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Racial Disparities in Healthcare Through the Lens of Systemic Racism
Racism and inequality in healthcare is a serious and complex issue of todays society that must be widely addressed in order for it to be acknowledged and finally changed. The American healthcare system has been experiencing racial disparities for decades, depriving people of color of decent medical help and healthcare services. It all comes out of the fact that black people, in general, are very likely to be discriminated against and segregated at each level of American society. This paper aims to analyze the current issue of racial disparities for African Americans in the healthcare system, compare and contrast the different groups involved, and express my personal position regarding the topic. Moreover, the possible scenarios for addressing the issue will be discussed to reach a mutually beneficial outcome.
Identifying the Diversity Situation
The problem of systemic racism has been given close attention since the beginning of massive protest in the streets of America that followed the cruel murder of George Perry Floyd, Jr. by white police officers on May 25. The Black Lives Matter movement has given rise to fighting for the rights and freedoms of the African American population in the United States. People of America acknowledge the racial disparities that blacks have to face every day in the country that claims to grant equal rights for each of its proud citizens. These disparities have been evident through the systematic discrimination of African Americans on each level of the social structure, including education, employment, law practices, as well as healthcare (Ray, V., 2017). In the year 2020, the racial disparities in healthcare became especially critical when America faced the COVID-19 pandemic and its consequences for the vulnerable part of the population. Unfortunately, racial discrimination is not only individual and reflects the personal attitudes of certain people, but it is also structural, affecting people of color from the perspective of the whole governmental establishment.
Historical Perspective
Racial prejudices towards different nations in America have a diverse history that is most painfully reflected in slavery and discrimination of African Americans. They were believed to have different, inferior bodies and body functions. This served as a justification for the discrimination and exploitation of black people. The idea of black people having certain shapes of sculps that showed their inferiority traits of character was also very popular among white people in the nineteenth century. It was convenient to use such a belief to trade black people and treat them as subordinates. Closer to the twentieth century, racism became more systematic, which is evident from using African Americans in medical experiments without their consent. Such a case as the Tuskegee study is a clear representation of unjust and cruel racial inequality in healthcare. The researchers from the government recruited more than five hundred poor African Americans from Alabama for studying syphilis. Most of these people never got any treatment and were left to die and nobody told them or their families the truth about the nature of such a cruel and inhumane experiment.
After the start of the civil rights movement, however, not much had changed for the African American population, as the segregation laws still separated them from the white people. Even though the Secretary of Health and Human Services finally issued the Heckler Report, which shed some light on the racial minority disparities, other socioeconomic factors exacerbated the discrimination of African Americans (Noonan et al., 2016). They suffered from high unemployment rates, poor living conditions, and increased risks of healthcare problems compared to the white population. When the epidemic of the Human Immunodeficiency Virus spread among Americans in the second half of the twentieth century, African Americans were at the most risk, with the majority of the infected people being gay Blacks. Moreover, African American women constituted more than 60 percent of the infected population (Brown, 2015).
Current Situation
The current COVID-19 pandemic has proved an immense lack of diversity in America, which originates from the issue of systemic racism. After the violent spread of the coronavirus epidemic, African Americans became the most affected social group, suffering the majority of the complications. As a consequence of systemic racism, Blacks are merely secured by the government in their workplace and social position. Thus, many had to ignore the lockdown, as they could not afford to work from home (Shah, 2020). They had to go out to work in such industries that imply physical presence and close interactions with people, such as, for example, the service or production sectors. Moreover, the coronavirus outbreak proves to be much more severe in the neighborhoods where the African American is predominant due to the lack of well-equipped hospitals. These hospitals, in turn, are full of sick patients and severely lack professional medical staff.
Significance of the Issue
The topic of systematic racism affecting African Americans in the way they are deprived of decent healthcare services, as well as their lack of fundamental citizen rights only maintains the broken state of American society. The country that is so powerful and prosperous cannot afford any of its social groups to struggle with poor living conditions and high death rates due to low standards of medical services. The young African American population will continue to lack good living conditions, decent education, and medical support, creating even more social and economic fragmentation of the United States. As a proud American citizen, it is emotionally challenging for me to observe the poor state of a significant part of our population. I believe in the unity of our nation and social justice for every person living in this great country. That is why I am convinced that the situation must be changed to resolve the issue of systemic injustice. This change will take place only through open conversations and raising as much public awareness as possible to make people see and acknowledge the importance of social and political transformation.
Comparative Analysis of the Cultural Groups
The discussed issue touches upon the different attitudes towards the white and black Americans, as well as diverse privileges and degrees of power possessed by the two groups. This constitutes the issue of racial discrimination in American society as a whole and its role in healthcare in particular. People of color are exposed to much stigmatization and struggle from its significant consequences for their health and general wellbeing. As mentioned above, the high death rates among African Americans, including the enormous number of cases of COVID-19 mortality, result from them having less access to decent healthcare and affordable medical services. Stereotypes and biases that are rooted in todays social perspective and fuel the power of the privileged part of the American population play an immense role in this unjust issue.
