The inequity between health outcomes among different racial groups in health care settings is a disgusting dark side to what is typically portrayed as an upstanding pillar of society. The bias and prejudice which exists in the health care field is not only palpable, but measurable. The public is predominantly ignorant of the statistics and data which highlight the vast disparities in quality of care and overall outcome of health facility visits among these diverse groups. Others dismiss the claim that there exists institutionalized racism in our health care system, and disregard the studies as misguided or unfounded. To truly establish equal health outcomes following care and create an environment in our hospitals which allows the patient, regardless of color, to receive the highest standard of care which can be provided, we must accept this information for what it is, the truth, even though it may be uncomfortable. Embracing that discomfort will allow providers to realize their own biases and not allow any perpetuation of this issue affecting millions.
On the intrapersonal level, physicians’ personal biases, whether conscious or not, affects treatment speed and efficiency of patients with different racial backgrounds. According to studies referenced in the article Can Health Care Be Cured of Racial Bias? by April Dembosky, African-Americans who present with the same symptoms and chief complaints as whites receive on average less prescription pain medication. Dembosky also states, “Black patients with chest pain are referred for advanced cardiac care less often than white patients with identical symptoms.” This chasm between whites and blacks receiving proper care adumbrates the prejudice and racism which exists in ambivalence, griping minorities with anxiety who seek treatment, while not affecting whites entirely, and completely results from health care providers acting upon their implicit biases.
Interpersonally, a lack of community understanding or acknowledgement of controversial fact perpetuates the inequality of health care outcomes. Studies, such as one published in the National Institute of Health’s National Library of Medicine stating that blacks were less likely than whites to receive opioid analgesics for the same health conditions, rarely make headlines. It is an unpopular topic of discussion to propose that those in charge of saving lives may also be treating patients differentially due to race and biases, a topic which is uncomfortable perhaps for the reason that it may install worry, and rightfully so, in such affected populations who will call upon these care providers for treatment in the future. Those who do find information on this subject may dismiss it because, similar to climate change, it is easier to dismiss an issue as being untrue than it is to try and generate a plausible solution. Whether it is due to ignorance of fact or blindness of truth, the lack of community involvement preserves the biases which leave some recipients of care behind. Were there more news coverage of such disparities, the public would pressure health institutions in which the gap is most extreme and catalyze positive change.
In the broader scope of public policy, there exists no legislation or regulation which standardizes the clinical pathways, the ideal sequence of treatment and timing of such care for a particular diagnosis, which must be followed for any patient, regardless of race. A mandatory level of standardization ensures equality for treatment of all groups, indifferent to the biases of any particular health care provider. Perhaps if such a standardization was incentivized, such as a penalty on insurance payments to the institution for differential health outcome due only to a difference in race without other complications, there could be a positive impact on reducing the difference in treatment of varying ethnicities with the same diagnosis.
According to the International Consortium for Health Outcomes Management, “We believe outcomes are the ultimate measure of success in health care.” If this is indeed the case, then our current health care system is blatantly failing the needs of underrepresented populations, and it is not only our responsibility, but our duty as the future of health care to establish an equity so desperately missing from our care of individuals, regardless of cultural background or ethnicity. To truly call oneself a health care provider, one must do so without difference of color or creed, for to do so is a disservice to not only the patient, but the entirety of the health care community.
What do you think is a good way to help break the cycle of prejudice and bias in our health care system? Is it feasible to dream of a health care system without prejudice?