
Healthcare disparities are when there are inequalities or differences of the conditions of health and the quality of care that is received among specific groups of people such as African Americans, Caucasians, Asians, or Hispanics. Not only does it occur between racial and ethnic groups, health disparities can happen between males and females as well. Minorities have the worst healthcare outcomes, higher death rates, and are more prone to terminal diseases. For African American men and women, some of the most common health disparities are diabetes, cancer, hypertension, cardiovascular disease, and HIV infections. Some factors that can contribute to disparities are healthcare access, transportation, specialist referrals, and non-effective communication with patients. There is also much racism that still occurs today, which can be another reason African Americans may be mistreated with their healthcare. “Although both black and white patients tended not to endorse the existence of racism in the medical system, African Americans patients were more likely to perceive racism” (Laveist, Nickerson, Bowie, 2000). Over the years, the health care system has made improvements but some Americans, such as African Americans, are still being treating unequally when wanting the same care they desire as everyone else.
In recent discussions of health care disparities, a controversial issue has been whether racism is the cause of health care disparities or not. On one hand, some argue that racism is a serious problem in the health care system. From this perspective, the Institute of Medicine (IOM) states that there is a big gap between the health care quality received by minorities, and the quality of health care received by non-minorities, and the reason is due to racism. On the other hand, however, others argue that health care disparities are not due to racism. In the words of Sally Satel, one of this view’s main proponents, “White and black patients, on average don’t even visit the same population of physicians” (Satel 1), hence this reduces the chances of racism being the cause of health care disparities. According to this view, racism is not a serious problem in the health care system. In sum, then, the issue is whether racism is a major cause of health care disparities as the Institute of Medicine argues or racism is not really an issue in the health care system as suggested by Sally Satel.
Despite the substantial developments in diagnostic and treatment processes, there is convincing evidence that ethnic and racial minorities normally access and receive low quality services compared to the majority communities (Lum, 2011). As such, minority groups have higher mortality and morbidity rates arising from both preventable and treatable diseases judged against the majority groups. Elimination of both racial and ethnic disparities is mainly politically sensitive, but plays an important role in the equitable access of services, including the health care ones without discrimination. In addition, accountability, accessibility, and availability of equitable health care services are crucial for the continually growing
Today’s society protects against discrimination through laws, which have been passed to protect minorities. The persons in a minority can be defined as “a group having little power or representation relative to other groups within a society” (The Free Dictionary). It is not ethical for any person to discriminate based on race or ethnicity in a medical situation, whether it takes place in the private settings of someone’s home or in a public hospital. Racial discrimination, in a medical setting, is not ethical on the grounds of legal statues, moral teachings, and social standings.
The use of racial or ethnical categories in medical research is a current debate in the scientific community. This debate was brought on by the Human Genome Project, which mapped all of the DNA building blocks in the human genome (Scherer, 2006). Those who are in favor of race being reported in research use the argument that categorizing by race improves the quality of care that is received by the patient (Ossario & Duster, January 2005). By categorizing people, it is easier to identify where the disparities are occurring within the health care system. While appears beneficial to the patient on the surface, the opposite effect seems to be occurring throughout medicine. Race is a social construct that is not biologically real. The nonstandard
It is said that Disparities in health, begin at birth for many African-Americans and continues through life. There are many inequalities in this county that has often got over looked. Health inequality is part of American life, so deeply entangled with other social problems — disparities in income, education, housing, race, gender, and even geography that analysts have trouble saying which factors are cause and which are effect (D. C., Alvin Powell, Harvard Staff Writer) . Stated in the article there has been a clinical study providing solid evidence that the suspicion about black Americans face life-threatening inequalities in healthcare, which was published by the Journal of American Medical Association. Blacks were less likely than whites to receive medical
Since Congress enacted the ACA in 2010, the United States government has repeatedly pointed to the law as evidence of its commitment to address racial disparities in access to health care, abide by its international human rights obligations, and advance the nation’s global credibility on nondiscrimination in health care. On the other hand, and by repealing ACA, the Congress is now in contradiction with its claims where it stated that ACA helped close the huge gap between racial minorities in accessing health insurance. In its 2010 report to the U.N. Human Rights Council on the state of human rights in the United States, the U.S. government asserted that the ACA “will help our nation reduce disparities and discrimination in access to care that
We all have one life to live, and the health care system does not need to have a place for hate, anger, stereotypes, discrimination, or racism. It is uncomfortable to the patients and to those who wants to deliver the best care possible, it is uncomfortable to hear people talking about how they are treated by different person and how they treat them back. We should all avoid discrimination, in order to eradicate those historic prejudices. This is the time to address all those differences and stop it from affecting the health of those patients and the minds of everyone involved because every healthcare giver sacrificed and studied really hard to protect and serve those in need and there is no space for differences, we need to create a safe environment because racism, hurts all of
The individual, group, and societal outcomes of discrimination in health care can be detrimental. Individuals may not receive the proper health care that they deserve due to being a victim of discrimination, and this may then lead to poor health outcomes. In addition, this same concept also goes for group and societal outcomes. In general, any sort of discrimination that leads to poor health care can be detrimental for an individual, group, and a society. Perceived discrimination is associated with both negative health outcomes and negative perceptions of quality of care (Andreae et al., 2015).