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Two Americas: A look at systemic racism in the healthcare system

Two Americas: A look at systemic racism in the healthcare system
Posted at 11:08 AM, Dec 01, 2020
and last updated 2020-12-01 13:08:54-05

We don’t often think of racism impacting people’s health. But Dr. Amber Johnson has made a career of studying how the two issues are intertwined.

“We’re in Los Angeles at this moment. Black women are the most rent-burdened in this area, so you think about having the stresses of being in a low-class environment and having to deal with racism and cope with racism," said Dr. Johnson, a professor at California State Long Beach who focuses on racism in health care. "And a lot of times, there’s feelings of isolation and loneliness all those things contribute to early physiological wear and tear on our body. Our bodies are literally wearing down."

Dr. Johnson says racism is ingrained in our health system. One reason she says implicit bias, which are attitudes or stereotypes that affect our understanding and our decisions, even if we don’t realize it.

“These implicit biases are passed down through practice, beliefs, experimentation, all these other things that really contribute to these implicit biases that we see, that are, that become very apparent when black people present in health care fields,” she explained.

But systemic racism may start before you get to the doctor's office. Some experts say it begins with access.

“People of color face long-standing and persistent disparities in health and healthcare, and these span across a wide array of measures,” said Samantha Artiga, the Director of the Disparities Policy Project at the Kaiser Family Foundation.

Artiga's job is to look at how people of different races, genders, and classes are treated differently within the health care system. She says disparities in health care and health outcomes start with access to care and works their way up through every imaginable facet of life.

“People of color are more likely to be uninsured than white individuals. That translates into increased barriers to access and care because they’re more concerned about costs, may have less access to a provider, not have a huge source of care outside of the emergency room,” she explained.

Those healthcare woes can then be tied directly to jobs because 159 million Americans of all races get health insurance through their employers.

But experts say the root of the race and health care problem lies in the kinds of jobs filled mostly by Black and Brown Americans. This is because they are more likely to be working in industries that may not offer coverage to their employees, or when it is offered it may not be affordable to individuals

Research from the National Institute of Health and the Center for American Progress shows African Americans in the US are less likely to have health care coverage than white people. That may be why Black women are more likely to be overweight. Black children are more likely to have asthma. Black adults are more likely to have hypertension. Cancer kills Black people at a higher rate than any other group. Black people are more likely to be diabetic than white people. Black babies die at more than double the rates of all other races in the US, and Black women die more than three times as often during childbirth as white women.

Those are just some of the disparities that exist.

Over and over again while researching this story, we heard about another major healthcare issue for many people of color: a shortage of doctors, nurses, and other health care workers that look like them, sound like them and have similar life experiences.

“Black physicians make up 4-5 percent of all doctors practicing nationwide, whereas, Blacks make up 13 percent of the US population,” said Dr. Leon McDougle, the president of the National Medical Association, a national group that represents Black physicians in the US.

He says when he was in medical school, he didn’t have a lot of Black classmates.

“I went to medical school here at the Ohio State in the mid-’80s and there weren’t many faculty doctors that looked like me, and when you saw a Black doctor, it almost became a mental image. So, that was inspiration for me to say this has to change,” said Dr. McDougle.

He says in 2020 when he sees patients of color, it has an impact on them and they have an impact on him and his students.

“More than half the time when I see patients, I have a medical student, and not too uncommonly, that student will be African-American or LatinX. And to just hear the patients give them, cause most of my patients are African American, and to hear them help uplift them in their pursuit of becoming a physician, I hear that all the time,” he said.

So, there is hope that there will be more healthcare workers of color, but there is still a long way to go. According to the Association of American Medical Colleges, over the last five years, the number of Black medical students has gone up about one percent, from 6 percent to 7 percent.

Many say that's not enough.

And the people working for change say the opportunity to make it happen is now.

“It’s hard work to move systems and move structures and I just hope we don’t miss the opportunity that is presented at this current time, in terms of the attention, focus, and movement to do something about it,”

“It’s not just for me to say I did this, but it’s for me, it’s for my mom, for my grandmother, it’s for my daughter. That’s four generations of black women that I’ve seen negatively affected by racism,” said Artiga.

“It’s killing Black people. It’s killing, it’s killing us,” said Dr. Johnson.