When we seek medical care, we all hope that we’ll be provided the best care possible, regardless of our individual circumstances. We expect that the treatment we receive will be equal to that of anyone else’s, and we trust that the people on our care team will also be on our team — regardless of any personal thoughts or feelings.
Yet, history has shown that not everyone is afforded this type of treatment when it comes to healthcare. In fact, one survey found that over 10 percent of Black adults, and an even higher percentage of Black women and Black adults living in low income households, reported being unfairly discriminated against or judged by a healthcare professional.
For millions of Black people and other People of Color in the United States, racial bias is a very real experience. It has led to serious healthcare disparities that affect everything from rates of diagnosis to treatment opportunities, and beyond.
Racial bias happens when attitudes and judgments toward people because of their race affect personal thoughts, decisions, and behaviors.
Whether implicit or otherwise, racial bias is evident in almost every area of healthcare, says Andrea Heyward, Director of the Community Health Worker Institute at the Center for Community Health Alignment. “Biases show up in many ways, including cultural and language barriers, and limited or no access to health insurance coverage, healthcare treatment, or social services due to immigration status,” Heyward tells Healthline.
The lack of multilingual staff at a medical facility is one example of racial bias in healthcare.
It shows itself as having different levels of evidence. The disproportionate mortality rate experienced by Black women in childbirth is one of the reasons for the bias in pain assessment and treatment.
Black people and people of color are more likely to be treated with bias in healthcare than any other group.
“Implicit bias is a form of racial bias in healthcare. When healthcare professionals make decisions about a person’s medical care, they are fueled by their own unconscious stereotypes and prejudices.”
There is a bias that can have a huge impact on the healthcare experience for people of color.
Recent preprint research, meaning it has not been formally peer reviewed, describes multiple ways in which racial bias can show up in modern AI healthcare systems.
Many of the data used to aid in diagnoses may be less applicable to minority communities if the overrepresentation of non-minorities is not limited.
biased statistics can affect accurate information for people of color, which is why many risk calculators have been created.
It is almost impossible for people of color to receive equal healthcare outcomes because of implicit and algorithm bias.
Racial bias in healthcare disproportionately affects Black communities. In fact, you only have to look as far as the recent pandemic to see the type of impact that racial bias has on Black people with COVID-19.
In one recent analysis of COVID-19 statistics in the United States, researchers discovered that severe racial and ethnic disparities have led to higher COVID-19 mortality rates in Black Americans. In fact, the disparity is so significant that Black people are over 3.5 times more likely to die from COVID-19 than white people.
And these disparities in COVID-19 hospitalization, death rates, and even vaccination rates, are only a small piece of the larger picture. We also know that:
- Black women are
more likelyto die from pregnancy-related complications, according to the Centers for Disease Control and Prevention.
- Black people are more likely to experience diabetes-related complications reports the American Diabetes Association.
- Black people — especially Black men — are
more likelyto be diagnosed with hypertension, according to the American Heart Association (AHA).
- Black people are more likely to be misdiagnosed or overly diagnosed with mental health conditions reports Mental Health America.
Black communities have been disproportionately affected by healthcare disparity due to racial bias. Other people of color experience biases that restrict access to quality care and services to address social determinants of health.
When it comes to COVID-19,
It is important to understand how issues such as health outcomes, lower quality of life, and decreased life expectancies impact the communities of black and brown people.
Where to report healthcare discrimination
If you feel that you’ve been unfairly discriminated against because of your race or ethnicity by a doctor or other healthcare professional, you can file a Civil Rights Complaint with the HHS Office for Civil Rights.
It can also be helpful to file an additional report with your state’s licensing board, but keep in mind that this board may differ depending on the type of medical professional you’re filing a complaint against.
Many of the issues are related to structural, institutional, and systemic racism. She stresses that it is important to understand the root causes of racial bias and the extent to which they span beyond the healthcare experience.
When we recognize just how pervasive racial bias is — not just in healthcare but also in education, employment, and other areas — we can see that the path to change isn’t as simple as just training our medical professionals. Instead, Heyward emphasizes that our approach to change should be multifaceted.
She says that we must take a hard look at the healthcare system as a whole and consider sustainable changes such as long-term investment in nonclinical roles, diversity within integrated care teams, and the integration of community health workers into both clinical and community settings.
Reducing racial bias looks like a long term thing. Here are a few areas that could potentially make a difference.
Ensuring healthcare professionals are not only educated but diverse
Training and supporting culturally competent healthcare professionals is one way to reduce racial bias in healthcare. The quality of care as patients and access to healthcare and social services are impacted by the lack of cultural competency and true understanding of Black, Indigenous, and People of Color.
But it’s not enough to just educate a population of healthcare professionals when they also lack diversity — having medical professionals from diverse racial and ethnic backgrounds is important, too.
Ensuring that there is also representation and diversity within care teams is a step further than cultural competency, racial, and implicit bias training.
Where to find culturally competent healthcare professionals
In modern medicine, it’s essential that Black, Indigenous, and other People of Color have access to culturally competent medical professionals. If you’re searching for culturally competent healthcare professionals in your area, these resources are a great place to start:
- HUED: find a culturally competent professional
- Health in her HUE: find a culturally competent professional
- Black Emotional and Mental Health Collective: find a Black wellness practitioner
- Clinicians of Color: find a therapist of color
- Asian Mental Health Collective: find an Asian therapist
- Latinx Therapy: find a Latinx therapist
Integrating community health workers into more areas of healthcare
“It’s known that bias shows up before a patient even gets to a hospital.”
“She says that one of the biggest barriers is not being able to access healthcare or social services. It affects people who don’t speak English at all, and people who have a first language other than English.”
So how can we address the racial bias that shows up from the moment someone seeks care? Well, this can be done through initiatives like the PASOs program at the Center for Community Health Alignment, which uses a community health worker model to help Latino and immigrant populations access healthcare and social services.
These kinds of initiatives are essential, says Heyward. She says that having a trusted member of the community supporting patients helps people of color and immigrant populations to not only access and navigate healthcare services but also allows for advocacy on behalf of patients who are not always seen, valued, or heard.
Creating more accessible healthcare services and funding
It is not enough to just help people access services, it is necessary to create sustainable change. We need to expand the services that we have.
More people in these communities can have access to healthcare if access to Medicare and other social healthcare programs is expanded.