Stereotypes and Biases
Stereotypes are identified by Hurwitz et al. as cognitive structures that contain the perceivers knowledge, beliefs, and expectations about human groups (1997). Indeed, the African American population is often perceived by the whites through the lens of their old and unjustified beliefs that bring distortion to their viewpoint and contribute to discrimination. The one stereotype that constitutes the majority of discrimination cases represents the image of a brutal and violent black male and a lazy, arrogant black female. These images are, most of the time, reinforced with respect to crime and welfare. Thus, black people are considered by many as criminals with alcohol and drug addiction. This is an unfair assumption, even though many African Americans do live in neighborhoods with high criminal activities and low living standards. However, this comes from the very fact that they are often deprived of decent healthcare, education, and job opportunities that result in people living worse than they wished to.
Another common bias against the African American population is that they are unwilling to get medical insurance and do not acknowledge financial and social wellbeing. Such a stereotype results in clinicians often disregarding patients of color. For example, white nurses regard white patients as being more mindful about their health and wellness, thus paying less attention and providing lower-quality care to black patients (Hall et al., 2015). However, the situation when black people do not get medical insurance derives from the fact that many of them simply cannot afford it as they have to first ensure paying for food and rent. Fortunately, when the Affordable Care Act was issued, the rate of the uninsured lowered to 9.5% (Noonan, 2016). Such results prove that African Americans are willing to pay for insurance as long as it is affordable and does not interfere with the expenses on their basic needs.
Privileges and Powers
Generally speaking, white people have more privileges and possess greater power in American society. White people have more power in political and legislative decisions, thus policy formation is mostly controlled by white males whose decisions are often unfavorable to the African American population. This way, blacks tend to be excluded from the existing social institutions (Jewell, 1993). This is again a clear representation of the systemic racism issue in the United States, which results in African Americans having less power in politics, healthcare, education, and other major branches of the countrys operational institutions. This creates outrageous police brutality reflecting in more cases of blacks being charged with crimes, detained, and receiving long sentences than similar cases with white people. African Americans, especially males, are more often arrested for minor offenses without official statements or any sufficient evidence. Such a lack of power over white police officers creates an even more substantial barrier between black people and racial equality in America.
Moreover, the white population has more privileges concerning high average incomes and a better living environment in safe neighborhoods with good, well-equipped hospitals. Especially it concerns the healthcare system, which gives black people less attention and recognition, leaving them with high chances of developing diabetes, asthma, cardiovascular disease, as well as high blood pressure and its adverse consequences. If left untreated or without any medical assistance, such health conditions lead to higher death rates among the African population, depriving them of the basic human right to be healthy and lead a happy, sufficient lifestyle. However, recently, African Americans are gaining more power in the face of the Black Lives Matter Movement, as people of different nations advocate for equal rights and recognition of black people on each level of American society.
Personal Position
As I reflect on the issue discussed in this paper, I find that my own attitude to it is rather biased. Because I understand the scope of the racial disparities in the American healthcare system regarding black people, I tend to be sympathetic towards this part of the countrys population. If white and black Americans are pleading for financial assistance for medical reasons, I am most likely to grant it to the African American patient, as they might not have any other chance to receive medical care. Hospital bills are often too high for an average American to pay for them without health insurance or a particular governmental program aimed at such cases. As mentioned above in the paper, many African Americans simply cannot afford medical insurance. Moreover, some medical personnel can be full of prejudices towards black and lower their chances to can decent care by not paying their full attention to African American patients. Therefore, my personal choice would be to assist them as much as possible to ease the burden of racial disparities that they have to deal with on a daily basis.
Additionally, I always believed that black people acquired stronger immunity since many have to work hard on several jobs in difficult conditions, live in neighborhoods with lower quality of life, and eat more processed, unhealthy foods than whites. Speaking of healthcare disparities, it is important to touch upon the mental health issues that African Americans have to deal with in such circumstances. In my opinion, black people are prone to develop anxiety and depressive state because of both the poor living and working conditions and the pressure they are going through being continuously stigmatized and deprived of their fundamental rights. Thus, I think that the African American population has more severe mental health issues than the white population, as fewer blacks can afford to go to therapy sessions and deal with their emotional difficulties. I also always believed black people to be more communal and devoted to family than whites. They have traditions to have meals together which=h always enhances the family spirit and makes people more unite and loving towards each other.
One more belief that I had regarding African Americans is that they often postpone going to the hospital unless they develop a condition that makes them finally seek professional medical help. It happens because, again, they might simply have no resources to pay for the doctors appointment. However, I used to have a stereotype implying that black people do not care about their health and are most likely to ruin it even more by drinking or any other bad habit. Fortunately, as I grew older, I realized that it is a deceiving point of view that is far from the truth for many African Americans, but this is the result of blacks being stigmatized continuously by society. That is why I am convinced that this issue must be efficiently addressed to finally stop this chain of unfair stereotypes that divide America even more and cause black people to struggle through life trying to live happy, healthy lives.
