Health disparities have historically impacted multiple populations throughout the U.S. When it comes to health and access to healthcare, consider the plight of Native Americans, undocumented immigrants, people experiencing homelessness and the chronically mentally ill, and rural communities in places like Appalachia, and we see a picture of what’s broken. The undeniable disservice that continues to millions of the most vulnerable is inexcusable, yet this legacy is slow to overcome.
In terms of Black communities and people of color, the disservice is centuries-old. To this day, the legacies of structural racism live on in health disparities that would have no place in 21st-century America if we had already learned our lessons and lived up to the potential outlined in our country’s founding documents.
Nonetheless, disproportionately negative statistics don’t lie. We know beyond the shadow of a doubt that Black Americans have received short shrift in the realms of health and healthcare since the first days of the American colonies, and the work to undo these wrongs is daunting and ongoing.
Distrust, Disparities, and Deceit
The Kaiser Family Foundation website states, “While Black people have made great contributions and achievements in the United States, they continue to face many health and health care disparities that adversely impact their overall health and well-being. These disparities have been exacerbated by the uneven impacts of the COVID pandemic, ongoing racism and discrimination, and police violence against and killings of Black people. Moreover, the long history of inequitable health outcomes among Black people reflects the abuses faced during slavery, segregation, mass incarceration, and their persistent legacies.’
Kaiser’s statistics point out that Black people face more significant financial obstacles to receiving appropriate healthcare and have a higher uninsured rate than white people. And with higher rates of poverty and food insecurity, it’s clear that many factors contribute to this calculus.
“The growing gap of health disparities within the American healthcare system is resulting in the unnecessary deaths of people of color and the continued mistrust of the healthcare system,” states Jasmyn Moore, MBA, BSN, RN, co-host of the Distrust and Disparities podcast.
“If you take a deep look into most health disparities that plague communities of color,” Ms. Moore continues, “you will see that the root cause is systemic racism. The medical field was built off experimenting on Black bodies.” In this statement, Ms. Moore is referring to a legacy exemplified by the Tuskegee experiments, where Black men were misled by researchers to believe that their syphilis was being treated, but in actuality, the course of the disease could be observed by scientists from the U.S. Public Health Service.
“We have all heard the negative statistics surrounding the health of Black, Indigenous, and people of color,” Moore states. “Black mothers are three times more likely to die during childbirth. Black infant mortality is twice as high compared to white babies. African Americans are more than twice as likely to die from cancer.”
Disturbing statistics are nothing new in the world of racial minorities in the United States. Moore comments that “the life expectancy gap between marginalized ethnic groups continues to widen despite health advancements. We are constantly bombarded with those negative and disheartening statistics. The blame is often placed on individuals and families versus a health care system that was not designed to promote and protect our health and livelihood.”
Moore concludes with the following food for thought: “Behind each of those statistics, racism plays a big factor that is often ignored. A report released by the National Academy of Medicine in 2003 pointed out how, in America, race is a determinant of health quality. Their study detailed how Black people and other ethnic minorities receive lower quality of health care than white people even when age, income, insurance status, and severity of conditions are comparable.”
Heightening the Focus
“The COVID-19 pandemic and nationwide racial justice movement over the past several years have heightened the focus on health disparities and their underlying causes and contributed to the increased prioritization of health equity,” states the Kaiser Family Foundation. “These disparities are not new and reflect longstanding structural and systemic inequities rooted in racism and discrimination.”
Aggressively addressing disparities at their root — including police violence against Black citizens, maternal-infant mortality, discriminatory housing policies, income inequality, the impact of climate change on vulnerable populations, and access to care — can lead to us cooperatively working together to find multifaceted and forward-looking solutions.
As the Kaiser Foundation pointed out, these disparities are nothing new; thus, dismantling the structural and societal issues that cause them is an uphill battle. That said, many individuals and organizations have set their sights on these issues, and the 21st-century racial justice movement is an intrinsic part of that process.
Those of us in the healthcare industry must maintain awareness, examine our own biases, and demand that our workplaces do their part in decreasing disparities impacting the populations of color that we serve. We carry that responsibility; stepping up and speaking out is our individual and collective moral obligation.