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Racism: A National Public Health Crisis?

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The American healthcare system is notorious for the deeply unequal way it favors those with means over those without. This disparity doesn’t just affect issues of class though, it also manifests in how patients are treated according to their race.

The devastating impact of the pandemic has only highlighted that health equity is still not a reality, as the coronavirus continues to ravage communities of color. Due, in part, to a long history of medical abuse and discrimination, Black communities have developed a deep-rooted distrust of medical professionals. This is one of the reasons black communities tend to participate less in vaccine trials and have a lower vaccination rate.

Medical racism pervades our healthcare system to this day, with study after study showing that black patients suffer disproportionately from neglect and dismissal at the hands of their healthcare providers. When a virus induces unpredictable, rapid deterioration like COVID can, it is crucial to catch symptoms early and take swift, aggressive action. But doctors regularly downplay pain in black patients, which some believe is why the black community has sustained a higher COVID death toll throughout the pandemic.

So, how do we fix it? Today’s Daily Dose dives in. We hope you share your thoughts with us too.

Revealing Inequities

1 – Blinding Bias

Black Americans experience higher rates of poverty and malnutrition, as well as lower education levels and less access to healthy food, all of which are proven risk factors when it comes to general health and well-being. Yet they are met with a medical system that insists on a supposedly “colorblind” approach that doesn’t actually meet their needs. That leads to a host of health disparities: Black patients are 40 percent more likely to have high blood pressure, Black children are twice as likely to develop asthma, and Black women are more susceptible to heart disease, stroke and diabetes. “We should ‘see color,’ and we should prioritize care based on these risk factors,” Ashton says. “We should … be doing more, not the same, and certainly not less, for women of color.”

2 – A History of Mistrust

Throughout history, the black community has suffered discrimination and abuse at the hands of medical professionals. One prominent example is the Tuskegee experiment of 1932, an event that displayed medical betrayal and exploitation of black men at the highest levels. In the study, 600 Black men were told they were being treated for “bad blood” but were actually deprived of treatment for 40 years as scientists studied the progression of syphilis, an easily treatable disease. Another well-known case study is that of Henrietta Lacks, a Black woman who died of cervical cancer in 1951 and a recent honoree of the World Health Organization. Lacks had her cells harvested for research without her knowledge or consent. She received no compensation or restitution and died in impoverished obscurity, even though her cells were incredibly influential to multiple scientific breakthroughs (including the polio vaccine). And over one hundred years before that, James Marion Sims, a 19th-century physician and the “father” of modern gynecology, accomplished medical breakthroughs by practicing excruciating medical surgeries without using anesthesia on Black enslaved women.

3 – Hospitals For Us, By Us

Black people have thicker skin and suffer less pain, right? No! These are shockingly racist myths that remain entrenched in the medical community today, which means when Black people report pain, they are not taken seriously by white doctors, which can lead to prolonged suffering. Studies show that Black patients do better with Black doctors because they communicate better, leading to improved treatment and patients who are more likely to seek preventive care. “What would happen if we created 100 all-Black hospitals around the country that were meant to be top-tier, best of the best?” asks Carlos Watson, OZY’s co-founder and CEO. America’s Jim Crow era saw a surge of all-Black hospitals, but they were starved of resources like other segregated institutions and were hardly “top-tier.” Today, there is only one remaining traditional Black hospital: Howard University Hospital, in Washington, D.C.

4 – The Overwhelming COVID Crisis

COVID-19 attacks the heart and lungs — areas where Black people are disproportionately vulnerable. It’s a big reason why Black people are three times as likely to be hospitalized and twice as likely to die of the virus than whites, with even worse rates for Latinos and Native Americans. These groups are also less likely to be vaccinated. While some attribute vaccine hesitancy to mistrust of the medical system among minority communities, studies show there’s little racial difference in reluctance to receive the coronavirus vaccine. This means barriers like pharmacy deserts, poverty and unemployment are more likely culprits.

Gender Disparity

1 – Fearful Patients

For some Black women, doctors can be a cause for fear, resentment and distrust. In fact, many Black women have used strategies to negotiate their uncomfortable interactions with doctors. And wealth, class and social status don’t bridge that divide in trust or care: Even multi-millionaire tennis star Serena Williams faced potentially life-threatening complications when doctors refused to listen to her after she delivered her daughter in 2017.

2 – Birthing Inequities

Black mothers are 243 percent more likely to die from pregnancy- or childbirth-related causes than white women. Dangers for Black patients arise from conditions such as preeclampsia — a complication involving high blood pressure that can lead to organ damage — and increased rates of hypertension, as well as hemorrhaging and infection. Black infant mortality rates are twice that of white infants, and Black patients are more likely to live in areas at risk for preterm birth, which comes with its own risks. And, as Williams exemplified, the differences in outcomes are not simply tied to poverty: Black women with college degrees still have a higher risk of severe complications than white women who never graduated from high school. One potential solution: Black doulas. As Sasha Mitchell-Fuller, a co-executive producer of The Carlos Watson Show, recalls, her doula cared for her, represented her and spoke for her in the hospital. With a doula who looked like her, Fuller’s birth experience was better than she thought possible.

3 – Breast Cancer in Black & White

Much like with birth outcomes, when it comes to breast cancer, social and economic disadvantages may explain the differences in outcomes between white and Black patients. For years, underserved areas lacked proper screening technology. Research also shows that some physicians might not share treatment options with Black patients because they felt they’d be less likely to comply than white patients. As a result, Black women are 41 percent more likely than white women to die of breast cancer, and Black and Latina women are 30 to 60 percent more likely to be diagnosed only after their cancer has progressed beyond Stage 1. According to recent findings, racial disparities in breast cancer survival could be cut if Black women had more frequent mammograms beginning at the age of 40. Here are some resources for screening and prevention.

Be Kind To Your Mind

1 – Dismantling the Stigma

From Golden Globe-winning actress Taraji P. Henson, who founded a mental health advocacy group, to Olympian Simone Biles, who spoke candidly about her struggles with anxiety after her recent withdrawal from the Olympics, Black leaders are speaking up about mental health. Black patients’ rates of mental illness are similar to the general population, but disparities in care exist. According to one study, more than a third of African American patients experiencing depression or anxiety felt they would be considered “crazy” to their social groups. Some…

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