Arguments for Each Group
When examining the issue of racial disparities in healthcare, the main supportive argument lies in statistics that demonstrate the disproportional rates of hospitalization and mortality among African Americans. As mentioned above, black people are more likely than whites to struggle with severe forms of various diseases, including high blood pressure, cardiovascular disease, HIV, AIDS, and tuberculosis. This is due to the fact that they often do not have the financial resources to seek professional help and pay for high-rate medical bills. Moreover, many poor African Americans simply avoid going to the doctors because they are not used to receiving medical treatment and do not see any point in doing that. The healthcare crisis among African Americans has also been exacerbated after the coronavirus pandemic spread throughout the country. It led to many blacks being exposed to the virus but remaining untreated due to the peculiarities of their outdoor professions and the immense lack of well-equipped hospitals. Thus, the statistics show disappointing results of African Americans being understated and deprived of decent healthcare, which leads to illnesses and deaths of innocent citizens.
The main argument supporting white Americans would be that, in general, they work harder to achieve and maintain a higher quality of life. They invest in higher education and their careers, purchasing good insurance coverage, and planning their retirement accordingly. From the point of view of American law, segregation had been eliminated, thus black people have the same right to receive medical care and enough attention from healthcare practitioners as white people do. Therefore, the very concept of the privilege of whites is considered a manifestation of racism. It follows that by law, people of color have the ability to have the same amount of wealth, high-quality education, and good living conditions. Most whites do not look down on black people, they are conscious of race equality and understand that the terrible history of discrimination and hatred must be left in the past. The problem here is not that white people are all racist but rather that some of them still have racial prejudices due to being the opposite of open-minded individuals.
Addressing the Issue
The first and main way to reduce and then completely eliminate racial disparities in healthcare is for the practitioners and society, in general, to acknowledge that the issue is real and the situation needs to be changed. Ignoring the problem or even denying its existence is going to make it even worse. Then, such social factors as housing, working, and living conditions must be actively addressed. Low wages, poorly constructed houses, living in dangerous neighborhoods it all leads to poor health of African Americans, their overall low wellbeing. Moreover, the issue of systemic racism in America must be widely acknowledged by the public. While it is true that not all people are racist, and it is a problem of certain individuals, racism is also about social structure in general. As mentioned before, the different levels of the countrys organization are discriminating in its nature, depriving people of color of the rights that they do have as citizens of the United States. It is necessary to embrace the fact that this is happening in todays America and work in the direction of changing this disappointing tendency.
Therefore, once the issue and the consequences it brings are acknowledged, the actions towards changing them can be the following. The first suggestion is to provide equitable distribution of resources to the areas and neighborhoods that are overpopulated and lack fundamental organizations such as well-equipped hospitals and medical facilities with accessible healthcare services. This can be achieved through governmental programs, both federal and statewide, which grant funds for building such facilities and providing them with professional employees. Moreover, the already existing facilities must be regularly funded to ensure their best operation in favor of the people living in these areas. This will lead to African Americans having better healthcare services that will satisfy their fundamental needs. The insurance policies must also be changed to make them more affordable for people with lower incomes. Moreover, the issue of healthcare disparities resulting from systemic racism can be altered by introducing cultural relativism. It implies accepting individual and cultural differences of people by society, thus dropping judgments and being empathetic to various ethnic groups. Through this concept, equality and acceptance can reform social norms and eradicate racial disparities whatsoever.
Conclusion
Slavery, discrimination, and ethnic intolerance have shaped todays state of America. In a country that is so proud of its cultural diversity and democratic values, racism and violation of the fundamental human rights of African Americans are still present and continue to affect millions of lives. The notion of systemic racism has penetrated each level of social organization in the United States, which is evident from the disparities in the American healthcare system. Black people do not receive enough medical attention and assistance they need due to racial prejudices and old stereotypes. To change the current situation for the better and eliminate systemic racism, at least in healthcare, it is necessary to raise public awareness, acknowledge the issues, and work to raising funds, changing governmental and state policies, alongside embracing cultural relativism.
References
Brown, K. M. (2015). The voices of African descent bisexual women: Experiences related to identity and disclosure in social support networks and health care settings in the United States and united kingdom (Order No. 3724189). Web.
Hall, W. J., Chapman, M. V., Lee, K. M., Merino, Y. M., Thomas, T. W., Payne, B. K., & Coyne-Beasley, T. (2015). Implicit racial/ethnic bias among health care professionals and its influence on health care outcomes: a systematic review. American journal of public health, 105(12), e60-e76.
Hurwitz, J., Peffley, M., & Sniderman, P. (1997). Racial stereotypes and whites political views of blacks in the context of welfare and crime. American Journal of Political Science. 41, 30-60.
Jewell, S.K. (1993). From mammy to miss America and beyond: Cultural images and the shaping of US policy. New York: Routledge.
Noonan, A. S., Velasco-Mondragon, H. E., & Wagner, F. A. (2016). Improving the health of African Americans in the USA: an overdue opportunity for social justice. Public health reviews, 37(1), 1-20.
Ray, V. (2017). Racial theories in the social sciences: A systemic racism critique. Contemporary Sociology: A Journal of Reviews.
Shah, M., Sachdeva, M., & Dodiuk-Gad, R. P. (2020). COVID-19 and racial disparities. Journal of the American Academy of Dermatology, 83(1), e35.
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