There is a dark history of racism in medicine that still persists today. While many people may be aware of the microagressions that BIPOC face on daily basis, there are more deadly forms of “subtle” racial bias that continue to put them at risk – health care.
According to the Human Genome Project, humans are 99.9% the same regardless of race, ethnicity, or nationality. Still, racism persists and continues to harm BIPOC through implicit racial biases in medicine.
Medical Racism is prejudice and discrimination in medicine and the healthcare system based on race.
Racism & Health
Racism itself has negative impacts on the health of Black people. Racial discrimination increases the risk of elevated blood pressure, causing more Black people to suffer from hypertension. Experiencing discrimination causes chronic stress that increases the likelihood of developing heart disease. Black women facing discrimination tend to have babies with lower birth weights.
Black men have continued to have a lower life expectancy than White men, White women, and Black women since 1900.
Healthcare professionals with racial biases can impact pain assessment, diagnosis, and treatment.
White healthcare professionals falsely believe that there are biological differences based on race, which causes racial bias when assessing pain and determining treatment plans. Black people are given significantly lower pain ratings than White people because there is an assumption that Black people feel less pain than White people do. Doctors are less likely to prescribe pain killers or accurate treatment recommendations to Black people when they are unable to correctly assess their pain.
According to a 2018 study, “Black patients are significantly more likely to receive an amputation than a salvage procedure.”
Black mothers are 3 times more likely to die from pregnancy and childbirth as white mothers. African-American babies are almost 3 times more likely to die within their first year as white babies.
African Americans and other BIPOC are less likely to receive procedures like kidney transplants and dialysis.
Even Black doctors are not immune to racism within medicine – whether it is peers or patients, Black doctors often have to prove themselves to others and remain calm while being berated by racist attacks.
Black people have reason to distrust healthcare professionals – historically, the power dynamic between doctor and patient has continued to keep Black people at a disadvantage. Black people have been used in studies without even knowing they were involved or against their will many times in history (from slavery to syphilis).
Jim Crow Laws led to segregated hospitals, often leaving those serving Black people understaffed and leading to many preventable deaths. Not only were Black people not given the same level of care as white people, they were used in experiments done without anesthesia and without their consent. This did not stop with experiments on enslaved people.
Black people and low-income people have been targeted by federally-funded programs for forcible sterilization and birth control, often without their consent or receiving full information about the procedures.
In 1951, Henrietta Lacks was experimented on by her white doctor who sampled and stole her cells without her consent. These cells are now know as HeLa cells and there are over 17,000 U.S. patents related to them. However, Henrietta and her family never benefited from this exploitation while white doctors made fortunes off of their research developing drugs for diseases like polio, Parkinson’s disease, and leukemia.
From 1932 to 1972, the US Public Health Service worked with the Tuskegee Institute studying the natural progression of syphilis in African Americans. The patients were 600 Black men who did not give their informed consent and were told they were being treated for “bad blood,” but were in fact not being treated at all. Although syphilis had a readily available and effective treatment, the Black men in the study were not being cured of their illness and instead many passed syphilis on to their families, suffered, and died.
The Black men in the study were not informed of the purpose of the study and may not have even known they were part of a study at all. Patients were also never given the option to leave the study, even when it became apparent that penicillin was a highly effective treatment being widely used.
Following the end of the study, a class-action lawsuit was filed by the study participants and their families. The U.S. government was required to give lifetime health/medical benefits and burial services to all living participants, wives, widows, and offspring as part of the $10 million out-of-court-settlement.
As a result of the studies, older Black men distrusted medical professionals.
The need for drastic change to address racism in medicine and healthcare is clear when looking at COVID-19 cases. According to the CDC, the highest hospitalization rates from COVID are among American Indian, Alaska Native, and Black people (5 times that of white people). For Hispanic or Latino people, the rate is 4 times that of white people. In Boston, Mayor Marty Walsh declared racism a public health crisis as Black people continued showing the highest rate of COVID.
The inequalities that Black people face compound and create a more dangerous situation. The higher risk is due to historical racial discrimination causing more racial and ethnic minorities to live in densely populated cities, live further from grocery stores and hospitals, rely on public transportation, and over-representation in the prison system. They are also more likely to be essential workers and not have sick leave. Black people have higher rates of heart disease, cancer, obesity, diabetes, and high blood pressure – all of which increase risks with COVID-19.
We need to be engaging in dialogue and open discussion with the people most affected. Without including them in the conversation, we cannot develop ways to address the problem. You cannot solve something you don’t understand.
We need policy reforms. We need to train community health workers. We need to provide information to healthcare professionals about the cultural difference among patients and how patients interact with the healthcare system. We need to provide resources and access to health care. We need to enforce safe work environments for workers during a global pandemic.